CN examinations

Question 1

CN I

Answer 1

1. observation of external nose
2. observation in internal nasal passage ( with nasal speculum and the post nasal mirror)
3. check sense of smell by testing each side separately & with a different scent

Question 2

CN II

Answer 2

1. observation of the eyes (limbus-to-lid, limbus-to-canthi)
2. test visual acuity (near or far)
3. test gross visual field (peripheral vision) aka Confrontation
4. pupillary light reflex (may be CN II or CN III) – direct and consensual response to light and accommodation
5. Ophthalmoscopic exam

Question 3

CN III, IV & VI

Answer 3

1. observation of the eyes (limbus-to-lid, limbus-to-canthi)– CN III, IV & VI
2. corneal light reflex (verify any suspicion of ocular malalignment)– CN III, IV & VI
3. pupillary light reflex (may be CN II or CN III) – direct and consensual response to light and accommodation
4. (6) cardinal fields of gaze (watch for nystagmus)- CN III, IV & VI

Question 4

CN V

Answer 4

1. corneal blink reflex
2. light touch sensation on the face
3. sharp sensation on the face
4. inspect muscles of mastication for tone and strength
5. jaw jerk reflex
6. general sensation of the anterior 2/3 of tongue

Question 5

CN VII

Answer 5

1. check musculature of the face (smile, look up, etc.)

2. check taste (anterior 2/3 tongue)

Question 6

CN VIII

Answer 6

1. observation of external ears
2. observation of internal ears
3. rinne test
4. weber test
5. finger rustle test
6. schwabach test
7. watch tick test

Question 7

CN IX & X

Answer 7

1. have pt say ‘Ahhhhh’ (soft palate should elevate)
2. gag reflex (posterior 1/3 tongue)
3. check phonation (K-L-M test, pronounce the sounds kuh, la, mi)

Question 8

CN XI

Answer 8

1. shoulder elevation

2. muscle strength (SCM & trap)

Question 9

CN XII

Answer 9

1. stick out tongue (fasciculation, atrophy, deviation)

2. tongue in cheek test