547 days

cranial nerve examination 1

not gonna go gym, im in the revision mindset right now, but i will do a light workout before bed. i really feel like i need to exercise.

cranial nerve examination: taken me so long to learn, let's see if i remember it.

Olfactory nerve (cranial nerve 1): any change in sense of smell?

cranial nerve 2: assess pupils reflex , visual acuity, visual fields, colour vision and fundoscopy.

- pupillary reflexes include: swinging light test between both eyes.

- then cover one eye and check light in pupil, repeat with other eye.

tell pt to look ahead, then bring a pen in the centre tell them to look at pen

snellen chart (i keep calling it a smellen chart :(  ) - 6 metres away, if pt wears long distance glasses, allow to wear glasses during test. if pt cant see, bring chart closer to 3m, if pt still cant see, assess vision by wriggling fingers, if cant see that, wriggle hands.

colour chart.

fundoscopy.

sit opposite pt, dont cover any eye, look ahead, tell me when you can see my fingers.

sit opposite pt, cover one eye, i cover opposite eye, wiggle fingers

cranial nerves 3, 4, 6.

sit opposite pt, H test.

cover test

cranial nerve 5

sensory

cotton wool on trachea

ask pt to close eyes, v1 v2 v3. v1 - sides of forehead. v2 sides of cheeks, v3 sides of chin. if pt cant feel light touch, would repeat with pin / needle. 

jaw clench, forehead and jaw.

cranial nerve 7

raise eyebrows

puff cheeks out

shut eyes against resistance

cranial nerve 8

rinnes -512hz on mastoid repeat on both ears, say when pt can stop hearing

webers, 512hz, forehead, ask where they hear the sound

whisper test, cover one ear, whisper numbers ask pt to repeat number

cranial nerves 9, 10

ask pt to open mouth and say ahh check for symmetry

ask pt to swallow and cough, check for delay

cranial nerve 11

shoulder resistance, head resistance

cranial nerve 12

tongue protrusion

tongue resistance in cheek

summarise - nad (no abnormalities detected, no nystagmus )

further investigation: motor and sensory examination of upper and lower limbs.

wash hands

Done.
Gonna tidy my room. Exercise maybe? I really want to but I'm just so tired
Bubble bath or shower depending on my mood. Almost fell asleep outside. H hasn't told me if she needs a lift tomorrow she said she'd let me know cos I texted her earlier but still haven't heard anything.
Dreading parking tomorrow 😭 do Not want to pay £14