Site Map	Examine the Cranial Nerves

• Introduce yourself and check the patient's identity
• Establish rapport with patient
• Explain examination & ask permission to examine
• General inspection of face

Olfactory - I

• Ask about changes to smell and taste

Eyes - II,III & VI

• Test visual acuity and colour vision
  • Snellen chart
  • Ishihara plates
• Test visual fields by confrontation
  • Assess blind spot
  • Test for visual neglect
• Test pupillary responces
  • Light (direct and consenstual)
  • Accommodation reflex
• Use a light to test for a squint
• Perform fundocopy
  • Examine disk
  • Examine retina
• Test eye movements
  • Ask about diplopia
  • Look for nystagmus

Trigeminal - V

• Sensory
  • Test light touch in all three divisions
  • Test corneal reflex
• Motor
  • Palpate muscles of mastication with teeth clenched
    • Temporalis
    • Masseter
  • Open & shut mouth against resistance
• Test jaw jerk

Facial - VII

• Look for facial asymmetry, particularly
  • Nasolabial folds
  • Angle of the mouth
• Motor
  • Test the muscles of facial expression
  • Motor fibres to stapedius (unusually loud sounds)
• Sensory
  • Anterior 2/3rds of the tongue via the chorda tympani

Vestibulocochlear - VIII

• Test hearing
  • Wispered words with a distraction in the opposite ear
  • Tuning fork tests
    • Rinne & Webber
    • Use a 512Hz fork
• Test for nystagmus and balance
  • Romberg's test

Glossopharyngeal - IX
Vagus - X
Hypoglossal - XII

• Ask about swallowing
• Using a light observe the soft palate and uvula during phonation
  • Listen for changes in vocal quality
• Inspect the tongue for
  • Wasting
  • Fasiculation
• Assess tongue movement
• Test gag reflex

Accessory - XI

• Look for wasting of the SCM and trapezius muscles
• Ask the patient to
  • Shrug their shoulders against resistance
  • Turn their head to either side against resistance

• Acknowlede patients concerns
• Encourage questions from patient & deal with them appropriately
• Appropriate summary & analysis of findings

Cranial Nerve Pathology