Cranial Nerve Exam

Cranial Nerve Examination

Table of Contents

• What is Expected from the Candidate
  • Communication and Preparation
  • Olfactory Nerve
  • 2nd Cranial Nerve (Optic Nerve)
  • 3rd, 4th, and 6th Cranial Nerves
  • V (Trigeminal Nerve)
  • VII (Facial Nerve)
  • Conclusion
• Additional Notes
  • Olfactory Nerve
  • Visual Acuity
  • Visual Fields
  • Pupillary Light Reflex
  • Extraocular Movements
  • Cover-Uncover Test
  • Alternate Cover Test
  • Trigeminal Nerve Sensory Testing
  • Trigeminal Nerve Motor Testing
  • Trigeminal Nerve Reflexes
  • Facial Nerve Sensory Testing
  • Facial Nerve Motor Testing
  • Notes

Cranial Nerve Examination

What is Expected from the Candidate

Communication and Preparation

• Demonstrate fluency in using communication skills.
• Explain the procedure and inquire about any background on it.
• Wash hands/use alcohol rub before and after the procedure.

Olfactory Nerve

• Ask the patient if they have noticed any change in their sense of smell lately.

2nd Cranial Nerve (Optic Nerve)

• Visual Acuity:
  • Use the Snellen eye chart.
• Visual Fields:
  • Confrontation test.
• Appropriate Distance:
  • Examination of the patient’s right and left eyes.
• Pupillary Light Reflex:
  • Both direct and consensual for left and right eyes.

3rd, 4th, and 6th Cranial Nerves

• Inspection:
  • Check for ptosis of both eyes.
• Extraocular Movements:
  • Through the six cardinal fields of gaze.
• Cover-Uncover Test.
• Alternate Cover Test.

V (Trigeminal Nerve)

• Sensory:
  • Test for touch/pain for ophthalmic, maxillary, and mandibular branches.
• Motor:
  • Test the power of the muscles of mastication (temporalis, masseter, and pterygoid).
• Reflexes:
  • Jaw jerk and corneal reflex.

VII (Facial Nerve)

• Sensory:
  • Test the anterior two-thirds of the tongue for sensation (taste).
• Motor:
  • Test the power of the facial muscles.

Conclusion

• Share the patient/assessor outcome of the examination.
• Thank the patient and ask if they have any questions.