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Cranial nerves, sources, https://www.youtube.com/watch?v=xrKbOF3vHo8&…

- - - - primary function is delivering the smell sensation
        
        its damage symptom is anosmia
        
        examination is to present to the patient different smell, to each nose whole, while the other is close just as are the eyes of the patient
- - - - leaves via the jugular foramen with the vagus nerve, and comes form the medulla, form the nucleus ambigues
        
        function is innervation of the larynx, pharynx, and the palate
        
        loss of function is visible by impaired swallowing or/ and hoarseness
        
        hoarseness- abnormal vice change
    - - goes through the foramen magnum and the jugular foramen and is associated with the accessory nucleus in the upper part of the spinal cord
        
        function is innervation of the sternocleidomastoid and trapezius muscles
        
        damage symptoms are impairment in the movement of the head and neck as well as inability of shrugging the shoulders
        
        The examination of this muscle is to assess the trapezius by asking the patient to shrink with his arms holding it and seeing if he is able to hold is against resistance form us pushing them down. Next a similar test is performed for the sternocleidomastoid muscle. The patient should be able to hold his neck on one of the sides against resistance.
- - - - is responsible for the movements of the superior oblique muscle
        
        damage symptom is extortion
- - - - is responsible for control of the facial expression muscles and its secretomotor portion, for the lacrimal, palatine, sublingual, nasal and submandibular glands, another function is the perception of taste of the anterior two third of the tongue
        
        loss of function of this nerve show symptoms like facial weakness, palsy, in case of the secretomotor portion a dry mouth and no tearing occurs but also loss of taste to the anterior 2/3 of the tongue can occur
        
        The examination of the facial nerve follows the, first, visual assessment if there are any asymmetries visibel in the face muscle tension, in the eyelid.
        
        The last of the examinations that could be performed is the taste examination of the anterior two third of the tongue. This can be easily done by putting a particular taste on that part of the tongue and asking the patient whether he fell it and what does it taste like, e.g. salty, sweet etc.
        
        Second test is to ask the patient to perform some movement tasks. The patient should rise his eyebrows without any difficulties and symmetrical. Next the patient should close his eyes and we should not be able to open them with our hands. Then, we should assess the patient smile with showed teeth, it should be symmetrical too. The following task is to check if the patient is able to puff his checks and hold the air in them, while we will be pushing on them (but not too strong).
- - - - it has sensory function for the skin around the ear and the mucous membranes of pharynx, larynx, trachea, lungs, oesophagus, stomach, intestines and gallbladder
        
        symptoms of damage are impaired cough reflex
        
        The examination of the gag reflex is an option to examine the afferent portion of the glossopharyngeal and the efferent portion of the vagus nerves. It is performed by taping on the pharynx by an object, what should trigger the gag, but it is not obligatory if one never had that reflex before.
        
        The vagus can be assessed based on the movement of the soft plate during sounds emission or just by the correctness of the swallowing
- - - - is responsible for the upper eyelid and the the eyeball movements (innervates the superior, medial and inferior rectus muscles as well as the inferior oblique), and its parasympathetic function is the pupillary constriction and accommodation
        
        damage causes ptosis and external strabismus and for the parasympathetic part dilated pupil and poor accommodation
        
        ptosis- falling of the upper part of the eyelid
        
        external strabismus- the problem with the eye muscles to focus on the sight axis
        
        Examination is to test how the patient is following an object, e.g. a finger, goal is to find out whether the movements are smooth without any interruptions or preference
- - - - V2, mamillary nerve
        
        goes through the foramen rotundum
        
        delivers the sensation of the midface
        
        damage usually is linked with sensory loss in the upper parts of the cheek
        
        This part of the V cranial nerv can be evaluated by pinching on the respective area of skin, while the patients eyes are closed and asking the patient whether he/she is able to sens it
      - V3, mandibular nerve
        
        enters the skull through the foramen ovale
        
        controls the mastication muscles and is responsible for the sensation of the lower third of the face
        
        loss of sensation in the lower third of the face as well as the impairment of chewing are symptoms of function loss
        
        The examination is based on the assessment of the chewing muscles working and those are the temporal the masseter and the pterygoid, the patient shall bit on his teeth and the contraction on the muscles can be assessed visually and by palpation. To test the hyperreflexia the jar reflex test can be performed checking how the jar will react to normal stimulation by tapping through a finger with the reflex hammer on the jar and assessing the reaction.
      - V1, ophthalmic nerve
        
        comes to the skull via the superior orbital fissure
        
        controls the sensation, eyeball, anterior scalp and upper part of the face
        
        loss of function involves mostly the sensory loss to forehead
        
        To examine the function we can touch the cornea of the eye with a sterile soft not sharp and harmless object and look for the answer, which will confirm the efferent response of the nerve also a option is the touch so sensation of the skin test
- - - - is responsible for sensory to oropharynx, posterior third of the tongue and carotid body as well as the sinuses. Furthermore it delivers the taste of the posterior part of the tongue, also it is responsible for the stylopharyngeus muscle and the parasympathetic portion for the parotid gland
        
        loss of function is respective to the function so, very rarely there is something wrong with the portion responsible for the oropharynx to sinuses sensation, but the one of the symptoms of damage is the loss of the taste to the posterior third of the tongue as well as the dry month is case of the lack of stimulation of the parotid gland
        
        One examination refers to the function of the posterior third of the tongue, by putting taste samples on that part of it and asking the patient of describe them with his/her eyes closed
- - - - is responsible for the control of the muscle lateral rectus
        
        damage to that nerve is linked with strabismus
        
        strabismus- wrong setting of the eyes, one is not aligned in the same direction as the other
- - - - it delivers the hearing, balance and position in space
        
        the loss of function of this nerve is deafness or loss of the balance
        
        The examination is the a simple test called the Webber and Rinne test. This test is to test the hearing acuity and is based on placing a tune fork on the top of the head (asking the patient if the sound is hearable symmetrically) and the second part is to place the form on the mastoid process again asking if the sound is hearable. After the last we put the fork parallel before the ear and again asking the patient if the sound is hearable. The test around the ear, so the mastoid placement and the aside of the ear placement of the fork are to measure if the bone density and its conduction compared to the air. Normally in all the cases the patient should not have any problem with the hearing if the nerve is working correctly.
        
        To asses the balance and the vestibular portion of the nerve a past point test is performed. This test is based on the fact that only a person with normal vestibular function can find its way back to a point in the space with closed eyes. So the patient is ask to do a movement with his hands, usually rise them up and first with open eye, then with closed eyes lower the arm so that his/her hands will touch an exact point.
- - - - its primary function is to innervate the tongue muscle
        
        symptoms of damage are impairment in tongue movement and it the speech
        
        The examination of this nerve is done by the assessment of the movements of the tongue. We ask the patient to pull his tongue out and move it to the sides, both those movements should be symmetrical. also a resistance test can be done to see how the tongue is holding on the cheek against it.
- - - - primary function is to deliver the vision
        
        damage results in visual impairment
        
        This nerve can be assessed by the Snellen chart and the visual fields test. how good the transition of the signal is we can also check via the pupil constriction test