(CN VII) Facial nerve

B. procedure I. Corneal reflex 1. Take a clean piece of cotton wool 2. Ask the patient to look away from the side being tested. 3. Gently touch the cornea with the cotton wool and the patient will blink. This requires the sensation of V but also the motor of VII. II. sensation (taste sensation of anterior two third of the tongue): 1. Ask the patient to protrude his tongue 2. use a cotton tip applicator dipped in a solution that is sweet, salty, sour, or bitter 3. Apply to one side then the other side of the extended tongue 4. ask the patient to tell you the taste before they pull their tongue back in the mouth III. Motor: N.B. The motor division of CN 7 supplies the muscles of facial expression. Start from the top and work down. 1. Inspect facial droop or asymmetry. 2. ask the patient to look upward and wrinkle his forehead (frontalis muscle), Obseve the wrinkles 3. Ask the patient close eyes tight (orbicularis oculi) against resistance, assess the power of the muscle. 4. Ask them to raise their eyebrows.Obseve if the furrows of the forehead symmetrical 5. Ask the patient to show their teeth, observe if there is any deviation of the nasolabial fold. 6. ask the patient to purse their lips or to whistle (orbicularis oris). 7. ask the patient to blow his cheek(buccinator) 8. Ask the patient to frown

N.B. Lesion of the facial nerve results in paralysis of the facial muscle with deviation of the mouth to the healthy side.