Cranial Nerve Osce

Question 1

General inspection

Answer 1

Muscle wasting
Facial asymmetry
Loss of expression 
Fasiculation
Discomfort

Question 2

Cranial nerve I

Answer 2

Olfactory

Change in smell?

Question 3

Cranial nerve II

Answer 3

Optic

Visual Acuity (Snellen)
Visual Fields (finger wiggle)
Fundoscopy (optic nerveroot consider)
Pupillary response (direct&consensual)
Pupillary response (accommodation/convergence)

Question 4

Cranial nerves III, IV & VI

Answer 4

Occularmotor, trochlear and abducens

Inspect resting gaze position
?ptosis
Test eye movements- finger H
 - ask double vision 
- look nystagmus

Question 5

Cranial nerve V

Answer 5

Trigeminal

Light touch - opthalmic, maxillary and mandibules (sharp as well, ?hot/cold)

Corneal reflex (if indicated) cotton wool in eye

Motor - palpate temple and jaw whilst jaw clenched

Resist Pt moving jaw side to side (pterygoid muscle)

Question 6

VII

Answer 6

Facial nerve

?asymmetry

Raise eyebrows (+resistance)

Screw eyes and resist opening

Toothy smile

Blow cheeks and resist

Whistle smile text

Taste sense

Question 7

VIII

Answer 7

Vestibulocochlear

Whisper hearing test

Otoscopy consider

Rhines test: tuning fork by ear and on mastoid process - ear louder

Weber’s test: tuning fork on top of head - shouldn’t be louder on one side

Question 8

IX and X

Answer 8

Glossopharyngeal and Vagus

Cough (bovine if damaged)

Say ah - soft palate and uvula move equally

Red lorry yellow lorry - lingual tongue

Baby hippopotamus- lips

Gag reflex (if indicated) stérile stick each side

Question 9

XI

Answer 9

Accessory

Shrug shoulders resistance

Turn head resistance

Question 10

XII

Answer 10

Hypoglossal

Fasicualtion in mouth

Stick tongue out - deviation

Move tongue side to side

Tongue in cheek resist