Cranial Nerve Assessent

Cranial Nerve Mnemonic

Oh, Oh, Oh, To Touch And Feel Alarmingly Good Velvet, AH

Sensory/Motor/Both Mnemonic for Cranial Nerves

Some Say Marry Money But My Mother Says Bad Business Marry Money

Parsympathetic

Oculomotor, Facial, Glossopharyngeal, Vagus

1st "Oh"

Olfactory

2nd "Oh"

Optic

3rd "Oh"

Oculomotor

"To"

Trochlear

"Touch"

Trigeminal

"And"

Abducens

"Feel"

Facial

"Alarmingly"

Acoustic

"Good"

Glossopharyngeal

"Velvet"

Vagus

"A."

Accessory/Spinal

"H."

Hypoglossal

Olfactory #

I

Optic #

II

Oculomotor #

III

Trochlear #

IV

Trigeminal #

V

Abducens #

VI

Facial #

VII

Acoustic #

VIII

Glossopharyngeal #

IX

Vagus #

X

Accessory/Spinal #

XI

Hypoglossal #

XII

Olfactory Assessment

close eyes and compress one nostril to note odors

Optic Assessment

assess visual acuity with chart and pencil to nose

Oculomotor Assessment

observe for eye size, symmetry, and shape of pupils (PERRL)

Trochlear Assessment

eyes can follow H pattern to determine deviation and involuntary movement

Trigeminal Assessment

clenth teeth, palpare temporal and masseter muscles, using sharp and dull tool sides on face, to determine deviation and involuntary movement

Abducens Assessment

eyes can follow H pattern to determine deviation and involuntary movement

Facial Assessment

checking for eyelid droop, can raise eye brows, can smile, and test pt strength by making them open eyes

Acoustic Assessment

occlude one ear for hearing and balance, whispering into ear

Glossopharyngeal Assessment

have patient say "ah" and inspect soft palate and uvula rise symmetrically

Vagus Assessment

have patient say "ah" and inspect soft palate and uvula rise symmetrically along with gag reflex

Accessory/Spinal Assessment

raise shoulders against resistance, face move left/right agaist resistance

Hypoglossal Assessment

stick out tongue and speech articulation

Olfactory Assessment Failure Findings

smell loss indicates head trauma, nasal stiffness, smoking, cocaine use or congenital defect (bilateral); frontal lobe lesion (unilateral)

Optic Assessment Failure Findings

horizontal defect (loss of vision in upper/lower eye), blind eye/bitemporal hernianopsia (loss of vision in outside half of each eye), left or right homonymous hermia opsia (loss of vision in right or left half of both eyes), homonymous quantrantic defect (loss of vision in the same quadrant of both eyes

Oculomotor Assessment Failure Findings

deviations result in problems with CN, ocular muscle or eye orbit that is fractured or imparing on the muscle or nerve; ptosis result of inflammation of CN-III, palsy, or myasthenia

Trochlear Assessment Failure Findings

deviations result in problems with CN, ocular muscle or eye orbit that is fractured or imparing on the muscle or nerve; ptosis result of inflammation of CN-III, palsy, or myasthenia

Trigeminal Assessment Failure Findings

unilateral weakness/inability to contract suggests trigeminal lesion; bilateral dysfunction suggests motor neuron involvement; unilateral loss suggests CN-V lesion

Abducens Assessment Failure Findings

deviations result in problems with CN, ocular muscle or eye orbit that is fractured or imparing on the muscle or nerve; ptosis result of inflammation of CN-III, palsy, or myasthenia

Facial Assessment Failure Findings

unilateral face drooping/paralysis indicates damage to CN-III

Acoustic Assessment Failure Findings

hearing loss suggests air and bone conduction problems; if dizzy when testing for balance with eyes closed there is CN-VIII disfunction

Glossopharyngeal Assessment Failure Findings

hoarseness suggests vocal cord problem; nasal quality suggests palate problem

Vagus Assessment Failure Findings

deviates to a side of a lesion - suggesting vagus nerve is paralyzed; absense of gag reflex suggests lesion on a nerve

Accessory/Spinal Assessment Failure Findings

supine pt with bilateral weakness of sternocleidomastoid will have trouble lifting head

Hypoglossal Assessment Failure Findings

tongue will deviate from a side if CN-XII lesion