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Cranial nerve assessment

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  1. Cranial nerve assessment Learn the 12 cranial nerves & function

  2. I olfactory • Controls sense of smell • close both eyes, close one nostril, • gently inhale to smell the scent • Determine the aroma

  3. II optic • Controls centraland peripheral vision • Test central vision by reading the eye chart • Test peripheral vision by moving your index fingers to check the superior and inferior fields with 1 eye closed (make a box & letter “H”)

  4. IIioculomotor • controls pupillary constriction • bring the light of the penlight from the outside periphery to the center of each eye, and note the response • Also, check where the eyelid falls on the pupil

  5. Iv trochlear • acts as a pulley to move the eyes down—toward the tip of the nose • instruct the patient to follow your finger while you move it down toward his nose without moving their head

  6. v trigeminal • covers most of the face • If a patient has a problem with this nerve, it usually involves the forehead, cheek, or jaw (trigeminal) • Facial sensation-touch side of face with cotton ball – look for blink/ask if sensed • Test the motor function – open mouth, clinch teeth --->palpate masseter muscle

  7. vi abducens • controls eye movement to the sides • With your finger, make a big X in the air and then draw a horizontal line across it. • Observe the patient for twitching of the eye

  8. vii facial • controls facial movements and expression • Test: wrinkle his forehead, close eyes, smile, pucker lips, show teeth, and puff out cheeks • Both sides of the face should move the same way

  9. viii acoustic • located in the ears, controls hearing • Check hearing by rubbing your fingers together by each ear (about 12” away) • Repeat with intensity

  10. Ix & x glossopharyngeal & vagus • which innervate the tongue and throat (pharynx and larynx), are checked together • GP - Swallow and say “AHHHHH” • Vagus– use tongue depressor to stimulate “gag” reflex

  11. xi spinal accessory • controls neck and shoulder movement • raise shoulders against your hands to assess the trapezius muscle • turn head against your hand to assess the sternocleidomastoid muscle

  12. xii hypoglossal • innervates the tongue • stick out tongue. It should be in the midline • Apply tongue depressor to test resistance of the tongue

  13. Cranial nerves by #’s