Cranial Nerves Lab Evaluation at Cape Fear Community College
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Free Cranial Nerves Lab Evaluation at Cape Fear Community College Questions
1. Which of the following cranial nerves innervate the parotid salivary gland?
- Facial
- Glossopharyngeal
- Hypoglossal
- CN VIII
Explanation
B. Glossopharyngeal The glossopharyngeal nerve (Cranial Nerve IX) provides parasympathetic innervation to the parotid salivary gland via the otic ganglion. This nerve stimulates saliva production from the parotid gland. Damage to CN IX can result in decreased salivation and impaired swallowing.
2. Which of the following cranial nerves is responsible for elevating the upper eyelid?
- CN 3
- CN 4
- CN 6
Explanation
A. CN 3 Cranial Nerve III (Oculomotor nerve) innervates the levator palpebrae superioris, the muscle responsible for elevating the upper eyelid. Damage to CN III results in ptosis (drooping eyelid), because the eyelid cannot be lifted properly without oculomotor function.
3. Damage to which of the following cranial nerves can result in strabismus?
- Olfactory
- Optic
- Oculomotor
- Trochlear
- Trigeminal
Explanation
D. Trochlear The trochlear nerve (CN IV) innervates the superior oblique muscle, which controls downward and inward eye movement. Damage to CN IV causes vertical strabismus, leading to misalignment of the eyes. Patients often tilt their head to the opposite side of the lesion and report vertical diplopia, especially when walking downstairs or reading. Trochlear palsy is a well-known cause of strabismus due to impaired superior oblique muscle function.
4. Which of the following cranial nerves are responsible for swallowing and vocalization?
- Facial
- Glossopharyngeal
- Hypoglossal
- CN VIII
Explanation
The glossopharyngeal nerve (CN IX) plays a key role in swallowing and vocalization by innervating the pharyngeal muscles and contributing to control of the gag reflex. It coordinates movements needed for swallowing and assists in producing sound through its motor influence on the pharynx. Damage may result in difficulty swallowing (dysphagia), loss of gag reflex, and speech changes.
5. The superior rectus, medial rectus, inferior rectus, and inferior oblique are innervated by which cranial nerve:
- Oculomotor
- Trochlear
- Abducens
Explanation
A. Oculomotor The oculomotor nerve (Cranial Nerve III) innervates the majority of the extraocular muscles: the superior rectus, medial rectus, inferior rectus, and inferior oblique. These muscles allow the eyes to move up, down, and medially, and assist in eye rotation and focusing. Damage to CN III may cause ptosis, pupil dilation, and the eye resting “down and out.”
6. Cranial nerve eight (CN VIII), auditory, consists of the following branches: Select all that apply.
- Cochlear
- Vestibular
- Maxillary
- Ophthalmic
- Mandibular
Explanation
A. Cochlear The cochlear branch carries auditory (hearing) information from the organ of Corti in the cochlea to the brainstem (cochlear nuclei). Hair cells transduce mechanical sound vibrations into neural impulses that travel via the cochlear nerve, enabling perception of pitch, loudness, and timbre. Damage to this branch commonly presents with sensorineural hearing loss, tinnitus, and difficulty understanding speech—especially in noisy environments. B. Vestibular The vestibular branch conveys balance and spatial orientation signals from the semicircular canals, utricle, and saccule to the vestibular nuclei. It detects angular and linear accelerations of the head, supporting gaze stabilization (via the vestibulo-ocular reflex) and postural control. Lesions produce vertigo, nystagmus, gait instability, and nausea, and are implicated in disorders such as vestibular neuritis and Ménière’s disease.
7. Damage to which of the following cranial nerves can result in ptosis, double vision, or unequal pupils?
- Olfactory
- Optic
- Oculomotor
- Trochlear
- Trigeminal
Explanation
C. Oculomotor The oculomotor nerve (CN III) controls most extraocular eye movements, raises the eyelid, and constricts the pupil. Injury to CN III can cause ptosis (drooping eyelid), diplopia (double vision) from impaired eye movement, and anisocoria (unequal pupils) due to loss of parasympathetic input. These are hallmark signs of cranial nerve III dysfunction, often seen in increased intracranial pressure, aneurysm, or midbrain lesions.
8. Rapid administration of furosemide can cause damage to which of the following cranial nerves?
- Trochlear
- Vestibulocochlear
- CN 7
Explanation
B. Vestibulocochlear Rapid IV administration of furosemide can be ototoxic, leading to damage of Cranial Nerve VIII (Vestibulocochlear nerve). This nerve controls hearing and balance. Ototoxicity may result in tinnitus, hearing loss, vertigo, and balance disturbances. To prevent this adverse effect, furosemide should be administered slowly and within recommended IV rate limits.
9. The glossopharyngeal nerve is assessed by asking the client to __________ and move their __________ __________.
- smile / eyebrows / upward
- swallow / soft palate / up and down
- protrude the tongue / tongue tip / side to side
- clench teeth / jaw / forward and backward
Explanation
The glossopharyngeal nerve (CN IX) is evaluated by observing swallowing and soft-palate movement. Asking the client to swallow and watching the soft palate move up and down assesses gag reflex and pharyngeal muscle function. Proper elevation indicates intact CN IX function, essential for swallowing and airway protection.
10. Which of the following cranial nerves do you assess for readiness to extubate or need to block for an awake fiber optic?
- Glossopharyngeal
- Hypoglossal
- Facial
- Spinal accessory
Explanation
A. Glossopharyngeal The glossopharyngeal nerve (CN IX) provides sensation to the posterior tongue, soft palate, and oropharynx, playing a key role in the gag reflex and airway protective reflexes. Before extubation, airway competence must be confirmed—adequate gag reflex and swallowing ability indicate readiness. During an awake fiber-optic intubation, the glossopharyngeal nerve is often blocked to reduce gagging and improve patient comfort.
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