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Cranial Nerve Examination (Inspection (Look for any signs of abnormalities…
Cranial Nerve Examination
Inspection
Look for any signs of abnormalities:
Appearance
Behaviour
Mood
Speech
Facial expressions
1. CNI
(Olfactory)
Ask pt to close eyes
Block one nostril
Smell & describe fragrance
Repeat with other nostril
2. CNII (Optic)
Test VA, one eye at a time
Test VF by confrontation
Accommodation reflex (CNII & III)
Pupillary light reflex/ RAPD (CNII & III)
Fundoscopy
3. CNIII, IV, VI
(Occulomotor, Trochlear, Abducens)
Look for ptosis
Extraocular movements ('H' shape)
Look for:
conjugate eye movement
nystagmus
Ask about diplopia
3. CNV
(Trigeminal)
Sensory
Ask patient to close eyes
Bilateral light touches at 3 divisions
Ask pt to say 'yes' when touch felt
Motor
Ask pt to clench teeth
Palpate masseter & temporalis
Test for movement & strength
4. CNVII
(Facial)
Observe facial symmetry
Ask pt to:
raise eyebrows
close eyes tightly & resistance
scrunch nose
puff out cheeks & resistance
show teeth
5. CNVIII
(Vestibulocochlear)
Whisper/rub test
Weber/Rinne test
6. CNIX, X
(Glossopharyngeal, Vagus)
Say 'Aahh'
Observe uvula symmetry/deviation
Observe swallow ability
7. CNXII
(Hypoglossal)
Ask pt to stick out tongue
Observe for fasciculations
Normal tongue will be midline
Ask to move tongue either side
Stick tongue in cheeks & resistance
8. CNXI
(Accessory)
Shrug shoulders & resistance
Head rotation & resistance