The 12 cranial nerves in order

1) Olfactory

2) Optic

3) Oculomotor

4) Trochlear

5) Trigeminal

6) Abducens

7) Facial

8) Acoustic

9) Glossopharyngeal

10) Vagus

11) Accessory

12) Hypoglossal

Olfactory

(1)

Smell

Identify a familiar scent

Optic

(2)

Vision

Read one eye at a time; test visual fields by having patient focus on my nose and identify # of fingers held up in all four quadrants

Oculomotor

(3)

eyeball and eyelid movement; lens shape

check pupillary responses by shining a light in one both should constrict; repeat on other pupil.  Check accomodation, move penlight toward patients nose pupils should constrict and converge.  Check EOM's by having patient look up, down, laterally and diagonally

Trochlear

(4)

Eyeball movement; proprioception

Have patient look down and in.

Trigeminal

(5)

sense of touch/pain of facial skin, nose, mouth, teeth and tongue; proprioception motor control of chewing

Have patient open and move mouth horizontally against my hand.  With patients eyes closed touch face with cotton and have patient identify area touched.

Abducens

(6)

Eyeball movement; proprioception

Have patient move eyes from side to side

Facial

(7)

Movement of facial muscles; tear & saliva secretions; sense of taste and proprioception

Ask patient to smile and raise eyebrows while keeping mouth and eyes closed.  Have patient identify salt or sugar placed on tongue

Acoustic

(8)

Hearing

Use a tuning fork, rub fingers, place a ticking watch, or whisper near both ears.

TALK TO PATIENT

Glossopheryngeal

(9)

Taste, touch and pain from tongue & pharynx; chemoreceptors; BP receptors; movement of tongue and swallowing; saliva secretion.

Touch back of throat with sterile tongue depressor or cotton tipped application.  Have patient swallow.

Vagus

(10)

Parasympathetic sensation and motor control of smooth muscles associated with heart, lungs, viscera; secretion of digestive enzymes.

Assess gag and swallowing with CN IX.  Assess vocal quality.

Accessory

(11)

Head movement; swallowing; proprioception

Have patient shrug shoulders and turn head from side to side.

Hypoglossal

(12)

Tongue movement, speech and swallowing; proprioception

Have patient stretch out tongue and move it internally from cheek to cheek.