Cranial Nerve Examination

I - Olfactory

• Changes in sense of smell? - blocked nose, head injury? - smell strong odours with one nostril at a time

II - Optic

• Snellen chart - 6m away
• Visual fields by confrontation - one eye occluded
• Fundoscopy - ptosis, squint, exopthalmus, pupil size and irregularities, nystagmus, infection, colour
• Light reflexes - direct and consensual
• Accomodation reflex

II - Optic, III - Oculomotor, IV - Trochlear, VI - Abducens

• Eye movements - H-shape pausing on edges
• Double vision?
• Trouble seeing the stairs as you walk down them?

V - Trigeminal

• Facial sensation - soft touch, sharp touch/pain
• Muscles of mastication - temporalis, masseter
• Reflex jaw jerk

VII - Facial

• Muscles of facial expression
• Facial asymmetry, involuntary movements
  
• Power
  
• "Me me me"
• Taste
• Salivation
• Dry eyes?/mouth?

V - Trigeminal, VII - Facial

• Corneal reflex

VIII - Vestibular Cochlear

• Examine ears
• Hearing aid?
• Auroscopy
• Whisper test
• Weber's test
• Rinne's test
• Arrange audiometry?
• Vertigo? - Hallpike manoeuvre

IX - Glossopharyngeal, X - Vagus

• Inspect palate and pharynx - pentorch
• Say "ahh" - uvula deviation?
• Cough
• Swallow
• Speech? - hoarseness
• Gag reflex

XI - Spinal Accessory

• Head movements
• Sternocleidomastoid - look over shoulders against resistance, head protraction against resistance
  
• Trapezius - shrug shoulders against resistance, action as if brushing hair
  

XII - Hypoglossal

• Protrude tongue - deviation?
• Movements of tongue
• Power of tongue - in cheek against resistance

X - Vagus, XII - Hypoglossal

• Perform tongue-twister