CSAD 234 Cranial Nerve Exam

for exam 2

cranial nerves usually left out of exam

1, 2, and 8

first two steps of CNE

introduce yourself and ask for consent

materials needed for CNE

penlight, gloves, tongue depressor, sharp and soft object, paper towel

CN 1 (olfactory nerve)

check smell by blocking one nostril and placing a scent in front of the other, then switch sides

CN 2 (optic nerve)

smellen chart, reading and color, pupillary reflex

CN 3, 4, and 6 (occulomotor, trochlear, and abducens nerves)

first tested; move finger in h shape and have patient follow without moving head; use penlight to look for pupillary reflex

CN 5 motor (trigeminal nerve)

opening and closing mouth; opening mouth and not letting examiner close it and vice versa; not letting examiner move tongue depressor between clenched teeth;

CN 5 sensory (trigeminal nerve)

distinguishing between sharp and soft objects when touched on both sides of the face in the three zones (V1, V2, and V3)

CN 7 (facial nerve)

check for asymmetry; raise and lower eyebrows; lower eyebrows and don’t let examiner raise them; pucker lips and smile

CN 7 & 10 (facial nerve and vagus nerve)

fill cheeks with air and don’t let examiner push the air out; pull tongue depressor back in when examiner pulls cheek out with it

CN 8 (vestibulocochlear nerve)

weber and rhine test; whisper abc on one side of ear and cba on the other

CN 9 & 10 (glossopharyngeal nerve and vagus nerve)

saying “ah” 4 times, and then saying one continuous “aah” for 4-5 seconds; coughing into arm (cough reflex); touching back of tongue with tongue depressor (gag reflex)

CN 11 (accessory nerve)

shrug shoulders up and down; raise shoulders and don’t let examiner push them down; look to the left and right; look to the left and right and don’t let examiner pull head forwards

CN 12 (hypoglossal nerve)

stick tongue out and point tip up, down, left, and right; stick tongue into cheek to push it out and don’t let examiner push it in; push tongue out and don’t let examiner push it back in with tongue depressor