Cranial Nerves

Question 1

Cranial Nerve I
Sensory, Motor, or both?
How do you test if it is intact?

Answer 1

Olfactory Nerve
Sensory only
Have the patient close their eyes, and introduce a familiar smell. If they identify it correctly, it is intact.

Question 2

Cranial Nerve II
Sensory, Motor, or both?
How do you check if it is intact?

Answer 2

Optic
Sensory only
Test visual acuity with the Snellen Chart, and Near vision.
Visual fields by confrontation test

Question 3

Cranial Nerve III
Sensory, Motor, or Both?
How do you test if it’s intact?

Answer 3

Oculomotor
Motor
Six cardinal gazes to check for extra-ocular movement.

Question 4

Cranial Nerve IV
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 4

Trochlear
Motor
Six cardinal gazes, check for extra-ocular movement.

Question 5

Cranial Nerve V
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 5

Trigeminal
Both
Facial sensation (sensory) - have patient close their eyes and use a cotton swab on cheeks, chin and forehead, have them identify where you touched.
Muscles mastication (motor)- clench jaw

Question 6

Cranial Nerve VI
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 6

Abducens
Motor
Six cardinal gazes, check for extra-ocular movement

Question 7

Cranial Nerve VII
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 7

Facial
Both
Facial expression (motor)- smile, frown, puff out cheeks, lift eyebrows
Taste (sensory)- anterior 2/3 of tongue, sweet and salty

Question 8

Cranial nerve VIII
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 8

Vestibulocochlear
Sensory
Whisper test
Weber test- hit the tuning fork on the palm of your hand, have the patient close their eyes and place it on the center of their head. Ask where they hear the sound, it should be in both ears.
Rinne test- hit the tuning fork on the palm of your hand, have the patient close their eyes, place the base of the fork on the mastoid bone behind the ear, ask the patient to identify when they stop hearing the sound.
Romberg’s test- Have the patient stand with feet together or shoulder width apart, close their eyes and arms to their sides. Maintain this position for 15-20 seconds without losing balance.

Question 9

Cranial Nerve IX
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 9

Glossopharyngeal
Both
Depress the tongue with a tongue blade, have the person say “ahh”, the soft palate and uvula should rise and tonsil pillars should move medially.

Question 10

Cranial Nerve X
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 10

Vagus
Both
Test the gag reflex

Question 11

Cranial Nerve XI
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 11

Spinal Accessory
Motor
Turn head against resistance, shrug shoulders against resistance.

Question 12

Cranial Nerve XII
Sensory, Motor, or Both?
How to check if it’s intact?

Answer 12

Hypoglossal
Motor
Have them stick their tongue out, should be midline. Have them repeat the phrase: Light, Tight, Dynamite or any words with L,T,D,N. Should be clear and distinct.