Cranial nerve assessments

  1. I (olfactory)
    • Close one nostril and sniff
    • Close one nostril and have pt smell familiar smell (coffee, vanilla, peppermint, etc.)
  2. II (optic nerve)
    • Visual acuity (read from card or newspaper)
    • Snellen chart (20 ft, left, right, and both eyes)
    • Confrontation test (visual fields, peripheral vision)
  3. III, IV, & VI: (oculomotor, trochlear, & abducens)
    • Positions test (focus on obj at 12 in, move horizontally, vertically and diagonally, observe for weakness, paralysis, nystagmus)
    • PERRLA
  4. V (trigeminal)
    • Clench teeth, palpate temporal and masseter muscles
    • Close eyes, detect wisp of cotton on forehead, cheeks, and chin
    • Corneal reflex (only if abnormal)
  5. VII (facial)
    • Facial symmetry on smile, frown, close eyes, lift eyebrows, puff cheeks, show teeth
    • Sensory: only tested w/ suspected injury
  6. VIII (acoustic)
    • Hearing (normal conversation)
    • Whisper
    • Webber (tuning fork on midline skull, equal or lateralized?)
    • Rinne test (air and bone conduction w/ tuning fork)
  7. IX & X (glossopharyngeal and vagus)
    • Depress tongue, say "aaahh", note midline rise of uvula soft palate
    • Touch throat (gag)
    • Vocal quality
  8. XI (spinal)
    • Equal size of sternomastoid and trapezius muscles
    • Shrug against resistance
    • Turn chin against resistance
  9. XII (hypoglossal)
    • Inspect tongue for wasting or tremors
    • Stick out tongue
    • Push tongue against cheek
    • Say "light, tight, dyanamite"
Card Set
Cranial nerve assessments
methods of assessing cranial nerves