Cranial Nerves:

Always Look Around For Any Clues!

Look For Walkers, Orthotics, Glasses Clues Are Everywhere In Neurology

Look For Asymmetry In The Face

Look For Any Abnormal Fasciculation

Look For Mask Liked Facies

Look Out For Frontal Balding

Look Out For Temporal Wasting

Look Out For Ptosis

Wish The Examiners

Sanitize Your Hands

Introduce Yourself To The Patient And What You Are Going To Do, Tell At Any Point Of Time If He Has Any Pain

Or Discomfort He Can Let You Know.

Cranial Nerve I

: Ask The Patient “Do You Have Any Problem With Sense Of Smell ?”

Cranial Nerve II:

A)Check Each Eye For Visual Acuity, Ask Patient To Close His One Eye And Do Finger Counting From 6 Feet

Distance, If Decreased From Three Feet, If Lesser, Fingers In Front Of The Eye , If Still Not Perceived, Shine Light

Into The Eye. One Eye At A Time. Patient Should Put His Glasses On If He Has Any. Do Not Waste Your Time With

Snellen’s Chart As Every Second Counts.

B)Colour Vision- Each Eye Separately , Different Colour, Carry A Red And Green Pen If Possible And Your Jobs

Done, Or At Least Use The Back Of Mdf Knee Hammer Where You Will Find The Red Cap. Do Not Search For Any

Colour Wool Chart None Will Be There

C)Visual Field By Confrontation Method. Try The Simple Method And Move To Complex One

D)Fundoscopy Offer To Do At The End

E)Look For Primary Position Of Pupils, Light Reflex-Two Times In Each Eye ( Direct And Indirect)And

Swing Light Test For Marcus Gunn

F)Accommodation.

Cranial Nerve III, IV, VI:

1.Inspect The Eyeballs-Is It Centre/Deviated To One Side/Ptosis

2.Check Eom – Move Finger As “ H”. Reinforce That The Patient Should Keep Head Steady

(Extremely Important)

3.Ask For Diplopia

4.Saccades —Rt,Lt,Up,Down. May Use Pen And A Torch.

Cranial Nerve V

V1,V2:Sensations On Forehead And Cheek

V3: Sensations And Motor Component Of It-Masticatory Muscles, Jaw Opening , Closing, Clenching Teeth And

Palpate The Muscles Of Mastication And Temporalis

Cranial Nerve VII:

1.Raise Eyebrows – As If You Are Surprised

2.Close Eyes Tightly – Don’t Let Me Open Them

3.Blow Out Cheeks, Hold The Air In Your Cheeks, Don’t Let Me Tap It Out.

4.Show Me Your Teeth Smiling

5.Vesicles Around The Ear

 Cranial Nerve VIII:

Hearing One Ear At A Time By Rubbing The Finger Gently Close To Pinna

Cranial Nerve IX & X:

 Check Soft Palate –Say “Aah”- Questions As ? -Chocking Etc. Do Not Do The Gag Reflex

Cranial Nerve XI:

1.Shrug Shoulders And Offer Resistance

2.Check For Sternocleidomastoid Tautness While Turning Head To Opposite Direction

Cranial Nerve XII:

1.Check For Atrophy, Fasciculations When Tongue Is Resting Position Inside The Mouth

2.Deviation By Putting The Tongue Out And Wiggling Right To Left

3.Power –Pushing Fingers From Inside Cheek