cranial nerve testing cheat sheat

Cranial Nerve Testing Cheat Sheet (I–XII)

CN I – Olfactory (Smell)

  • Function: Sense of smell

  • How to Test:

    • Have client close eyes.

    • Occlude one nostril at a time.

    • Ask client to identify a familiar scent (e.g., coffee, cologne).

  • Normal Finding: Correctly identifies odor in each nostril.

  • Document As: Smell intact bilaterally.

CN II – Optic (Vision)

  • Function: Visual acuity

  • How to Test:

    • Ask client to read printed material at approximately 14 inches.

    • Test each eye separately, then both eyes together.

  • Normal Finding: Able to read with each eye and both eyes.

  • Document As: Vision intact OU (both eyes).

CN III – Oculomotor (Eye Movement & Pupils)

  • Function: Eye movement, pupil reaction, eyelid elevation

  • How to Test:

    • Shine a penlight to check direct and consensual pupillary response.

    • Test accommodation (near to far object).

  • Normal Finding: Pupils equal and round. Constrict to light and near focus.

  • Document As: PEARL (Pupils Equal And Reactive to Light).

CN IV – Trochlear (Eye Movement)

  • Function: Downward and inward eye movement

  • How to Test:

    • Have client follow a penlight through vertical and diagonal movements.

  • Normal Finding: Smooth, coordinated eye tracking with no double vision.

  • Document As: Eye Movement Normal.

CN V – Trigeminal (Face Sensation & Chewing)

  • Function: Facial sensation, corneal reflex, mastication

  • How to Test:

    • Light touch (using cotton) to forehead, cheeks, and jaw.

    • Assess sharp versus dull sensation.

    • Assess hot versus cold sensation.

    • Light touch to lateral sclera (evaluate corneal reflex).

  • Normal Finding: Sensation intact; positive blink (corneal) reflex.

  • Document As: Facial sensation intact, corneal reflex present.

CN VI – Abducens (Eye Abduction)

  • Function: Lateral eye movement

  • How to Test:

    • Have client follow a penlight through the six cardinal fields of gaze.

  • Normal Finding: Eyes move together without nystagmus (eye twitch).

  • Document As: Eye movement normal with no nystagmus present.

CN VII – Facial (Facial Expression & Taste)

  • Function: Facial movement, taste (anterior two-thirds of the tongue)

  • How to Test:

    • Ask client to smile, frown, raise eyebrows, puff cheeks, close eyes tightly. (Optional: Taste identification).

  • Normal Finding: Symmetrical facial movements; taste intact.

  • Document As: Facial movements symmetrical.

CN VIII – Vestibulocochlear (Hearing & Balance)

  • Function: Hearing and equilibrium

  • How to Test:

    • Stand behind the patient with their eyes closed.

    • Snap fingers on the right and left sides.

    • Observe gait and balance (Optional: Weber & Rinne tests).

  • Normal Finding: Hears sounds bilaterally; maintains steady gait and balance.

  • Document As: Hearing intact, balance normal.

CN IX – Glossopharyngeal (Swallow & Gag)

  • Function: Swallowing, palate elevation, gag reflex

  • How to Test:

    • Ask client to say "ah" and then swallow.

  • Normal Finding: Palate rises symmetrically.

  • Document As: Swallowing intact.

CN X – Vagus (Voice & Swallowing)

  • Function: Speech, swallowing, autonomic control

  • How to Test:

    • Ask client to speak (assess high pitch tone and low pitch tone).

  • Normal Finding: Clear speech.

  • Document As: Voice clear.

CN XI – Accessory (Head & Shoulder Movement)

  • Function: Shoulder shrug, head rotation

  • How to Test:

    • Shrug shoulders against resistance.

    • Turn head against resistance (Optional test).

  • Normal Finding: Strong, symmetrical movement.

  • Document As: Strength intact bilaterally.

CN XII – Hypoglossal (Tongue Movement)

  • Function: Tongue movement and speech

  • How to Test:

    • Ask client to stick out tongue.

    • Move tongue side to side.

  • Normal Finding: Tongue midline, moves freely.

  • Document As: Tongue movement intact.