{"id":5437,"date":"2025-12-09T12:46:42","date_gmt":"2025-12-09T17:46:42","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5437"},"modified":"2025-12-10T12:59:57","modified_gmt":"2025-12-10T17:59:57","slug":"neurologic-dysfunction-and-coma-assessment","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/neurologic-dysfunction-and-coma-assessment\/","title":{"raw":"11p4  Neurologic Dysfunction and Coma Assessment","rendered":"11p4  Neurologic Dysfunction and Coma Assessment"},"content":{"raw":"<h1><strong>Brain Anatomy and Vital Centers<\/strong><\/h1>\r\n<ul>\r\n \t<li>The\u00a0<strong>brainstem<\/strong>\u00a0is divided into:\r\n<ul>\r\n \t<li><strong>Midbrain<\/strong>: helps coordinate movement and reflexes.<\/li>\r\n \t<li><strong>Pons<\/strong> (belly of seahorse-shaped): relays signals, respiratory rhythmicity center and cranial nerves control facial movements.<\/li>\r\n \t<li><strong>Medulla oblongata<\/strong>: houses critical\u00a0<strong>vital centers<\/strong> (heart rate, force of heart contraction, respiration) and <strong>reticular activating system (RAS)<\/strong>, which regulates consciousness.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>RAS and Consciousness<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Reticular Activating System (RAS)<\/strong>: a network of neurons in\u00a0<strong>brainstem<\/strong>\u00a0that regulate\u00a0<strong>wakefulness<\/strong>.<\/li>\r\n \t<li>Damage to RAS\u00a0<strong>causes decreased consciousness<\/strong>, coma, or even death.<\/li>\r\n \t<li>Brain swelling or lesions can compress RAS, impairing consciousness.<\/li>\r\n<\/ul>\r\n<h1><strong>Causes of Altered Consciousness<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Direct damage<\/strong>:\r\n<ul>\r\n \t<li>Stroke, trauma, tumors, bleeding.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Indirect causes<\/strong>:\r\n<ul>\r\n \t<li><strong>Ischemia<\/strong>\u00a0(lack of oxygen, e.g., myocardial infarction).<\/li>\r\n \t<li><strong>Toxins<\/strong>\u00a0(alcohol, drugs, uremia).<\/li>\r\n \t<li><strong>Metabolic disturbances<\/strong>:\r\n<ul>\r\n \t<li>Hypoxia, acidosis, hypoglycemia.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Infection<\/strong>\u00a0or\u00a0<strong>inflammation<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Progression to Coma<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Early signs<\/strong>:\r\n<ul>\r\n \t<li>Confusion, disorientation, lethargy.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Progression<\/strong>:\r\n<ul>\r\n \t<li>Reduced responsiveness,\u00a0<strong>stupor<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Deep coma<\/strong>:\r\n<ul>\r\n \t<li>Cannot respond to stimuli.<\/li>\r\n \t<li>Life-threatening, requires urgent care.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Monitoring and Assessment<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Vital signs<\/strong>:\r\n<ul>\r\n \t<li>Heart rate, respiration, blood pressure, temperature.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Reflex testing<\/strong>:\r\n<ul>\r\n \t<li>Pupillary reflex.<\/li>\r\n \t<li>Cranial nerve reflexes.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Glasgow Coma Scale (GCS)<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Purpose<\/strong>: assesses level of consciousness.<\/li>\r\n \t<li><strong>Scores<\/strong>:\r\n<ul>\r\n \t<li>13-15: mild\/no coma.<\/li>\r\n \t<li>9-12: moderate impairment.<\/li>\r\n \t<li><strong>4-8<\/strong>: coma.<\/li>\r\n \t<li><strong>3<\/strong>: deep coma (poor prognosis).<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Lower scores indicate worse prognosis.<\/li>\r\n \t<li>The longer a person remains in a coma, the worse the prognosis.<\/li>\r\n<\/ul>\r\n<h1><strong>Brainstem Reflexes:\u00a0\u00a0<\/strong><\/h1>\r\n<h1><strong>1.\u00a0 Pupillary Light Reflex<\/strong><\/h1>\r\n<ul>\r\n \t<li>Shine light into eyes.<\/li>\r\n \t<li>Pupils should\u00a0<strong>constrict<\/strong>.<\/li>\r\n \t<li><strong>Dilatation (\"blown pupils\")<\/strong>\u00a0indicates\u00a0<strong>brainstem damage<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>2.\u00a0 Oculocephalic Reflex (Doll\u2019s eyes)<\/strong><\/h1>\r\n<ul>\r\n \t<li>Turn patient's head to the side.<\/li>\r\n \t<li><strong>Normal<\/strong>:\r\n<ul>\r\n \t<li>Eyes\u00a0<strong>move<\/strong> opposite to the the direction of head turn.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Abnormal<\/strong>:\r\n<ul>\r\n \t<li>Eyes\u00a0<strong>stay fixed<\/strong>\u00a0(no movement), indicating brainstem impairment.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>3.\u00a0 Oculovestibular Reflex (Caloric Test)<\/strong><\/h1>\r\n<ul>\r\n \t<li>Use warm or cold water (or air) to irrigate ear.<\/li>\r\n \t<li><strong>Normal<\/strong>:\r\n<ul>\r\n \t<li>Eyes gaze\u00a0<strong>toward<\/strong> the cold water or <strong>away<\/strong> from the warm water.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Abnormal<\/strong>:\r\n<ul>\r\n \t<li>No eye movement, indicating brainstem damage.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>4.\u00a0 Corneal Reflex<\/strong><\/h1>\r\n<ul>\r\n \t<li>Touch cornea with gauze.<\/li>\r\n \t<li>Normally, eyeblink occurs.<\/li>\r\n \t<li>Absence suggests\u00a0<strong>brainstem or cranial nerve damage<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>5.\u00a0 Gag Reflex<\/strong><\/h1>\r\n<ul>\r\n \t<li>Touch the back of the throat.<\/li>\r\n \t<li>Normally, the person\u00a0<strong>gags<\/strong>.<\/li>\r\n \t<li>Absence indicates neural impairment.<\/li>\r\n<\/ul>\r\n<h1><strong>Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li>Reflex tests evaluate\u00a0<strong>brainstem and cranial nerve<\/strong>\u00a0function.<\/li>\r\n \t<li>Good prognosis correlates with\u00a0<strong>higher GCS scores<\/strong>\u00a0and intact reflexes.<\/li>\r\n \t<li>Deep coma and absence of reflexes suggest\u00a0<strong>brain death<\/strong>\u00a0or severe brainstem injury.<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<table class=\"grid landscape\" style=\"height: 572px\">\r\n<tbody>\r\n<tr class=\"shaded\" style=\"height: 46px\">\r\n<td style=\"height: 46px;width: 91.3312px\"><strong>Cranial Nerve<\/strong><\/td>\r\n<td style=\"height: 46px;width: 119.925px\"><strong>Nerve Name<\/strong><\/td>\r\n<td style=\"height: 46px;width: 167.737px\"><strong>Mnemonic Memory Trick<\/strong><\/td>\r\n<td style=\"height: 46px;width: 328.069px\"><strong>Function<\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN I<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Olfactory<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Ol<\/strong><\/span>d<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Smell<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN II<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Optic<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Op<\/strong><\/span>ie<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Vision<\/td>\r\n<\/tr>\r\n<tr style=\"height: 90px\">\r\n<td style=\"height: 90px;width: 91.3312px\"><strong>CN III<\/strong><\/td>\r\n<td style=\"height: 90px;width: 119.925px\">Oculomotor<\/td>\r\n<td style=\"height: 90px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Occ<\/strong><\/span>asionally<\/td>\r\n<td style=\"height: 90px;width: 328.069px\">Eyelid movement\r\n\r\nEye movement\r\n\r\nPupil constriction<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN IV<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Trochlear<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Tr<\/strong><\/span>ies<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Eye movement<\/td>\r\n<\/tr>\r\n<tr style=\"height: 60px\">\r\n<td style=\"height: 60px;width: 91.3312px\"><strong>CN V<\/strong><\/td>\r\n<td style=\"height: 60px;width: 119.925px\">Trigeminal<\/td>\r\n<td style=\"height: 60px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Tri<\/strong><\/span>gonometry<\/td>\r\n<td style=\"height: 60px;width: 328.069px\">Facial sensation\r\n\r\nChewing<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN VI<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Abducens<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>A<\/strong><\/span>nd<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Eye movement<\/td>\r\n<\/tr>\r\n<tr style=\"height: 60px\">\r\n<td style=\"height: 60px;width: 91.3312px\"><strong>cCN VII<\/strong><\/td>\r\n<td style=\"height: 60px;width: 119.925px\">Facial<\/td>\r\n<td style=\"height: 60px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>F<\/strong><\/span>eels<\/td>\r\n<td style=\"height: 60px;width: 328.069px\">Facial expression, Saliva, Lacrimal glands, Taste\r\n\r\n&nbsp;<\/td>\r\n<\/tr>\r\n<tr style=\"height: 60px\">\r\n<td style=\"height: 60px;width: 91.3312px\"><strong>CN VIII<\/strong><\/td>\r\n<td style=\"height: 60px;width: 119.925px\">Vestibulocochlear<\/td>\r\n<td style=\"height: 60px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Ve<\/strong><\/span>ry<\/td>\r\n<td style=\"height: 60px;width: 328.069px\">Hearing\r\n\r\nBalance<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN IX<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Glossopharyngeal<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Glo<\/strong><\/span>omy<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Taste, Swallowing<\/td>\r\n<\/tr>\r\n<tr style=\"height: 46px\">\r\n<td style=\"height: 46px;width: 91.3312px\"><strong>CN X<\/strong><\/td>\r\n<td style=\"height: 46px;width: 119.925px\">Vagus<\/td>\r\n<td style=\"height: 46px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Vag<\/strong><\/span>ue<\/td>\r\n<td style=\"height: 46px;width: 328.069px\">Swallowing, Taste, &amp; PSNS control of visceral organs<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN XI<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Accessory<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>A<\/strong><\/span>nd<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Shoulder shrug <em>(trapezius<\/em> and <em>sternocleidomastoid)<\/em><\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px\">\r\n<td style=\"height: 30px;width: 91.3312px\"><strong>\u00a0CNXII<\/strong><\/td>\r\n<td style=\"height: 30px;width: 119.925px\">Hypoglossal<\/td>\r\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Hypo<\/strong><\/span>active<\/td>\r\n<td style=\"height: 30px;width: 328.069px\">Tongue movement (speech and swallowing)<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>","rendered":"<h1><strong>Brain Anatomy and Vital Centers<\/strong><\/h1>\n<ul>\n<li>The\u00a0<strong>brainstem<\/strong>\u00a0is divided into:\n<ul>\n<li><strong>Midbrain<\/strong>: helps coordinate movement and reflexes.<\/li>\n<li><strong>Pons<\/strong> (belly of seahorse-shaped): relays signals, respiratory rhythmicity center and cranial nerves control facial movements.<\/li>\n<li><strong>Medulla oblongata<\/strong>: houses critical\u00a0<strong>vital centers<\/strong> (heart rate, force of heart contraction, respiration) and <strong>reticular activating system (RAS)<\/strong>, which regulates consciousness.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>RAS and Consciousness<\/strong><\/h1>\n<ul>\n<li><strong>Reticular Activating System (RAS)<\/strong>: a network of neurons in\u00a0<strong>brainstem<\/strong>\u00a0that regulate\u00a0<strong>wakefulness<\/strong>.<\/li>\n<li>Damage to RAS\u00a0<strong>causes decreased consciousness<\/strong>, coma, or even death.<\/li>\n<li>Brain swelling or lesions can compress RAS, impairing consciousness.<\/li>\n<\/ul>\n<h1><strong>Causes of Altered Consciousness<\/strong><\/h1>\n<ul>\n<li><strong>Direct damage<\/strong>:\n<ul>\n<li>Stroke, trauma, tumors, bleeding.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Indirect causes<\/strong>:\n<ul>\n<li><strong>Ischemia<\/strong>\u00a0(lack of oxygen, e.g., myocardial infarction).<\/li>\n<li><strong>Toxins<\/strong>\u00a0(alcohol, drugs, uremia).<\/li>\n<li><strong>Metabolic disturbances<\/strong>:\n<ul>\n<li>Hypoxia, acidosis, hypoglycemia.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Infection<\/strong>\u00a0or\u00a0<strong>inflammation<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Progression to Coma<\/strong><\/h1>\n<ul>\n<li><strong>Early signs<\/strong>:\n<ul>\n<li>Confusion, disorientation, lethargy.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Progression<\/strong>:\n<ul>\n<li>Reduced responsiveness,\u00a0<strong>stupor<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Deep coma<\/strong>:\n<ul>\n<li>Cannot respond to stimuli.<\/li>\n<li>Life-threatening, requires urgent care.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Monitoring and Assessment<\/strong><\/h1>\n<ul>\n<li><strong>Vital signs<\/strong>:\n<ul>\n<li>Heart rate, respiration, blood pressure, temperature.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Reflex testing<\/strong>:\n<ul>\n<li>Pupillary reflex.<\/li>\n<li>Cranial nerve reflexes.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Glasgow Coma Scale (GCS)<\/strong><\/h1>\n<ul>\n<li><strong>Purpose<\/strong>: assesses level of consciousness.<\/li>\n<li><strong>Scores<\/strong>:\n<ul>\n<li>13-15: mild\/no coma.<\/li>\n<li>9-12: moderate impairment.<\/li>\n<li><strong>4-8<\/strong>: coma.<\/li>\n<li><strong>3<\/strong>: deep coma (poor prognosis).<\/li>\n<\/ul>\n<\/li>\n<li>Lower scores indicate worse prognosis.<\/li>\n<li>The longer a person remains in a coma, the worse the prognosis.<\/li>\n<\/ul>\n<h1><strong>Brainstem Reflexes:\u00a0\u00a0<\/strong><\/h1>\n<h1><strong>1.\u00a0 Pupillary Light Reflex<\/strong><\/h1>\n<ul>\n<li>Shine light into eyes.<\/li>\n<li>Pupils should\u00a0<strong>constrict<\/strong>.<\/li>\n<li><strong>Dilatation (&#8220;blown pupils&#8221;)<\/strong>\u00a0indicates\u00a0<strong>brainstem damage<\/strong>.<\/li>\n<\/ul>\n<h1><strong>2.\u00a0 Oculocephalic Reflex (Doll\u2019s eyes)<\/strong><\/h1>\n<ul>\n<li>Turn patient&#8217;s head to the side.<\/li>\n<li><strong>Normal<\/strong>:\n<ul>\n<li>Eyes\u00a0<strong>move<\/strong> opposite to the the direction of head turn.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Abnormal<\/strong>:\n<ul>\n<li>Eyes\u00a0<strong>stay fixed<\/strong>\u00a0(no movement), indicating brainstem impairment.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>3.\u00a0 Oculovestibular Reflex (Caloric Test)<\/strong><\/h1>\n<ul>\n<li>Use warm or cold water (or air) to irrigate ear.<\/li>\n<li><strong>Normal<\/strong>:\n<ul>\n<li>Eyes gaze\u00a0<strong>toward<\/strong> the cold water or <strong>away<\/strong> from the warm water.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Abnormal<\/strong>:\n<ul>\n<li>No eye movement, indicating brainstem damage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>4.\u00a0 Corneal Reflex<\/strong><\/h1>\n<ul>\n<li>Touch cornea with gauze.<\/li>\n<li>Normally, eyeblink occurs.<\/li>\n<li>Absence suggests\u00a0<strong>brainstem or cranial nerve damage<\/strong>.<\/li>\n<\/ul>\n<h1><strong>5.\u00a0 Gag Reflex<\/strong><\/h1>\n<ul>\n<li>Touch the back of the throat.<\/li>\n<li>Normally, the person\u00a0<strong>gags<\/strong>.<\/li>\n<li>Absence indicates neural impairment.<\/li>\n<\/ul>\n<h1><strong>Summary<\/strong><\/h1>\n<ul>\n<li>Reflex tests evaluate\u00a0<strong>brainstem and cranial nerve<\/strong>\u00a0function.<\/li>\n<li>Good prognosis correlates with\u00a0<strong>higher GCS scores<\/strong>\u00a0and intact reflexes.<\/li>\n<li>Deep coma and absence of reflexes suggest\u00a0<strong>brain death<\/strong>\u00a0or severe brainstem injury.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<table class=\"grid landscape\" style=\"height: 572px\">\n<tbody>\n<tr class=\"shaded\" style=\"height: 46px\">\n<td style=\"height: 46px;width: 91.3312px\"><strong>Cranial Nerve<\/strong><\/td>\n<td style=\"height: 46px;width: 119.925px\"><strong>Nerve Name<\/strong><\/td>\n<td style=\"height: 46px;width: 167.737px\"><strong>Mnemonic Memory Trick<\/strong><\/td>\n<td style=\"height: 46px;width: 328.069px\"><strong>Function<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN I<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Olfactory<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Ol<\/strong><\/span>d<\/td>\n<td style=\"height: 30px;width: 328.069px\">Smell<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN II<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Optic<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Op<\/strong><\/span>ie<\/td>\n<td style=\"height: 30px;width: 328.069px\">Vision<\/td>\n<\/tr>\n<tr style=\"height: 90px\">\n<td style=\"height: 90px;width: 91.3312px\"><strong>CN III<\/strong><\/td>\n<td style=\"height: 90px;width: 119.925px\">Oculomotor<\/td>\n<td style=\"height: 90px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Occ<\/strong><\/span>asionally<\/td>\n<td style=\"height: 90px;width: 328.069px\">Eyelid movement<\/p>\n<p>Eye movement<\/p>\n<p>Pupil constriction<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN IV<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Trochlear<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Tr<\/strong><\/span>ies<\/td>\n<td style=\"height: 30px;width: 328.069px\">Eye movement<\/td>\n<\/tr>\n<tr style=\"height: 60px\">\n<td style=\"height: 60px;width: 91.3312px\"><strong>CN V<\/strong><\/td>\n<td style=\"height: 60px;width: 119.925px\">Trigeminal<\/td>\n<td style=\"height: 60px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Tri<\/strong><\/span>gonometry<\/td>\n<td style=\"height: 60px;width: 328.069px\">Facial sensation<\/p>\n<p>Chewing<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN VI<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Abducens<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>A<\/strong><\/span>nd<\/td>\n<td style=\"height: 30px;width: 328.069px\">Eye movement<\/td>\n<\/tr>\n<tr style=\"height: 60px\">\n<td style=\"height: 60px;width: 91.3312px\"><strong>cCN VII<\/strong><\/td>\n<td style=\"height: 60px;width: 119.925px\">Facial<\/td>\n<td style=\"height: 60px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>F<\/strong><\/span>eels<\/td>\n<td style=\"height: 60px;width: 328.069px\">Facial expression, Saliva, Lacrimal glands, Taste<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr style=\"height: 60px\">\n<td style=\"height: 60px;width: 91.3312px\"><strong>CN VIII<\/strong><\/td>\n<td style=\"height: 60px;width: 119.925px\">Vestibulocochlear<\/td>\n<td style=\"height: 60px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Ve<\/strong><\/span>ry<\/td>\n<td style=\"height: 60px;width: 328.069px\">Hearing<\/p>\n<p>Balance<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN IX<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Glossopharyngeal<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Glo<\/strong><\/span>omy<\/td>\n<td style=\"height: 30px;width: 328.069px\">Taste, Swallowing<\/td>\n<\/tr>\n<tr style=\"height: 46px\">\n<td style=\"height: 46px;width: 91.3312px\"><strong>CN X<\/strong><\/td>\n<td style=\"height: 46px;width: 119.925px\">Vagus<\/td>\n<td style=\"height: 46px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Vag<\/strong><\/span>ue<\/td>\n<td style=\"height: 46px;width: 328.069px\">Swallowing, Taste, &amp; PSNS control of visceral organs<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>CN XI<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Accessory<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>A<\/strong><\/span>nd<\/td>\n<td style=\"height: 30px;width: 328.069px\">Shoulder shrug <em>(trapezius<\/em> and <em>sternocleidomastoid)<\/em><\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td style=\"height: 30px;width: 91.3312px\"><strong>\u00a0CNXII<\/strong><\/td>\n<td style=\"height: 30px;width: 119.925px\">Hypoglossal<\/td>\n<td style=\"height: 30px;width: 167.737px\"><span style=\"text-decoration: underline\"><strong>Hypo<\/strong><\/span>active<\/td>\n<td style=\"height: 30px;width: 328.069px\">Tongue movement (speech and swallowing)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"author":1370,"menu_order":11,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5437","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":76,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5437","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":9,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5437\/revisions"}],"predecessor-version":[{"id":5557,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5437\/revisions\/5557"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/76"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5437\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5437"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5437"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5437"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5437"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}