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    Cranial Nerve Examination

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    Althea Aubrey Agbayani
    This document outlines how to examine the 12 cranial nerves. It describes tests to assess each nerve's sensory and motor functions. For each nerve it lists what to examine, such as visual acuity for the optic nerve or shoulder strength for the accessory nerve. The examination involves basic tests like smell identification, eye movement, facial expression and swallowing. The goal is to localize any deficits in cranial nerve function through a standardized bedside assessment.

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    Cranial Nerve Examination

    Uploaded by

    Althea Aubrey Agbayani
    68 views6 pages
    This document outlines how to examine the 12 cranial nerves. It describes tests to assess each nerve's sensory and motor functions. For each nerve it lists what to examine, such as visual acuity for the optic nerve or shoulder strength for the accessory nerve. The examination involves basic tests like smell identification, eye movement, facial expression and swallowing. The goal is to localize any deficits in cranial nerve function through a standardized bedside assessment.

    Original Title

    CRANIAL NERVE EXAMINATION

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    This document outlines how to examine the 12 cranial nerves. It describes tests to assess each nerve's sensory and motor functions. For each nerve it lists what to examine, such as visual acuity for the optic nerve or shoulder strength for the accessory nerve. The examination involves basic tests like smell identification, eye movement, facial expression and swallowing. The goal is to localize any deficits in cranial nerve function through a standardized bedside assessment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    68 views6 pages

    Cranial Nerve Examination

    Uploaded by

    Althea Aubrey Agbayani
    This document outlines how to examine the 12 cranial nerves. It describes tests to assess each nerve's sensory and motor functions. For each nerve it lists what to examine, such as visual acuity for the optic nerve or shoulder strength for the accessory nerve. The examination involves basic tests like smell identification, eye movement, facial expression and swallowing. The goal is to localize any deficits in cranial nerve function through a standardized bedside assessment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 6

    CRANIAL NERVE EXAMINATION

    1. Wash hands and put on gloves. Prepare work


    area.

    Olfactory Nerve
    Responsible for the sense of smell.
    – Check that nasal passages are clear.
    – Ask the patient to close his eyes and shut one
    nostril with a finger.
    – Present a well-known odor and ask the patient to
    sniff and identify them.
    Optic Nerve
    Afferent to the brain, Responsible for the sense of vision.
    Visual Acuity
    -By using Snellen Chart 6 meters away from the patient,
    testing each eye separately, if the patient uses glasses, ask
    them to put them on. Ask the patient to read from top
    down until he can no longer distinguish the letters.
    Visual Field (Confrontation Test)
    Ask the patient to cover one eye and look directly into
    your opposite eye. Shut your other eye the wiggle your
    finger in each of the four quadrants and asks the patient to
    state when the finger is seen.
    Light Reflex(Papillary Reaction)
    Ask the patient to look forward as shine the penlight
    obliquely into each pupil. Pupillary constriction should be
    noted on the eye examined (direct response) and on the
    opposite eye (indirect or consensual response

    Oculomotor Nerve
    Afferent to the brain
    Examination for III, IV and VI nerves
    – Look for: 1. Ptosis 2.Squint (eyes straight forward)
    – Light Reflex (Pupillary Reaction)
    – Accomodation
    – H-Shape and XExam (extraocular Movement

    Trigeminal Nerve
    Sensory: Ipsilateral Face general sensations (touch,
    pressure, temperature, Pain, Vibration)
    Anterior 2/3 of the tongue (general sensations)
    Motor: which supplies Muscles of Mastication
    – Note any Wasting of muscles of mastication.
    – Ask the patient to clench his teeth, then feel the
    masseters & estimate their bulk.
    – Ask the patient to open his jaw against the resistance of
    your hand, and note any deviation.
    2 Reflexes
    1- Corneal Reflex (using a damp cotton wool; lightly
    touching the lateral edge of the cornea while the patient
    looks upwards)
    2- Jaw Jerk or Reflex (ask the patient to let his mouth
    hanging loosely open, place your forefinger in the midline
    between lower lip and chin then percuss finger with a
    hammer and note any reflex (shutting of the jaw),
    normally it is absent

    Sensory: Taste sensation of Anterior 2/3 of the tongue (by


    applying cotton buds on the patient’s tongue dipped in
    Sugar, Salt, Vinegar, Quinine solutions, with rinsing his
    mouth out between each test).
    Motor:
    – Note any asymmetry (whole face, blinking, eye closure)
    or flattening of the nasolabial folds.
    – Ask the pt. to wrinkle the forehead or look up.
    – Ask the pt. to bare his teeth.
    – Ask the pt. to screw his eyes to keep them closed while
    you are trying to open them.
    – Ask the pt. to blow out his cheeks.
    Reflexes:
    – Corneal Reflex
    – Glabellar tap produce blinking in response to the first
    several taps

    Vestibulocochlear Nerve
    – Whispered voice test.
    – Weber’s & Rinne’s Test
    Glossopharyngeal Nerve & X. Vagus Nerve
    Gag Reflex
    Unpleasant test, use the more reliable Water Swallow test
    instead (in fully conscious patients) and observe for
    absent swallow, cough or delayed cough, or change in
    voice quality.
    – Say “Ah”, and look at the movements of the palate &
    uvula.
    – Ask the patient to puff out his cheeks with the lips
    tightly closed and feel for air escaping from their nose

    Accessory Nerve
    – Observe for any shoulder or neck muscle wasting or
    hypertrophy.
    – Shrug Shoulders against resistance.
    – Turn Head against Resistance

    Hypoglossal Nerve
    – Observe for Wasting, fasciculation or involuntary
    movement.
    – Protrude Tongue, and look for any deviation or
    involuntary movement.
    – Move Tongue from side to side
    –
    – Test power, by asking the patient to press his tongue
    against his cheek while you apply pressure from the
    outside
    Assess speech & Swallowing
    13. Document the findings and do handwashing.

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