CN Action Clinical S&S Injury Site Treatment

I – Olfactory Interpret odor and ID Anosmia Cribriform plate

Olfactory groove mass (meningioma)
Aura odor Seizure disorder – Entorhinal cortex/
Uncus
II – Optic
III – Oculomotor Keep eyes fixated and fuse Binocular diplopia – oblique Pupil Involving Palsy – Compression by Coiling of aneurysm
images Ptosis Post. Comm. A. aneurysm
Eyes down and out Pupil Sparing Palsy – tiny embolism of Eye patch – will resolve
Large, dilated pupil vasa nervosum on own
IV – Trochlear See III Binocular diplopia – oblique
V – Trigeminal Facial sensation Wernicke’s Triad – Memory Compression of n. by artery (SCA, Vascular decompression
mm. of mastication (except problems and korsakoff’s psychosis, PCA) surgery (Janetta
buccinator-CN VII) gait ataxia, ophthalmoplegia/ paresis Procedure)
Trigeminal Neuralgia
VI – Abducens See III Binocular diplopia – Horizontal
VII – Facial Facial expression Facial (Bell’s) palsy – inability to
Salivation wrinkle forehead, widened palpebral
Lacrimation fissure, ∅ bury eyelashes, flattened
Dampen loud sounds nasio-labial fold,
Taste ant. 2/3 tongue
VIII – Vestibulocochlear
IX – Glossopharyngeal Pharyngeal mm. Neuropathic pain w/ swallow Compression by Int. Carotid A.
Taste post. 2/3 Pain w/ root of tongue palp. Compression by PICA
Gag reflex
X – Vagus Pharynx/soft palate mm. Syncope d/t asystole Compression by PICA – causes
Larynx sensation, mm. overflow of paraSNS
ANS signals
XI – Accessory SCM Inability to rotate head opposite Damage to n. (lymph node resection)
Trapezius mm. Inability to abduct arm past 90°
XII - Hypoglossal Tongue mvmts Tongue deviates to affected side Medulla

CN I, II, III, IV – tell whether midbrain is intact

CN V, VI, VII, VIII – tell about integrity of pons
CN IX, X, XI, XII – tell about integrity of medulla

Cavernous Sinus Thrombosis – often 2° to infection (sinusitis, otitis media, etc.) – Tx w/ ABs, +/- drainage
- Chemosis/proptosis, periorbital swelling – congested ophthalmic vein
- Blindness – compression of central retinal artery (NOT CN II)
- Ophthalmoparesis, papillary dilation – CN III, IV, VI injury
- Forehead paresthesia – CN V (V1, V2) damage