After this course, you should make sure that you can:

• Describe the clinically relevant structure of cranial nerves V, VII, VIII, IX, X & XII
• Outline the principal properties, relations and functional interactions of these structures
• Assess their status via case history observation and appropriate testing
• Demonstrate key psychomotor skills relevant to your examination of the above

• Apply the above to a novel theoretical clinical situation, testing hypotheses generated

• Explicitly analyse your diagnostic process, reflecting on its strengths and weaknesses

• Evaluate the bearing of these processes on your subsequent healthcare

NB the above may be the subject of formative or summative assessment, in line with your prevailing professional body's guidelines

References

Visit as many of the references shown below as possible prior to your course. These are drawn from a variety of texts and take a range of forms (pictorial, textual and tabular). Our intention is to provide you with an assortment of information sources that you can choose from - and that you can match to your own learning style.

Nerve V has vital sensory function but also controls muscles of mastication: Ref 4 p 82

Nerve VII: examples of Upper and Lower Motor Neurone disorder: Ref 4 pp 78-80

Examining the face: Ref 8 pp 91-98; figs 11.1 and 11.2

Procedure for nerves V-XII: Ref 1 pp 332-347, Ref 8 pp 85-102

Cranial nerve VIII: tests and interpretations: Ref 8 pp 99-102

XI and XII - examples of clinical manifestation: Ref 4 p 169

Examining the mouth: Ref 8 pp 103-107; fig 13.1

You'll need to bring your own:

Bright pen torch
Clinically clean and unused pins (dressmakers’ or equivalent)
Queen Square tendon hammer
Tongue depressors and orange sticks (or equivalent)
Tuning forks - 512 Hz. especially

Indications: Change in facial sensation, expression and symmetry
Unexplained or unusual headaches or facial pain
Vertigo / poor coordination. Difficulties with eating, swallowing, speaking. Concerns regarding potential structural changes in the upper spinal cord / lower brainstem

• Structures involved
Key sensory, motor, autonomic functions. Nuclei, origins and destinations
Relation to cranial foramina and and other clinically important structures

• Cranial nerve V
Reduction or alteration of function. How do you perform your examination accurately? Some questions that you will be helped to answer include: is the jaw jerk a useful test? How can you tell whether facial sensory symptoms come from peripheral or central nervous system damage? How can this cranial nerve give information about the spinal cord and brainstem?

• Cranial nerve VII
Gathering information on somatic, autonomic and sensory functions
Determining cause and site of facial nerve injury: is it LMNL or UMNL?

• Cranial nerve VIII
Vestibular and auditory function testing. Could you tell whether vertigo was caused by vestibulococchlear nerve or brainstem damage?

• Cranial nerves IX and X
Why and when should patients open their mouths and say ‘ah’?

• Cranial nerves XI and XII
Assessing these two cranial nerves might allow you to detect CNS conditions such as motor neurone disease. Find out how!

• Altered cranial nerve function – interpretation and terminology
Analyse, record and communicate findings accurately and succinctly
 

© Crawford & Cook 2005-9