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. The superior rectus, medial rectus, inferior rectus, and inferior oblique are innervated by which cranial nerve:
- A. Oculomotor
- B. Trochlear
- C. 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.”
2. Ketamine administration can result in nystagmus. Which of the following cranial nerves is responsible for this phenomena?
- A. Oculomotor
- B. Cranial nerve 6
- C. CN IV
Explanation
B. Cranial nerve 6 Cranial nerve VI (Abducens nerve) innervates the lateral rectus muscle, which abducts the eye. When ketamine is administered, it can affect ocular muscle control and cause nystagmus, including lateral gaze nystagmus. Because CN VI controls side-to-side eye movement, dysfunction or overstimulation of this pathway can contribute to the horizontal nystagmus often seen with ketamine use.
3. Which of the following cranial nerves is responsible for medial movement of the eye?
- A. CN 3
- B. CN 4
- C. CN 6
Explanation
A. CN 3 Cranial Nerve III (Oculomotor nerve) innervates the medial rectus muscle, which moves the eye medially (toward the nose). When CN III is functioning properly, the eye can adduct smoothly. Damage to this nerve results in difficulty moving the eye inward and may cause diplopia (double vision) and lateral drifting of the affected eye (strabismus).
4. Deviation of the uvula indicates damage to which of the following cranial nerves:
- A. Hypoglossal
- B. Glossopharyngeal
- C. CN VII
- D. CN 8
Explanation
B. Glossopharyngeal Although the vagus nerve (CN X) is the primary nerve associated with uvular deviation, the glossopharyngeal nerve (CN IX) works closely with CN X in palatal movement and the gag reflex. Damage in this pathway results in the uvula deviating away from the side of the lesion due to unopposed pull of the intact muscles. A weak soft palate droops on the affected side, and the uvula is pulled toward the normal side.
5. The superior oblique is innervated by which cranial nerve:
- A. Oculomotor
- B. Trochlear
- C. Abducens
Explanation
B. Trochlear The trochlear nerve (Cranial Nerve IV) innervates the superior oblique muscle. This muscle allows the eye to move downward and inward (depression in adduction). Damage to CN IV causes difficulty looking down, especially when reading or walking down stairs, and may result in vertical diplopia and a characteristic head tilt to compensate.
6. Damage to which of the following cranial nerves can result in strabismus?
- A. Olfactory
- B. Optic
- C. Oculomotor
- D. Trochlear
- E. 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.
7. To assess the hypoglossal nerve, the nurse asks the client to stick out their tongue and move it side-to-side.
- A. True
- B. False
- C. Ask the client to shrug shoulders against resistance
- D. Ask the client to read a Snellen chart
Explanation
The hypoglossal nerve (CN XII) controls tongue movement. The correct assessment is having the client protrude the tongue and move it side-to-side. Normal findings include smooth movement and midline protrusion. Deviation may indicate hypoglossal nerve damage on the weak side.
8. Which of the following cranial nerves innervate the parotid salivary gland?
- A. Facial
- B. Glossopharyngeal
- C. Hypoglossal
- D. 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.
9. How does the nurse test cranial nerve two (CN II)?
- A. Ask the client to identify different tastes.
- B. Ask the client to clench their teeth.
- C. Ask the client to cover each eye separately and read the Snellen chart.
- D. Ask the client to shrug shoulders against resistance.
Explanation
Cranial nerve II is the optic nerve, responsible for vision. The nurse tests CN II by assessing visual acuity, most commonly using a Snellen eye chart. Each eye is tested separately to identify deficits in central vision. This helps determine clarity of sight and identifies potential neurological or ocular problems such as optic neuritis or visual field loss.
10. Cranial Nerve 4 innervates which of the following? Select all that apply.
- A. Lateral rectus
- B. Superior rectus
- C. Medial rectus
- D. Inferior rectus
- E. Superior oblique
- F. Inferior oblique
Explanation
E. Superior oblique Cranial nerve IV (Trochlear nerve) innervates the superior oblique muscle. This muscle depresses the eye and rotates it inward, especially when the eye is adducted. Damage to CN IV results in vertical diplopia (double vision) and difficulty looking down, such as when reading or walking downstairs. Patients may tilt their head away from the affected side to compensate.
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