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Simple Tests For Cranial Nerves


The Twelve Cranial Nerves

I Olfactory
-Smell (Sensory)
To test: Have subject close eyes. Place orange in front of nose & ask subject to identify the smell. *Do NOT use ammonia.
Frontal lobe damage may cause an inability to smell or anosmia.

II Optic
-Vision (Sensory)
To test: Have subject read letters on a board. Also check peripheral vision by having subject look at your nose while you, the tester, takes a small object and moves it through subject's peripheral vision along side of head. Have subject identify when the object disappears in their peripheral vision. Repeat on other side.

III Oculomotor
-Messages to innervated muscles (Sensory)
Raises upper eyelid, turns eye up, down, & towards the nose, constricts pupil, accommodates eyes (Motor)
To test: Have subject follow your finger with his eyes as you move your finger in an "H" pattern so that subject must watch your finger move up, down, & sideways in & out.

IV Trochlear
-Messages to innervated muscles (Sensory)
-Eyeball movement turning eye downward & laterally to the side (Motor)
To test: Have subject follow your finger in an "L" pattern down in front of the bridge of subject's nose & then outward towards lower cheek.

V Trigeminal
Three Divisions
1. Opthalmic
-Sensation of cornea, skin of forehead, scalp, eyelids, nose, & mucous membranes of the paranasal sinuses & nasal cavity (Sensory)
2.Maxillary
-Sensation of skin over maxilla, upper teeth & jaw, mucous membrane of nose, maxillary sinus, & palate (Sensory)
3.Mandibular
-Muscles of mastication (Motor)
-Sensation of skin over cheek, lower teeth & jaw, TMJ, and anterior tongue (Sensory)
To test: Place stimulus close to eye to test blink response. Have subject clench teeth and palpate masseter muscle size.

VI Abducens
-Lateral eye movement (Motor)
To test: Have subject follow object with his eyes as it moves from side to side

VII Facial
-Taste from anterior 2/3 of tongue, lacrimal gland (Sensory)
-Muscles of facial expression; stapedius (Motor)
To test: Have subject smile. Have subject identify taste on anterior 2/3 of tongue.

VIII Vestibulocochlear (Auditory)
-Position & movement of head, balance & equilibrium, hearing (cochlear)(Sensory)
To test: Test subject's ability to hear a whisper behind ear. Test balance standing with eyes open & closed with feet together.

IX Glossopharyngeal
-Taste of posterior 1/3 of tongue (Sensory)
-Swallowing (Motor)
To test: Test GAG reflex

X Vagus
-Sensation from larynx, pharynx, esophagus, trachea, heart, & other thoracic abdominal organs, & smooth muscle of the heart; carotid & aortic bodies (Sensory)
-Movement of several organs (Motor)
To test: Have subject speak. Is the sound of their voice clear?

XI Spinal Accessory
-Messages of innervated neck & shoulder muscles; pharynx & larynx with CN X (Sensory)
-Shoulder & head movement; SCM & trapezius (Motor)
To test: Have subject rotate head right & left. Have subject elevate both shoulders.

XII Hypoglossal
-Messages of tongue innervation (Sensory)
-Tongue movements (Motor)
To test: Have subject stick out tongue & look for any deviations. Tongue always deviates towards the side of injury.

Cranial nerve facts
Cranial nerves I, III, & VIII are sensory only
The nuclei of CN III - XII are located in the brainstem
CN V is the largest cranial nerve & its cell bodies are located in the midbrain
*Tip to remember the CN's & in order:
On Old Olympus Towering Tops A Finn And German Vaulted and Hopped


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