NeurophysiologyChapter 12

Perry C. Hanavan, Au.D.

Basal Ganglia (Nuclei)

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Equilibrium of Neuron

Myelin Sheath and Node of Ranvier

Synaptic Junction

Neurotransmitters

Neuromuscular Junction (Motor Unit)

Muscle Fiber Components

Muscle Spindle

Muscle Spindle Function to Control Muscle Length

Cranial Nerve- How to test the nerve- If the nerve is diseased or damaged-

1 (one)-to the nose Can the patient smell strong herbs? Patient cannot smell anything and may not be able to taste food very well.

2 (two)-to the eyes Can the patient count your fingers and tell you how many you are showing?

Patient loses sight in one or both eyes with no cataracts or injury.

3 (three), 4 (four), and 6 (six)-to the muscles that move the eyes, the eyelids and the pupils

Can the patient open their eyes, look up and down and to each side? Do they complain of seeing double? Are the pupils the same size? They should be. Shine a light in the patient’s eye and their pupils should get small. In a dark room, their pupils should be larger.

Patients may have a droopy eyelid or a very large pupil that does not get smaller even when you shine light on the eye. If one pupil is bigger than the other, one of the eyes may have an injured nerve. Patients may complain of double vision.

If the double vision is from a cranial nerve problem, it will get better when you cover one eye!!

Sometimes you may see that one eye is not moving very well. This can be a cranial nerve problem too.

5 (five)-to the face to feel Touch the patient’s face lightly with soft cloth on each side. Can they feel the soft touch on both sides?

Patients may have numbness on one side of the face, maybe only in one small area. Sometimes people can get terrible pains in the face without any other problem.

7 (seven)-to the face to move Ask the patient to close their eyes. Ask them to smile. Ask them to raise their eyebrows as though they are surprised.

The patient may have a weak face on one side that looks very droopy. They may not be able to smile on one side or close one eye. They may have saliva (spit) dripping out of their mouth.

The eyebrows on the same side as the weak face will also be weak if this is a cranial nerve problem.

 

Cranial Nerve-How to test the nerve- If the nerve is diseased

or damaged-

8 (eight)-to the ear for hearing and balance Test the patient’s hearing. Ask them a question but do not let them watch your lips move. In children, have someone call their name softly from across the room.

Patients may complain of hearing loss. Children with poor hearing may not complain of hearing problems, but may speak normally for their age. Some problems with cranial nerve 8 cause patients to feel as though they are spinning or to hear ringing in their ears. Patients may feel unstable and have problems walking. They may stumble as if they are drunk.

9 (nine) and 10 (ten)-to the back of the mouth and throat

Ask the patient to open their mouth and say "AAAHHH". Watch the palate. It should go up on both sides. If you have a tongue blade (no sharp edges!) or a cotton swab, you can lightly touch the back of the patient’s throat by the palate. They should gag. Watch the patient take a sip of water.

The patients may choke when drinking water. Their palate may go up only on one side. They may not gag when you touch the back of their mouth.

11 (eleven)-to the shoulders Ask the patient to shrug their shoulders. One shoulder may be too weak to shrug

12 (twelve)-to the tongue Ask the patient to open his mouth but keep the tongue inside. Examine the tongue while it sits quietly in the mouth. Ask the patient to stick out their tongue straight out.

The tongue may be weak and wasted on one side. When they try to stick out their tongue, it may go off to one side.

Cranial Nerves

• Cranial Nerves function

• CN Table

• Cranial Nerve Summary

Brodmann’s Area Map of Brain

Cerebral Aneurysm Repair

• CAR with clip• Drs. Payner and

Cohen-Gadol, neurosurgeons at Goodman Campbell Brain and Spine

Intracranial Blood Vessel Block

• Stroke treatment• Developed by Dr.

Jeffrey Saver's group at UCLA Stroke Center

• Covidien Solitaire FR Revascularization Device

• Restore circulation and remove clots using a single device

Head Trauma

• Tumor Locator