CRANIAL NERVE

CN I (OLFACTORY)
Pt.’s eyes should be closed. Check patency of nostrils, occlude one nostril at a time for patient’s
ability to identify the smell of common substances (alcohol).

CN II (OPTIC)
Tests visual acuity and visual fields.

CN III, IV, VI (OCCULOMOTOR, TROCHLEAR, ABDUCENS)

Tests EOMs by having the client move the eyes through the 6 cardinal fields of gaze with the head
held steady. Test pupillary reaction to light and accommodation.

CN V (TRIGEMINAL)
MOTOR: Touch the masseter muscle by instructing pt. to bite down and clench her teeth. I am
assessing for the muscle mastication. I am feeling for the masseter, pterygoid muscle. Have the
patient open their mouth and resist the examiner's attempt to close the mouth.
(Normal): So upon inspection, there are no signs of jaw deviation.
ABNORMAL: If there is weakness of the pterygoids the jaw will deviate towards the side of the
weakness.

SENSORY: Pt. close his eyes and identify when nurse is touching her face at the forehead, cheeks,
and chin bilaterally—first with the finger and then with a toothpick. (Ask pt. sharp or dull)
(Normal): So upon inspection, facial sensation is observed.
Test corneal reflex test by touching the cornea with a wisp of cotton NORMAL: Pt. should blink
ABNORMAL: If A weak blink is observed, this is due to facial weakness such as 7th cranial nerve
paralysis.

CN VII (FACIAL)
MOTOR: has the pt make faces, such as smile, frown or whistle.

CN VIII (VESTIBULOCOCHLEAR)
Hearing;
Weber:
Start the fork vibrating by tapping it on my opposite hand. Place the base of the tuning fork firmly on
top of the patient's head. Ask the patient where the sound appears to be coming from (normally in
the midline). Normal is to hear equally in bone ears. If louder in one ear, it is abnormal. Abnormal
indicates conductive hearing loss in that ear or sensory hearing loss in opposite ear.

Rinne:
Place the base of the tuning fork against the mastoid bone behind the ear. When the patient no
longer hears the sound, hold the end of the fork near the patient's ear (air conduction is normally
greater than bone conduction).
(Normal): (positive result) = hearing sound still once moved behind mastoid bone.
Abnormal = not hearing the sound, usually indicates conductive hearing loss.

CN IX, X (GLOSSOPHARYNGEAL, VAGUS)

MOTOR: Asks pt. to say “ah” while depressing tongue with a tongue blade.
(Normal): Upon inspection the soft palate and uvula rises which is good.

SENSORY: Touch back of pharynx with tongue blade to induce a gag reflex. Tell the pt this
procedure may be uncomfortable.
(Normal): Upon inspection, there is a stimulation of gag reflex which is a normal finding. Since
this indicates that this prevents swallowing any foreign substance by contracting the pharynx.

CN XI (ACCESSORY)
Have the pt. turn his head from side to side against resistance. (Assessing for the muscle strength of
sternocleidomastoid)
Place hands on pt’s shoulders and has client shrug his shoulders against resistance. (assessing for
trapezius muscle strength)

CN XII (HYPOGLOSSAL)
Have the pt: a. Say “d, l, n, t.”

Protrude the tongue and move it from side to side. I am inspecting tongue for atrophy and
fasciculations.

(Normal): So far so good. No signs of any tongue weaknesses, which is a normal finding.
ABNORMAL: If there is unilateral weakness, the protruded tongue will deviate towards the weak side
or lesion.
THE EARLY BIRD CATCHES THE WORM.

Being first improves the chances of success.

So when you wanted to succeed in doing
something, it is better to start as soon as
possible. Procrastination is the biggest slayer
of minds, and if you start out late, you might
miss great opportunities that may come along
in your life.

EXPLAIN YOUR UNDERSTANDING ABOUT THE SAYING….

"All that we are is the result of what we have thought." -Budha

My understanding about this quote is,

Whatever we receive, is the result of our
thoughts. All the achievements are the result
of our attitude and power of thinking. THAT IS
HOW POWERFUL ARE MIND IS.