Sports Med - Cranial Nerves

Cranial nerve 1

Olfactory (smell)

Cranial nerve 1 - Assessment

Have patient smell alcohol wipe while closing their eyes

*Test one nostril at a time

Cranial nerve 2

Optic (vision)

Cranial nerve 2 - Assessment

Have patient close one of their eyes and ask how many fingers you’re holding up (*Make sure their head doesn’t move while performing)

Have patient read something close and near

*Preferably Snellen eye chart

Cranial nerve 3

Oculomotor (opening of eyelid, pupillary reaction and size regulation, eye adduction and downward rolling)

Cranial nerve 3 - Assessment

Have patient follow your pointer finger while it moves down (*Make sure their head doesn’t move while performing)

PERRLA (Pupils Equal, Round, Reactive to Light, and Accommodation) (for 2-4 passes)

H pattern (medial/vertical eye movement)

Cranial nerve 4

Trochlear (upward eye movement)

Cranial nerve 4 - Assessment

Have patient follow your pointer finger while it moves up (*Make sure their head doesn’t move while performing)

H pattern (down/lateral eye movement)

Cranial nerve 5

Trigeminal (mastication and face sensation)

Cranial nerve 5 - Assessment

Motor: Have the patient bite down and palpate temporalis and masseter

Sensory: Test sensation with fingers or blunt object over forehead, cheek, and mandible

Cranial nerve 6

Abducens (lateral eye movement)

Cranial nerve 6 - Assessment

Have patient follow your pointer finger while it moves side to side (*Make sure their head doesn’t move while performing)

H pattern (lateral eye movement)

Cranial nerve 7

Facial (facial expression and taste)

Cranial nerve 7 - Assessment

Motor: Raise eyebrows, smile, frown, puff cheeks (essentially any facial expression)

Sensory: Tongue depressor (popsicle stick), taste and identify food

Cranial nerve 8

Vestibularcochlear (hearing and equilibrium)

Cranial nerve 8 - Assessment

Hearing: Have patient close their eyes and snap your fingers, asking them where they hear it (left, right)

Equilibrium: Romberg test (Have patient stand with their feet together and eyes closed; Check for swaying or falling)

Snapping fingers while patient closes their eyes, Weber test

Cranial nerve 9

Glossopharyngeal

Cranial nerve 9 - Assessment

Have patient swallow, then use a tongue depressor (popsicle stick) to touch the back of the patient’s tongue for gag reflex and taste the “wood”

Cranial nerve 10

Vagus

Cranial nerve 10 - Assessment

Have patient say “ahhh”

Swallowing

Cranial nerve 11

Accessory (trapezius and sternocleidomastoid muscle (SCM))

Cranial nerve 11 - Assessment

Resisted shoulder shrugs (traps), resisted head rotation (SCM)

Cranial nerve 12

Hypoglossal (tongue movement)

Cranial nerve 12 - Assessment

Have patient stick out tongue and move it from side to side