I II III IV V VI VII VIII IX X XI XII

O O O T T A F V G V A H
S S M M B M B S B B M M
S: Sensory M: Motor B: Both
Nerves have Parasympathetic: X, IX, VII, and III “1973”

CN I  Olfactory Nerve
Examine with well known odor that is not volatile and irritating.

CN II  Optic Nerve

 Visual Acuity.
 Visual Field.
 Light Reflex “Direct & Indirect”.
 Ishihara Test For color Blindness

CN III, IV, VI  Extraocular Movements imp

 Introduce yourself & take Permission.

 Ask the patient to Fix his eyes on the wall.
 Inspect for
 Ptosis “Myotonia, Myasthenia gravis, 3rd N palsy, trauma, Horner syndrome, DM”.
 Squint or Strabismus.
 Light Reflex “Direct & Indirect”.
 Afferent: Optic Nerve.
 Efferent: Oculomotor Nerve.
 Eye Movement Examination “H shape”
 R. eye  : Lateral Rectus
 R. eye  : Medial Rectus
 R. eye  : Superior Rectus & inferior Oblique
 R. eye  : Inferior Rectus & Superior Oblique

CN V  Trigeminal nerve imp

Sensory: over the face except the angle of the mandible “C2”, Anterior 2/3 of the tongue.

Motor: Muscle of mastication “(temporalis, masseter)”

Reflexes: Corneal Reflex “Afferent: Trigeminal Nerve & Efferent: Facial Nerve”
  Introduce yourself & take Permission.
 General Sensation of the face: “Touch (Light & Deep ) & pain”
 Over the three branches “V1, V2, V3”
 The Anterior 2/3 of the tongue.
 Corneal Reflex:
 “Look up!”,  his lower lid, Touch the cornea using sterile cotton  + : Bilateral Blinking
 Motor Examination:
 Close your mouth:
 Inspect & palpate for Atrophy
 Open your Jaw & and move from side to side against resistance.
 Jaw Jerk Reflex:
 Place your finger over the patient's chin and then tap the finger with a reflex hammer.

CN VII  Facial nerve imp

Sensory: supply taste to the anterior 2/3 of the tongue “not typically assessed during examination”

Motor: Muscles of facial expression

Eyes Mouth
Parasympathetic: “Lacrimation, submandible, & Sublingual”
UMN Normal Weak
UMN Palsy: Infection, Stroke, Space occupying mass. LMN Weak Weak

LMN Palsy: Idiopathic, Local Edema, demyelination in the petrous bone.  Bell’s palsy

 Introduce yourself & take Permission.

 Motor Examination: Inspection
 Symmetry of the forehead.
 Nasolabial fold
 Pseudoptosis
 Mouth angle deviation.
 Raise both eyebrows then give an angry look.
 Close both eyes tightly & don’t let me open them.
 Show both upper and lower teeth.
 Puff out both cheeks then Whistle.

CN VIII  Vestibulocochlear Nerve

 Hearing: Whisper numbers in one ear and ask the patient to repeat the numbers.
 Conduct the Rinne test and Weber test.

CN IX and X  Glossopharyngeal and Vagus Nerve

 Gag Reflex “Afferent: Glossopharyngeal nerve & Efferent: Vagus Nerve ”

 Say “AHH”
CN XI  Accessory Nerve

 Shrug shoulders and don’t let me put them down.

 Turn head from side to side also against resistance.

CN XII  Hypoglossal Nerve

 Protrude your tongue and move it from one side to another.

 Inspect for tongue atrophy, fasciculations or asymmetry.