Cranial Nerve Examination

Question 1

Asymmetric pupils

Answer 1

Optic, Oculomotor (II, III)

Question 2

Dropping upper eyelid

Answer 2

Oculomotor, III

Question 3

Abnormal eye position

Answer 3

Oculomotor, trochlear, abducens (III,IV, VI)

Question 4

Drooping or asymmetry of facial muscles

Answer 4

VII (Facial)

Question 5

Difficulty with articulating words

Answer 5

V,VII, X, XII

Question 6

Anosia

Answer 6

inability to detect smells

Question 7

Olfactory testing:

Answer 7

patient closes eyes, closes one nostril, then smells coffee or cloves

Question 8

Optic testing:

Answer 8

with one eye covered, patient looks into examiner’s eye; examiner positions finger midway between patient’s eye and examiner’s own eye, just beyond edge of examiner’s own peripheral vision; examiner moves finger slowly toward the visual center until patient reports seeing the finger

Question 9

Oculomotor function:

Answer 9

moves eyes up, down, medially; raises upper eyelid; constricts pupil

Question 10

Oculomotor testing:

Answer 10

ask the patient to look straight ahead; ask the patient to look upward without moving head

Question 11

Function of trochlear:

Answer 11

moves eye medially and down

Question 12

Trochlear testing:

Answer 12

patient’s eye follows examiner finger about 50 degrees adduction, then down

Question 13

Branches of trigeminal

Answer 13

ophthalmic
maxillary
mandibular

Question 14

Testing trigeminal

Answer 14

with eyes closed, use light touch and pin to assess facial sensation in 3 areas: forehead, cheek and chin

Question 15

Abducens function:

Answer 15

abducts eye

Question 16

Testing abducens

Answer 16

patient follows examiner’s finger to look laterally

Question 17

Branches of facial nerve

Answer 17

Temporal
Zygomatic 
Buccal
Mandibular
Cervical

Question 18

Testing facial:

Answer 18

facial movements of smile, puff cheeks, close eyes, wrinkle forehead

Question 19

Conductive Deafness

Answer 19

when transmission of vibrations is prevented in the outer or middle ear. Commonly from excessive wax in the outer ear canal or inflammation of the inner ear

Question 20

Sensorineural Deafness

Answer 20

due to damage of the receptor cells or the cochlear n; less common than conductive deafness. Usually ototoxic drugs, Meniere’s Disease and acoustic neuromas

Question 21

Tinnitis

Answer 21

sensation of ringing, hissing or buzzing sounds

Question 22

Motor function of glossopharyngeal

Answer 22

swallowing

Question 23

Testing glossopharyngeal

Answer 23

touch soft palate with cotton swab (gag reflex)

Question 24

Testing vagus

Answer 24

patient opens mouth and says “ah”, examiner observes soft palate

Question 25

Testing spinal accessory

Answer 25

manual muscle test of SCM and UT

Question 26

Testing hypoglossal

Answer 26

protrude tongue

Question 27

Pupillary: pupil of eye constricts when light is shined into eye

Answer 27

Afferent: optic
Efferent: oculomotor

Question 28

Consensual: pupil of eye constricts when light is shined into other eye

Answer 28

Afferent: optic
Efferent: oculomotor

Question 29

Masseter: when masseter is tapped with a reflex hammer, the muscle contracts

Answer 29

Afferent: Trigeminal
Efferent: Trigeminal

Question 30

Corneal (blink): when the cornea is touched, the eyelids close

Answer 30

Afferent: Trigeminal
Efferent: Facial

Question 31

Accommodation: lens of eye adjusts to focus light on the retina, pupil constricts, and pupils move medially when viewing an object at close range

Answer 31

Afferent: Optic
Efferent: Oculomotor

Question 32

Gag: touching of pharynx elicits contraction of pharyngeal muscles

Answer 32

Afferent: Glossopharyngeal
Efferent: Vagus

Question 33

Swallowing: food touching entrance of pharynx elicits movement of the soft palate and contraction of muscles of the pharynx

Answer 33

Afferent: Glossopharyngeal
Efferent: Vagus