Cranial Nerve Testing

Question 1

CN III - Oculomotor
CN IV - Trochlear
CN VI - Abducens

Answer 1

Pupillary Reflex: Shine flashlight in 1 of pt’s eyes (swing light from out to in), avoid shining in other eye
Ptosis & Visual tracking: Observe eyes at rest for deviation from midline, eyelids not drooping. Ask pt to follow large H pattern w/out moving head

Question 2

CN V - Trigeminal

Answer 2

Sensory: Assess sensation of upper, middle and lower face using safety pin (sharp/ dull)
Motor: assess muscles of mastication (master, temporals) by palpating muscles as you ask pt to clench teeth repeatedly

Question 3

CN VII - Facial

Answer 3

Muscles of facial expression; raise eyebrows, wrinkle forehead, frown, close eyes tightly, smile, pucker/ whistle

Question 4

CN VIII - Vestibulocochlear

Answer 4

Vestibular division: Head thrust test

Question 5

CN XI - Accessory

Answer 5

Motor to traps and SCM; MMT of upper trap, active head turn to left, PT applies resistance to turn head to the right; tolerates max resistance

Question 6

CN XII - Hypoglossal

Answer 6

Tongue muscles; Ask pt to stick tongue out as far as possible, move tongue from side to side, push against tongue with tongue depressor; equal and symmetrical tongue movement and strength

Question 7

CN II - Optic

Answer 7

Visual Acuity: Reach chart with one eye closed - repeat with other eye
Visual fields: pt looks straight ahead, with one eye covered, focus on examiner’s nose. Examiner tests visual fields by wiggling fingers for peripheral vision