Cranial Nerve Assessment

Front 1

CN I OLAFACTORY

Back 1

occlude one nostril and present aromatic substance.
"CN I -intact"

Front 2

CN II OPTIC NERVE

Back 2

Confrontation test -tests peripheral vision -use opthamoloscope to examine ocular fundus.
"visual fields are full by confrontation -CN II intact"

Front 3

CN III OCULARMOTOR

Back 3

EOM's, positions of gaze, opening of eyelids, pupil constriction, shape of lens. Tested with CN IV (TROCHLEAR) and CN IV (ABDUCENS).

Front 4

CN IV TROCHLEAR

Back 4

Down and inward eye movement.
Tested with CN III (OCULARMOTOR) and VI (ABDUCENS).

Front 5

CN VI ABDUCENS

Back 5

Lateral movement of the eye.
Tested with CN III and CN IV.
"corneal light reflex intact bilatteraly, EOM's intact without nystagmus. CN's III, IV, VI intact"

Front 6

CN V TRIGEMINAL

Back 6

Motor: muscles of mastication-- palpate TM muscles as pt clenches teeth. Should be strong/symmetric on both sides. Try to desperate by pulling down on chin. "muscle strenght is strong and symmetric CN V (motor) is intact"
Sensory: sensations of face, scalp cornea, et al.-- use cotton on face with eyes closed. "patient feels sensation CN V (sensory is intact"

Front 7

CN VII Facial

Back 7

motor: facial muscles-- close eyes, speech, close mouth, puff cheeks, smile, frown, show teeth.
sensory: not regularly tested: taste
"symmetry is present, CN VII is present"

Front 8

CN VIII Acoustic

Back 8

Use Whisper, Webber, and Rhinne tests. "CN VIII intact: AC to BC is 2:1 (Rhinne, sound is heard equally in both ears (Webber), patient able to appreciate whispered sounds."

Front 9

CN IX Glossopharyngeal

Back 9

phonation and swallowing -- depress tounge. AHHHH. notepharyngeal movement. Gag reflex. Tested with
CN X (VAGUS)

Front 10

CN X Vagus

Back 10

pharynx and larynx (talking and swallowing) "uvuvla moves midline and upward CN IX and CN X intact".

Front 11

CN XI SPINAL ACCESSORY

Back 11

movement and sternomastoid muscles-- shoulder shrug against resistance. "full range of motion against gravity, full resistance at head, neck, and shoulders, CN XI intact".

Front 12

CN XII HYPOGLOSSAL

Back 12

movement of tongue --inspect tounge. Ask person to say, "light, tight and dynamite" "tongue is symmetrical --CN XII is intact"