cranial nerve examination

There are 12 pairs of cranial nerves, which are generally named after Roman numerals. The first pair and the second pair (sniffing, visual) cranial nerves are the nerve fiber bundles of the secondary and tertiary neurons in the intracranial part, and the remaining 10 pairs of the cranial nerves are connected with the brainstem, and the brain stem has its nucleus, movement. The position of the nucleus is close to the midline and the nucleus is on the outside. Part XI of the cranial nerve (parallel nerve) is emitted from the upper anterior horn of the cervical spinal cord. The cranial nerve has sensory fibers and motor fibers, which mainly dominate the head and face. Pairs I, II, and VIII are sensory nerves, and pairs III, IV, VI, XI, and XII are motor nerves, and pairs V, VII, IX, and X are mixed nerves. In addition, III, VII, IX, and X contain parasympathetic nerve fibers. Except for two pairs (the lower part of the cerebral nucleus in VII and XII), the nuclear innervation of all cranial nerve nucleus is double-dominated. The diagnosis of brain damage by cranial nerve examination is extremely meaningful. There are 12 pairs of cranial nerves. Checking the cranial nerves should be performed in order to avoid repetition and omission. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: Maintain a normal diet and schedule. Normal value There are many items involved in cranial nerve examination, and only some of them are listed here, such as: 1. Olfactory nerve examination: When the smell is normal, the smell of the test item can be clearly distinguished. 2. Optic nerve examination: the visual field is normal, the eyeball moves freely in the inward, upper and lower directions, and the eyeball is down and the abduction movement is normal. 3, facial nerve examination: in the quiet, talking and doing facial movements without the asymmetrical side muscles. 4, auditory nerve examination: normal hearing, can correctly distinguish the sound heard, eyeball tremor, closed eye walking test, walking test, dislocation nystagmus are normal and closed eyes can stand. Clinical significance Abnormal results: There are many items involved in cranial nerve examination, and abnormal results of various examinations indicate different parts of the brain and different nerve lesions. Such as: 1. After olfactory nerve damage: The smell of the test item cannot be clearly distinguished. People who need to be examined: patients who are not sensitive to odors. 2, after optic nerve damage: abnormal results: abnormal changes in visual field suggest damage to the optic nerve pathway; if the ptosis is found during the examination, the movement of the eyeball inward, upper and lower directions is limited, all suggesting oculomotor nerve paralysis; such as eyeball Lower and abduction movements are weakened, suggesting that the pulley nerve is damaged. People who need to be examined: patients with abnormal vision. 3, after facial nerve damage: impaired ipsilateral movements, common in facial nerve spasm and cerebrovascular disease. People who need to be examined: Patients with facial paralysis. 4, after the auditory nerve damage: can not correctly distinguish the sound heard, eyeball tremor, closed eye walking test, walking test, dislocation nystagmus abnormality and closed eyes can not stand. People who need to be examined: Patients with symptoms such as facial pain and hearing loss. Precautions Forbidden before examination: Maintain a normal diet and schedule. Requirements for examination: Doctors should try to relax their facial muscles when they are examined. Don't be too nervous and actively cooperate with the doctor's work. Note after inspection: First, life should be regular: the elderly can do some work within their power, but not too tired. Second, control of high blood pressure: in order to ideally control blood pressure, we must pay attention to many aspects. (1) Blood pressure control at an ideal level: Intervention experiments in a large population in China have shown that 140/80 mmHg may be the ideal blood pressure value for prevention of cerebrovascular disease. However, some people's blood pressure drops to this level, but the symptoms of cerebral ischemia may occur. The reason may be that the blood pressure is too fast, or the ideal blood pressure for these people is slightly higher than the above value. This is due to individual differences. A more feasible method is to gradually lower the blood pressure to the above level or slightly higher for a period of time without the symptoms of cerebral ischemia. (2) The blood pressure should be controlled smoothly: the "peak" and "valley" of blood pressure within 24 hours are close to each other, so as to avoid damage to the blood vessel wall caused by blood pressure fluctuations, and prevent cerebral hypoperfusion caused by low blood pressure. Do not buck too fast. (3) Maintain a comfortable mood: The occurrence of essential hypertension has a significant relationship with the environment and mental state. Environmental factors include diet, social environment, life changes, and mental conflicts. High levels of stress events can cause sympathetically mediated vasoconstriction and other autonomic responses, with large and lasting effects on blood pressure. Brod observed that hypertensive patients have a longer vasoconstrictor response than normal in stress. Susceptible physique shows an acute and persistent increase in blood pressure in general and specific stress responses. Psychophysiological studies suggest that mental stress, autonomic activity, and conditional effects can cause high blood pressure. Therefore, supportive psychotherapy for hypertensive patients is necessary. (4) Simultaneous use of non-drug therapy: such as limiting salt intake, weight loss, lowering blood lipids, moderate exercise, biofeedback therapy, etc., can consolidate and promote the antihypertensive effect of drugs. Third, maintain a good attitude: maintain optimism and avoid being too excited. To calm the mind, reduce the troubles, sorrows and sorrows, indifferent to fame and fortune, contentment and happiness. Fourth, pay attention to diet: diet should pay attention to low fat, low salt, low sugar. Eat less animal brain, internal organs, eat more vegetables, fruits, soy products, with appropriate amount of lean meat, fish, eggs. Fifth, prevention of constipation: dry stool, defecation force, not only increased abdominal pressure, blood pressure and intracranial pressure also rise, it is easy to cause fragile small blood vessels to rupture and cause cerebral hemorrhage. To prevent constipation, eat more fiber-rich foods such as greens, celery, leeks and fruits. Appropriate exercise and abdomen self-healing massage before getting up in the morning, or use appropriate drugs such as Ma Ren Wan, honey orally, open the gel, glycerin for external use; can effectively prevent constipation. Sixth, prevent fatigue: physical labor and mental work should not be too tired, overload work can induce cerebral hemorrhage. Seven, pay attention to the weather changes: cold weather is a good season of brain stroke, vasoconstriction, blood pressure is easy to rise, we must pay attention to keep warm, so that the body adapts to climate change. Also, according to your own health, carry out some appropriate physical exercise, such as walking, doing broadcast gymnastics, etc., to promote blood circulation. Eight, often left hand: In daily life, use the left upper limb and the left lower limb, especially the left hand, can reduce the burden of the left hemisphere of the brain, and can exercise the right hemisphere of the brain to strengthen the coordination function of the right hemisphere of the brain. Medical research shows that cerebral hemorrhage is most likely to occur in the right hemisphere with weak blood vessels, so the best way to prevent the occurrence of cerebral hemorrhage is to turn two fitness balls with your left hand in the morning and evening to help the development of the right hemisphere. Nine, pay close attention to your own physical changes: strokes will have some aura symptoms, such as no headache, severe headache, dizziness, syncope, some sudden numbness, fatigue or temporary amblyopia, language communication difficulties, etc., should promptly seek medical treatment . Inspection process There are many brain nerve examination items, only the following are listed here: 1, olfactory nerve test (olfactorynerveexamination) olfactory sensitivity can be understood through consultation. 2, visual field examination (visualfieldexamination) field of vision refers to the range that the patient can see in front of the eye, when the eyeball does not move. 3, trigeminal nerve examination (trigeminalexamination) trigeminal nerve has both motor and sensory functions. The examination includes facial sensation examination, motor function examination, corneal reflex examination and mandibular reflex examination. 4, facial nerve examination (facialnerveexamination) includes two parts of exercise and taste examination. 5, the auditory nerve examination includes hearing examination and vestibular function examination, it is used to determine whether the cochlear and vestibular nerves have lesions. Not suitable for the crowd Inappropriate crowd: None. Adverse reactions and risks Nothing.

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