Cranial Nerves

Question 1

What are the tests of the optic nerve?

Answer 1

AFRO

A - Acuity (Snellen)
F - Fields with white pin + inattention
R - Reflexes (visual Light, accommodation, swinging light test)
O - Ophthalmoscopy

Question 2

What is the test for CN III, IV and VI?

Answer 2

H test - testing the muscles of the eyes

Check for double vision!!

Question 3

What are the tests for the trigeminal nerve (CN V)?

Answer 3

Test for sensation on face (V1, V2, V3)

Test the muscle of mastication - masseter, temporalis

NOT NEEDED FOR YR 3 OSCE

Question 4

What are the tests for the facial nerve?

Answer 4

Inspect for signs of weakness

Ask to raise eyebrows

Ask to Close eyes tightly and try to open them

Ask to keep lips tightly shut and try to open them

Ask pt to show teeth

Also - can ask about: change in hearing and change in taste, dry mouth, dry eyes

Question 5

How do you assess the glossopharyngeal and vagus nerves?

Answer 5

Use tongue depressor and torch - Look at uvula

UVULA DEVIATES AWAY FROM SIDE OF LESION

Ask pt to say Aah - check for palate and uvula movement upward

Question 6

How do you assess the spinal accessory nerve?

Answer 6

Ask pt to shrug shoulders and stop you from pushing them down - Trapezius

SCM - ask patient to push cheek against your hand

Question 7

How do you assess the hypoglossal nerve?

Answer 7

Ask patient to stick tongue out

Look for fasciculation, wasting and deviation

Ask patient to wiggle tongue from side to side

Ask the patient to put tongue into cheek and push against cheek

Question 8

What do you look for on general inspection?

Answer 8

General appearance, facial asymmetry, ptosis, swelling, erythema