Cranial Nerves

Wash Hands Introduce Patients Name Explain Procedure Consent Expose Chest Position sat in chair Inspect Deformities Scaring Swelling Skin Colour Changes s!mmetr! CN I Olfactory Confirm nostrils are clear ssess Smell with smell "ars#$alcohol gel% while closing one nostril CN II Optic Visual Acuity(patient wearing glasses): sk patient to read a Snellen chart Visual Fields: Patient co&ers one e!e Sitting 'pposite Examiners palms in front of each e!e ssess detection of finger mo&ement in ( )uadrants ssess *lind spot si+e with red pin Pupillary Reflexes: Shine light in e!e to asses direct light reflex sses consensual light reflex Swinging ,ight -est ccommodation look at *ack of room then finger. #patient con&erging on finger to create pupil constriction% Colour /ision Ishihara chart 0undoscop! CN III, IV, VI (Occularmotor, Trochlear, Abducens) H1-est CN V Tri eminal 'pen 2outh and resist closure 3rit -eeth 0eel 2assiter and -emporalis Close Pts E!es ssess sensation at each di&ision on *oth sides Corneal 4eflex 5aw 5erk Stick to test touch on ant. 6$7 tongue CN VII ! "acial 0urrow E!e*rows Wrinkle 0orehead Close E!es tightl! and tr! to open Show -eeth 8low out cheeks -aste test ant. 6$7 CN VIII ! Vestibulocochlear Whisper in each ear while co&ering the other 4enne -est Wa*er -est #2iddle of head% CN I# ! $lossopharyn eal CN # Va us Speech for d!sarthria$d!sphonia 2ake patient sa! 9 hh: and look for palate and u&ula mo&ement sk patient to swallow some water -est gag reflex with tongue depressor #onl! in a &er! thorough
exam%

CN #I Accessory Shrug shoulders and maintain position against resistance -urn head to each side and push awa! examiners hand CN #II ! %ypo lossal 'pen pt mouth and o*ser&e tongue for de&iation; wasting or fasiculations Protrude tongue to see de&iation -est power *! pushing against tongue in cheek ssess speech *! asking pt to sa! <!ellow lorr!= Close
2ichael Smith 6>?>

Cranial Nerves
-hank Patient Wash Hands

Overall
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2ichael Smith 6>?>