Cranial Nerve Lab Worksheet PDF

**[Cranial Nerve Lab Worksheet]** [**Cranial nerve assessment** ] - *[CN I/Olfactory ]* - *(Sensory): Test smell (Eyes closed, would test one nostril at a time using distinctive smelling items such as coffee grounds)* - [CN II/Optic] - (Sensory): - Vision: Tes...

**[Cranial Nerve Lab Worksheet]** [**Cranial nerve assessment** ] - *[CN I/Olfactory ]* - *(Sensory): Test smell (Eyes closed, would test one nostril at a time using distinctive smelling items such as coffee grounds)* - [CN II/Optic] - (Sensory): - Vision: Test acuity with Snellen chart or holding up fingers - Contralateral pupil constriction: Test using penlight, obliquely shine into eye and assess constriction of [contralateral pupil]. Normal response both ipsilateral and contralateral pupil constriction. - [CN III/Oculomotor] - (Motor): - Elevates eyelid: Ask patient to raise eyebrows/open eyes - All eye movements, [except] lateral deviation and diagonal downward/medial: Test using 'H pattern' asking patient to track your finger - Ipsilateral pupil constriction: Test using penlight, obliquely shine into eye and assess constriction of [ipsilateral pupil.] Normal response is pupil constriction) - [CN IV/Trochlear ] - (Motor): Eye movement DOWN/IN: Assess during 'H pattern' finger tracking as you bring your finger toward the patient's nose - [CN V/Trigeminal] - (Sensory): Sensation from face: Test using light touch to face at bilateral forehead (ophthalmic branch); cheek (maxillary branch); lateral jaw (mandibular branch) - (Motor): Muscles of mastication: Test with jaw clench; patient resists PT trying to open mouth or push jaw laterally with moderate force; PT should palpate masseter during jaw clench - [CN VI/Abducens] - (Motor): Eye movement OUT: Assess during 'H pattern' finger tracking - *[CN VII/Facial ]* - *(Sensory): Taste for salty, sweet, sour on anterior 2/3^rd^ tongue: Test with patient's eyes closed and tongue sticking out. Place something sweet (typically sugar liquid) on anterior tongue and ask patient to identify)* - (Motor): Muscle of facial expression: Ask patient to smile, frown, puff out cheeks, open/close eyes and mouth - [CN VIII/Vestibulocochlear ] - (Sensory): Balance: Test with Romberg balance test; stand unsupported/eyes closed x 30 seconds - (Sensory): Hearing: Test with patient's eyes closed, finger rub. \*\*If abnormality present, further testing using tuning fork to determine sensorineural vs conductive hearing loss - Sensorineural hearing loss: problem in inner ear or due to auditory nerve damage - Conductive hearing loss: problem due to sound not reaching inner ear, due to obstruction (ear wax) or trauma - [Weber Test:] Tests sensorineural vs conductive hearing loss - Strike and place tuning fork on midline of scalp/forehead; Ask where they hear the vibration - [Normal]: vibration heard equally in both ears - [Conductive hearing loss:] sound heard best in affected ear - [Sensorineural hearing loss]: sound heard best in normal/unaffected ear - [Rinne Test:] Tests air conduction (outside ear) vs bone conduction (on mastoid process) - Strike tuning fork and place on patient's mastoid process until they indicate they can no longer hear it THEN move still vibrating tuning fork adjacent the outer ear until they indicate they can no longer hear it - [Normal:] Air conduction better than bone conduction; patient should hear sound of tuning fork adjacent to their ear persist almost twice as long as the sound when tuning fork on mastoid process - [Abnormal:] Bone conduction better than air conduction; patient cannot hear sound conducted through air after the tuning fork is moved from mastoid process to adjacent to ear (indicates conductive hearing loss - [Abnormal:] Patient cannot hear vibration on mastoid process = sensorineural hearing loss - *[CN IX/Glossopharyngeal and CNX/Vagus]:* - *(Sensory): Taste for sour and bitter on posterior 1/3^rd^ tongue: Test with patient's eyes closed and tongue sticking out. Place something sour/bitter (typically lemon juice) on posterior tongue and ask patient to identify)* - *(Motor): Control of pharynx: Test by asking patient to open mouth and say 'ahhhhh'; observe for difficulty swallowing; test gag reflex by carefully moving tongue depressor toward back of patient's throat until gag reflex elicited* - [CN XI/Spinal accessory] - (Motor) Strength of SCM and UT; Test UT strength with resisted shoulder shrug; observe for atrophy of SCM or UT muscles - *[CN XII/Hypoglossal]* - *(Motor) Tongue movement; Test by asking patient to stick out tongue and observe for side-to-side deviation/atrophy, can ask patient to move tongue side-to-side (\*deviation occurs TOWARD affected side due to unopposed action of the unaffected muscle)*