● Ask the patient to closed eyes
CRANIAL NERVE ASSESSMENT ● Using test tubes with hot and cold water
● Put to patient forehead , cheeks and chin
# NAME COMPONENT FUNCTION
Neuralgia: Pain upon touching face
I Olfactory Se- Afferent Smell
MOTOR
Instrument: Non-noxious odors Mastication
● Lemon, coffee, cloves or tobacco. ● Palpate Masseter and Temporalis
Procedure: ● Ask patient to mimic chewing
● Evaluate the patency of the nasal passages bilaterally by
asking the patient to breath in through their nose while VI Abducens Mo- Efferent Eye Movement -
the examiner occludes one nostril at a time. Outward rotation
● Once patency is established, ask the patient to close
Instrument: Penlight
their eyes.
Procedure:
● Occlude one nostril, and place a small bar of soap near ● Same as cranial nerve 3
the patent nostril and ask the patient to smell the object
and report what it is. Note: Can do one test to save time
● Making certain the patient's eyes remain closed.
● Switch nostrils and repeat. VII Facial Mixed Sensory- Taste ant.
● Furthermore, ask the patient to compare the strength Tongue
of the smell in each nostril.
Motor- Facial
Expression
II Optic Se- Afferent Vision
Instrument: Bubble Gum
Perform this part of the examination in a well lit room and Procedure:
make certain that if the patient wears glasses, they are wearing Sensory
them during the exam. ● Let the patient taste the gum
Instrument: Snellen Chart , Alternative Chart (Bond Paper with Motor
written words) , Pen Light ● Check the facial expression
Procedure: ● Ask the patient to:
Visual Acuity ○ Raise eyebrows (Occipito Frontalis)
● Hold the chart 14 inches from the patient's face ○ Frown (Corrugator Supercilli)
● Ask the patient to cover one of their eyes completely ○ Wrinkling of nose (Procerus and Nasalis)
with their hand and read the lowest line on the chart ○ Smile and show top teeth (Zygomaticus Major)
possible. ○ Pout (Orbicularis Oris)
● Have them repeat the test covering the opposite eye. ○ Compression of cheek (Buccinators)
● If the patient has difficulty reading a selected line, ask
them to read the one above. VIII Vestibulocochlear Se- Afferent Hearing and Balance
● Note the visual acuity for each eye.
● Distant vision is tested by asking the patient to read the
Instrument: Tuning Fork
Snellen chart at a distance of 20 feet.
Procedure:
● Assess hearing by instructing the patient to close their
Pupillary Light Response
eyes and to say "left" or "right" when a sound is heard in
● Put light on eyeball in mid distance
the respective ear.
● Observe for constriction and dilation
● Vigorously rub your fingers together very near to, yet
not touching, each ear and wait for the patient to
III Oculomotor Mo- Efferent Eye Movement - respond.
Up/Down ● After this test, ask the patient if the sound was the same
in both ears, or louder in a specific ear.
Instrument: Pen Light ● If there is lateralization of hearing abnormalities perform
Procedure: the Rinne and Weber tests using the 256 Hz tuning fork.
Movement
● Make sure that the patient is in steady position Weber’s Test
● Ask the patient to follow the pen light ● Lateralization
● Move the penlight horizontally ● Wrap the tuning fork strongly on your palm
● Press the butt of the instrument on the top of the
Accommodation patient's head in the midline
● Check for the constriction and dilation of pupils by ● Ask the patient where they hear the sound
● Moving the penlight closer to the eye (constriction)
away to the eye (dilation) Rinne’s Test
● Air Conduction to Bone Conduction
Note: Can do in one eye to prevent crossing of eyes ● Wrap the tuning fork firmly on your palm
● Place the butt on the mastoid eminence firmly.
IV Trochlear Mo- Efferent Eye Movement - Inward
rotation Air Conduction: Near the ear
Bone Conduction: Mastoid eminence
Instrument: Pen Light
Procedure: Result:
● Make sure that the patient is in steady position Air Conduction > Bone Conduction = Sensorineural
● Ask the patient to follow the pen light Bone Conduction > Air Conduction = Conductive Hearing Loss
● Move the penlight downward and inward (L)
IX Glossopharyngeal Mixed Sensory- Taste post.
V Trigeminal Mixed Sensory- Face Tongue
Motor- Mastication Motor- Salivation
Instrument: Cotton Buds , Cotton , Sharp end or Pin , Test Tubes Procedure:
Procedure: ● Ask the patient to say “AH”
Corneal Reflex ○ Observe ovula
● Ask the patient to look up without moving the head ● Ask the patient to swallow
● Using cotton buds , touch the sclera (white part of the ○ Gag Reflex
eye)
● Patient should blink X Vagus Mixed Sensory- Thoracic and
Abdominal
CRANIAL NERVE ASSESSMENT ● Using test tubes with hot and cold water
● Put to patient forehead , cheeks and chin
# NAME COMPONENT FUNCTION
Neuralgia: Pain upon touching face
I Olfactory Se- Afferent Smell
MOTOR
Instrument: Non-noxious odors Mastication
● Lemon, coffee, cloves or tobacco. ● Palpate Masseter and Temporalis
Procedure: ● Ask patient to mimic chewing
● Evaluate the patency of the nasal passages bilaterally by
asking the patient to breath in through their nose while VI Abducens Mo- Efferent Eye Movement -
the examiner occludes one nostril at a time. Outward rotation
● Once patency is established, ask the patient to close
Instrument: Penlight
their eyes.
Procedure:
● Occlude one nostril, and place a small bar of soap near ● Same as cranial nerve 3
the patent nostril and ask the patient to smell the object
and report what it is. Note: Can do one test to save time
● Making certain the patient's eyes remain closed.
● Switch nostrils and repeat. VII Facial Mixed Sensory- Taste ant.
● Furthermore, ask the patient to compare the strength Tongue
of the smell in each nostril.
Motor- Facial
Expression
II Optic Se- Afferent Vision
Instrument: Bubble Gum
Perform this part of the examination in a well lit room and Procedure:
make certain that if the patient wears glasses, they are wearing Sensory
them during the exam. ● Let the patient taste the gum
Instrument: Snellen Chart , Alternative Chart (Bond Paper with Motor
written words) , Pen Light ● Check the facial expression
Procedure: ● Ask the patient to:
Visual Acuity ○ Raise eyebrows (Occipito Frontalis)
● Hold the chart 14 inches from the patient's face ○ Frown (Corrugator Supercilli)
● Ask the patient to cover one of their eyes completely ○ Wrinkling of nose (Procerus and Nasalis)
with their hand and read the lowest line on the chart ○ Smile and show top teeth (Zygomaticus Major)
possible. ○ Pout (Orbicularis Oris)
● Have them repeat the test covering the opposite eye. ○ Compression of cheek (Buccinators)
● If the patient has difficulty reading a selected line, ask
them to read the one above. VIII Vestibulocochlear Se- Afferent Hearing and Balance
● Note the visual acuity for each eye.
● Distant vision is tested by asking the patient to read the
Instrument: Tuning Fork
Snellen chart at a distance of 20 feet.
Procedure:
● Assess hearing by instructing the patient to close their
Pupillary Light Response
eyes and to say "left" or "right" when a sound is heard in
● Put light on eyeball in mid distance
the respective ear.
● Observe for constriction and dilation
● Vigorously rub your fingers together very near to, yet
not touching, each ear and wait for the patient to
III Oculomotor Mo- Efferent Eye Movement - respond.
Up/Down ● After this test, ask the patient if the sound was the same
in both ears, or louder in a specific ear.
Instrument: Pen Light ● If there is lateralization of hearing abnormalities perform
Procedure: the Rinne and Weber tests using the 256 Hz tuning fork.
Movement
● Make sure that the patient is in steady position Weber’s Test
● Ask the patient to follow the pen light ● Lateralization
● Move the penlight horizontally ● Wrap the tuning fork strongly on your palm
● Press the butt of the instrument on the top of the
Accommodation patient's head in the midline
● Check for the constriction and dilation of pupils by ● Ask the patient where they hear the sound
● Moving the penlight closer to the eye (constriction)
away to the eye (dilation) Rinne’s Test
● Air Conduction to Bone Conduction
Note: Can do in one eye to prevent crossing of eyes ● Wrap the tuning fork firmly on your palm
● Place the butt on the mastoid eminence firmly.
IV Trochlear Mo- Efferent Eye Movement - Inward
rotation Air Conduction: Near the ear
Bone Conduction: Mastoid eminence
Instrument: Pen Light
Procedure: Result:
● Make sure that the patient is in steady position Air Conduction > Bone Conduction = Sensorineural
● Ask the patient to follow the pen light Bone Conduction > Air Conduction = Conductive Hearing Loss
● Move the penlight downward and inward (L)
IX Glossopharyngeal Mixed Sensory- Taste post.
V Trigeminal Mixed Sensory- Face Tongue
Motor- Mastication Motor- Salivation
Instrument: Cotton Buds , Cotton , Sharp end or Pin , Test Tubes Procedure:
Procedure: ● Ask the patient to say “AH”
Corneal Reflex ○ Observe ovula
● Ask the patient to look up without moving the head ● Ask the patient to swallow
● Using cotton buds , touch the sclera (white part of the ○ Gag Reflex
eye)
● Patient should blink X Vagus Mixed Sensory- Thoracic and
Abdominal
