Clinica Skills : Cranial Nerve Exam.

Question 1

What is cranial nerve 1?

Answer 1

Olfactory 👃

Question 2

What is cranial nerve 2?

Answer 2

Optic 👁️

Question 3

What is cranial nerve 3?

Answer 3

Oculomotor 👀

Question 4

What is cranial nerve 4?

Answer 4

Trochear 👀

Question 5

What is cranial nerve 5?

Answer 5

Trigeminal 😉

Question 6

What is cranial nerve 6?

Answer 6

Abducens 👀

Question 7

What is cranial nerve 7?

Answer 7

Facial 😖

Question 8

What is cranial nerve 8?

Answer 8

Vestibulocochlear 👂

Question 9

What is cranial nerve 9?

Answer 9

Glossopharyngeal 🥤

Question 10

What is cranial nerve 10?

Answer 10

Vagus ⛓️‍💥

Question 11

What is cranial nerve 11?

Answer 11

Accessory 🫸🏾👩🏾

Question 12

What is cranial nerve 12?

Answer 12

Hypoglossal nerve 😛

Question 13

How do we test for cranial nerve 1?

Answer 13

• olfactory nerve 👃
• ask the patient if they have had any changes to their sense of smell
• even if they say no - give them a strong smelling substance to smell

Question 14

How do we test cranial nerve two?

Answer 14

• optic nerve 👁️
• first - inspect the eyes for size, shape and symmetry
  Ask the patient if they wear glasses or contacts and ask that they put them on 🤓

Assess the patients visual acuity -> from a 6m distance ask the patient to read the lowest letters they can see from the Snellen chart

Assess visual fields - ask the px to cover one of their eyes, and cover the same eye. Ask the patient to focus on one point of your face ie nose and ask they dont look away or move their head. Tell the px you are going to wiggle your fingers and let me know when they start to see the finger moving.
- assess on both eyes and make sure you cover the same eye too

Assess visual inattention
- ask the px to focus on one point of your face again
- hold hands out laterally and ask the px to point at which hand is waggling/moving
- do both hands at the end simultaneously to see if they can correctly identify this

Assess reflexes
- accommodation reflex - ask the patient to focus on a far away object and then hold the pen towards their nose and ask then to focus on that —> the Px pupils should constrict and converge bilaterally
- pupillary light reflex - ask the patient to put their hand in between their eyes and ask them to focus on a didstant point. Shine the light into the eye and observe for consensual and direct pupillary constriction. Also look at the other eye too see if it also constricts and converges - it should
- consensual response - do the swinging light test - the patient does not need to put their hand between their eyes. The consensual response is easily assessed by swinging the light between both eyes and ask - the pupils should constrict and dilate appropriately. If the pupil dilates when the light is shone in it instead of constricting, it is less sensitive to light and this is a cause for concern.

Fundoscopy

Question 15

How do we assess for CN3,4 and 6?

Answer 15

These are the oculomotor, trochlear and abducens nerves - those responsible for eye movements.