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CN I
- Olfactory
- Sensory - Test Smell
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CN II
- Optic
- Sensory - Visual Acuity (Snellen Chart, should state that this has been previously completed in the lab), visual fields (confrontation test, assesses peripheral vision)
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CN III
- Oculomotor
- *Note - CN III, IV AND VI tested together
- Motor - EOM (Assess CN III, IV and VI together, note nystagmus in 6 cardinal fields of gaze [diagnostic positions test] and perform corneal light reflex, and cover/uncover test); PERRLA (Assess pupils, direct and consensual response to light, and assess accommodation, Pupils Equal Round Reactive to Light and Accomodate)
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CN IV
- Trochlear
- Motor - Inferior medial eye movements [the Superior Oblique muscle] assessed with EOM assessment
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CN V
- Trigeminal
- Sensory - light touch sensation of face (forehead, cheeks, chin) using cotton ball
- Motor - clench teeth and palpate temporal and masseter muscles, try to separate jaws by pushing down on chin, normally cannot separate
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CN VI
- Abducens
- Motor - Lateral eye movements [the Lateral Rectus muscle], assessed with EOM
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CN VII
- Facial
- Sensory - Taste on the anterior 2/3 of the tongue
- Motor - Movement of the forehead and mouth [raise eyebrows, show teeth, smile, puff cheeks, close eyes tightly]
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CN VIII
- Acoustic
- Sensory - Hearing (Whisper test; test one ear at a time, move behind patient and whisper 3 unrelated words; Weber test - check to see if the tone sounds the same in both ears; Rinne test - compare air and bone conduction; place tuning fork on mastoid process and ask patient to signal when sound goes away, then move tuning fork in front of ear canal and have them signal when sound goes away. Normal response is AC > BC; test both ears)
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CN IX
- Glossopharyngeal
- *Note - CN IX , X are tested together
- Motor - Swallowing and phonation (observe uvula rise and fall symmetrically, "Say ahh")
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CN X
- Vagus
- Motor - Swallowing and phonation (Gag reflex - touch posterior pharyngeal wall with a tongue blade, does not have to perform on validation partner, but should be able to describe how to test gag reflex)
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CN XI
- Spinal Accessory
- Motor - Shoulder movement and shrug against resistance and rotate head against resistance (Assesses muscle strength of sternocleidomastoid and trapezius muscles, 5/5 is normal)
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CN XII
- Hypoglossal
- Motor - Tongue movement (protrude tongue)
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