Cranial Nerve testing

Question 1

Olfactory Nerve

Answer 1

Smell- have two different smells ready, smell them yourself before making the patient smell. Test one nostril at a time making sure the other one is closed.

Question 2

Optic Nerve

Answer 2

Test vision (glasses on if required)- read letters from a chart, with one eye closed. Move hand into peripheral vision.

Question 3

Oculomotor

Answer 3

Form H with hands and ask patient to follow. One eye closed then together.
Approach the eye with a pen light.

Question 4

Trochlear

Answer 4

Form X and H with hands and ask patient to follow. One eye closed then together.

Question 5

Trigeminal

Answer 5

Eyes closed- touch forehead, cheek and chin with cotton wool.
Tell patient to clench their teeth and feel for the muscle near the forehead and the jaw.
Open mouth and resist closing.

Question 6

Abducens

Answer 6

Form H with hands and ask patient to follow. One eye closed then together.

Question 7

Facial

Answer 7

Make facial expressions- blow out cheeks, raise eyebrows, purse lips, screw the eyelids shut.
Taste in the anterior 2/3 of the tongue.
Has the patient had dry eyes or mouth?

Question 8

Vestibulocochlear

Answer 8

Mask one ear and whisper into the other.
Tuning fork on the mastoid process and ask if they can hear, when they can no longer hear put it in front of their ear. Press the tuning fork on their forehead.
Balance- walk in a straight line with eyes closed.

Question 9

Glossopharyngeal

Answer 9

Taste in the posterior 1/3 of the tongue. Swallowing. Do they have dryness of mouth?

Question 10

Vagus

Answer 10

Speech? Gut motility/heart racing.

Question 11

Spinal Accessory

Answer 11

Shrug shoulders then ask to shrug against resistance. Turn head against resistance. Swallow

Question 12

Hypoglossal

Answer 12

Protrude out the tongue and move side to side. Assess the strength of the tongue by pushing against the cheek.