Cranial Nerve Examination

Last updated 03.11.12













Rapid Assessment of Cranial Nerves







Olfactory Nerve (CNI)



Olfactory Nerve

-  Not routinely tested

-  Anosmia

-  Usually presents as loss of taste

-  Check individually




Cranial Nerves II, III, IV & VI (2,3,4,6)



Optic, Occulomotor, Trochlear, Abducens Nerves

-  See Eye Exam




Trigeminal Nerve (CNV)



Trigeminal Nerve

-  Corneal reflex

-  Divisions

-  Opthalmic (V1)

-  Maxillary (V2)

-  Mandibular (V3)

-  Facial sensation (V1, V2, V3)

-  Pain: trigeminal neuralgia

-  Muscles of mastication (power)

-  Jaw Jerk

-   Patient to relax jaw w mouth slightly open

-   Place your thumb on point of pts chin

-   Tap your thumb

-   Normal = twitch of masseter or jaw closure, sometimes absent


Trigeminal Sensation




Cranial Nerve VII (7)




- Facial expression: raise eyebrows, close eyes, puff cheeks, smile

-  UMN: lower face effected, upper spared

-  Bells Palsy (LMN): facial hemiparesis

-  Hyperacusis

-  Taste ant. 2/3


Facial Nerve



Cranial Nerve VIII (8)



Vestibulocochlear Nerve

-  Vestibular --> Hallpike manouvre, balance

-  Cochlear --> see Ear Exam


Hallpike Manouvre

-  Turn patients head 45o to side, then whilst supporting the head raplidly pace the head in the hanging position

-  Positive if nystagmus & vertigo to stimulated side

-  Should improve within 30-60 seconds

-  Indicates vestibular dysfunction: BPPV




Cranial Nerve IX (9)



Glossopharyngeal Nerve

- Taste post. 1/3 tongue

- Gag reflex




Cranial Nerve X (10)



Vagus Nerve

- ahhhhh (uvula), dysphonia, dysphagia

- Palatal movement

- Gag reflex





Cranial Nerve XI (11)



Accessory Nerve

- Shrug shoulders: trapezius

- Laterally rotate head: SCM




Cranial Nerve XII (12)



Hypoglossal Nerve

- Tongue protrusion (deviates to effected side)

- UMN: bilateral effect

- LMN: unilateral effect