Neuro examinations

Question 1

CN 2

Answer 1

Optic:

Visual acuity (each eye), pupil reflex (direct and consensual), accommodation, swinging light test, visual fields, fundoscopy

Question 2

CN 7

Answer 2

Facial:

Raise eyebrows, screw up eyes, blow out cheeks, purse lips, blow out cheeks, close mouth tight.

Any change in sense of taste (anterior 2/3 of tongue)

Question 3

CN 1

Answer 3

Olfactory:

“Have you noticed any change in your sense of smell?”

Question 4

CN 3

Answer 4

Oculomotor:

Question 5

CN 8

Answer 5

Vestibulocochlear: Gross hearing test at 60cm.

Rinne’s and Webber’s if needed.

Can also test balance (vestibular).

Question 6

CN 6

Answer 6

Abducens:

Question 7

CN 11

Answer 7

Accessory:

Shrug shoulders and turn head against resistance.

Question 8

CN 12

Answer 8

Hypoglossal:

Tongue for wasting and fasciculations. Stick tongue out (deviates towards lesion). Power of tongue in cheek.

Question 9

Name the muscles and cranial nerves involved in the following eye movements

Answer 9

Question 10

CN 5

Answer 10

Trigeminal:

Sensation to each side of the face (forehead, cheek, jaw). Feel the bulk of masseter and temporalis bilaterally. Open their mouth against resistance (jaw will deviate to the side of a lesion).

Corneal reflex, Jaw-jerk (rarely done).

Question 11

CN 4

Answer 11

Trochlear:

Question 12

CN 3, 4 and 6

Answer 12

CN 3: Oculomotor.

CN 4: Trochlear.

CN 6: Abducens.

Question 13

CN 9 and CN 10

Answer 13

Glossopharyngeal: Any problems swallowing, gag reflex.

Vagus: Palet - deviation of the uvula (away from a lesion) get patient to say aah to confirm.

Ask the patient to cough