Examination Of Cranial Nerves

Examination Of Cranial Nerves

The Olfactory Nerve

Test The Smell Sensation With Common Bedside Substances Such As Soap, Toothpaste Etc. Present These Substances To Each Nostril Separately And Ask The Patient To Name Them.  

The Optic Nerve

Visual Acuity –

Distance Vision: Snellen’s Chart (6 Meters)

cranial-nerve-examination

Near Vision: Jaeger’s Chart (65 Centimetres)

Field Of Vision: Moving Finger

Test Colour Vision: Ishihara Chart  

The Oculomotor Nerve

Eye Movements Eyelid Movement Pupil  – Size Symmetry Reactions(Direct & Consensual Light Reflexes, Accommodation Reflex)  

The Trochlear Nerve

Eye Movements  

The Trigeminal Nerve

Sensory Functions Sensations To Face Corneal Reflex Motor Function By Testing The Muscles Of Mastication – Ask The Patient To Clinch Their Teeth While You Palpate Both Masseter Muscles Above The Angles Of The Jaw And Then While You Palpate Both Temporalis Muscle Over Temples. Test The Pterygoid Muscles By Forceful Opening Of The Jaw Against Resistance Jaw Jerk – Is A Vth Nerve Stretch Reflex  

The Abducens Nerve

Eye Movements  

The Facial Nerve

Facial Symmetry & Movements –

  • Frontalis – Ask The Patient To Raise Their Eyebrows While You Look  For Asymmetry Of The Forehead Skin Creases.
  • Orbicularis Oculi – Ask The Patient To Close Their Eyes While You Try To Prevent This With Your Finger And Thumb.
  • Orbicularis Oris – Ask The Patient To Purse The Lips Shut And Stop You From Opening Them.    

Assessment Of Taste – Test The Sense Of Taste Using Strong Solutions Of Sugar And Common Salt, And Weak solution of Citric Acid And Quinine, As Tests Of ‘Sweet’, ‘Salt’, ‘Sour’, And ‘Bitter’  Respectively.  

The Vestibulocochlear Nerve

Assessment Of Hearing – Whisper To Each Ear Tuning Fork Tests ( Rinne & Weber) Assessment Of Vertigo  

The Glossopharyngeal Nerve

Taste Sensation Of  Posterior 1/3rd Of The Tongue Pharyngeal Or Gag Reflex (Sensory / Afferent)  

The Vagus Nerve

Pharyngeal Or Gag Reflex (Motor / Efferent) Palatal Elevation – Ask The Patient To Open Mouth And Say ‘Aah’.  

The Accessory Nerve

Upper Trapezius Muscle Fibre – Ask The Patient To Shrug (Elevate) Their Shoulders While You Press Downward On Them.     Sternomastoid Ask The Patient To Turn The Head While You Resist With A Hand On The Side Of Face: Note Contraction Of The Activated Sternomastoid Muscle On The Side Opposite To The Direction Of Movement.  

The Hypoglossal Nerve

Any Wasting, Fasciculation Or Note Tremor Of The Tongue. Ask The Patient To Put Out Their Tongue As Far As Possible    – With A Unilateral Hypoglossal Lesion The Tongue Is Protruded More On The Normal Side, So That It Deviates Towards The Paralysed Side Instead Of Being Straight.

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