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Cranial Nerves Exam

Explore the 12 pairs of cranial nerves and their functions, such as sensory input, muscle control, and organ innervation, with step-by-step procedures to test each nerve's functionality. Includes tests for smell, vision, eye movement, facial sensation, jaw function, auditory acuity, taste, and motor function. Learn how to assess deficiencies in motor function of the palate, pharynx, and larynx, control of trapezius and sternocleidomastoid muscles, and tongue movements. Master the art of conducting a thorough cranial nerves examination.

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Cranial Nerves Exam

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  1. Cranial Nerves Exam

  2. 12 pairs of cranial nerves.

  3. Functions of cranial nerves • 􀂇 Some of these nerves bring information from the sense organs to the brain; • 􀂇 Others control muscles; • 􀂇 Others are connected to glands or internal organs such as the heart and lungs.

  4. The innervation areas of the cranial nerves

  5. [Experimental method & procedure] CN I: Olfactory: smell 1. Ask the subject if he/she has a subjective olfactory problem. 2. Check for rash, deformity of nose.

  6. CN II: Optic: vision • 􀂇 There are two main aspects to this nerve: • 􀂄 1. Examine visual acuity • 􀂄 2. Examine visual fields

  7. CN III, IV, VI: Oculomotor, Trochlear,Abducens • 􀂇 CN III Oculomotor: • 􀂄 Eyelid and eyeball movement • 􀂇 CN IV Trochlear: • 􀂄 Innervates superior oblique • 􀂄 Turns eye downward and laterally • 􀂇 CN VI Abducens: • 􀂄 Turns eye laterally • 􀂇 Cranial Nerves III, IV and VI supply the muscles of eye movement and are tested as a unit.

  8. 1. Appearance of eyes: 2. Eyeball movement: 3. Look at pupils: 4. Test pupillary light reaction: 5. Pupillary reaction to convergenceتقارب and accommodation reflex

  9. CN V: Trigeminal • 􀂇 Functions: - Chewing - Face & mouth touch & pain • 􀂇 1. Facial sensation: • 1) Use sterile sharp item on forehead, cheek and jaw. • 2) If abnormal, then test temperature

  10. 2. Motor: Subject opens mouth, clenches teeth اطبق الاسنان. • 1) Palpate temporal, masseter muscles as they clench. • 2) Subject opens mouth; assess the symmetry of the mouth.

  11. 􀂇 3. Test jaw jerk: • 1) Examiner places finger on tip of jaw. • 2) hold patellar hammer halfway up shaft and tap examiner’s finger lightly. • 3) Usually nothing happens, or just a slight closure.

  12. CN VII: Facial • Functions: controls most facial expressions, secretion of tears & saliva, taste

  13. CN VIII: Vestibulocochlear • 􀂇 Functions: hearing; equilibrium sensation • 􀂇 Auditory acuity 1. Rinne test: 2. Weber test:

  14. CN IX, X: Glossopharyngeal, Vagus • 􀂇 CN IX Glossopharyngeal: • 􀂄 taste • 􀂄 senses carotid blood pressure • 􀂇 CN X Vagus: • 􀂄 senses aortic blood pressure • 􀂄 slows heart rate • 􀂄 stimulates digestive organs • 􀂄 taste

  15. CN IX, X: Glossopharyngeal, Vagus • 􀂇 Some useful tests for detection of deficiencies in motor function of the palate, pharynx, and larynx are . • 1. Palatal Elevation • 2. Gag reflex • 3. Voice Quality • 5. Taste test .

  16. CN XI: Accessory • 􀂇Functions: • Controls trapezius & sternocleidomastoid • Controls swallowing movements

  17. Sternocleidomastoid Trapezius muscle

  18. CN XI: Accessory • 􀂇 1. Sternocleidomastoid • Press a hand against the patient's jaw and have the patient rotate the head against resistance. Pressing against the right jaw tests the left sternocleidomastoid and vice versa. • 􀂇 2. Trapezius • Have the patient shrug shoulders against resistance and assess weakness.

  19. CN XII: Hypoglossal • Function: controls tongue movements 1. Listen to articulation نطق. 2. check tongue in mouth . 3. Protrude tongue: deviates to affected side.

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