Cranial Nerve Assessment Form
Function
General inspection
Muscle wasting
Facial symmetry
Loss of expression
Comfort/pain
CN I – Olfactory Nerve
CN II – Optic Nerve
CN III – Oculomotor Nerve
Assessment
Inspection
Sensory: smell
Ensure patency of each nares
Use known scents to check each nostril
Test one nares at a time with eyes closed
Detect odor when present at 10 cm
Sensory: vision
Distance visual acuity: Snellen chart
Near vision acuity: Jaeger, Rosenbaum
hand held chart
Color vision: Ishihara color plates
Afferent impulse from eye to brain + CN III efferent impulse
from eye to brain  papillary response to light
Peripheral visual fields: Confrontation
test
View red reflex: fundoscopy
Motor: EOM
Remaining eye movements: 6 cardinal
fields of gaze
Raises eyelid: look for ptosis (eyelid
droop)
Pupillary response (reflexes) to light:
CN IV – Trochlear Nerve
Motor: EOM
CN VI – Abducens Nerve
Motor: EOM
 Direct
 Consensual
Pupillary response: accommodation
Superior oblique muscle:
 moves eye down when looking
towards the nose
 rotates eye internally
Lateral rectus muscle:
Comments

CN V – Trigeminal Nerve

Ophthalmic branch

Maxillary branch

Mandibular branch
Sensory, Motor
Sensory: forehead,
nose, nasal cavity
Sensory: lower
eyelid, upper
teeth/lip, cheek,
nose
Sensory: tongue,
lower teeth/lip,
chin, mastication
muscles
Motor: Muscle
supply to muscles
of mastication,
chewing
Wipe cotton ball lightly over scalp,
forehead
Wipe cotton ball lightly over paranasal
sinuses
Wipe cotton ball lightly over jaw

Inspect face for muscle atrophy
and tremors

Have patient clench teeth and
then palate the temporalis muscle
and masseter muscle for muscle
strength
Move jaw from side to side

CN VII – Facial Nerve (5 branches)
Ophthalmic branch
(sensory) of CN V
and motor function
of CN VII
Sensory, Motor
Sensory: Anterior
2/3 of tongue
Motor: Facial
muscles of scalp,
ear
moves eye laterally: look for
nystagamus
Corneal reflex
X
Identify sweet, salty tastes on anterior
2/3 tongue
 Inspect face at rest and during
conversation
 Raise eyebrow
 Wrinkle forehead
 Squeeze eyes shut while you try to
open them
 Smile
 Puff out cheeks
 Purse lips and blow out (whistle)
 Show teeth
CN VIII – Acoustic
(Vestibulocochlear) Nerve

Vestibular division
Sensory
Sensory:
equilibrium,
balance




Cochlear division
CN IX Glossopharyngeal Nerve
CN X Vagus Nerve
CN IX and CN X are tested together
Sensory

Test patients who present with
new onset “dizziness”
Indirectly test by assessing gait
and balance and looking for
nystagmus
Dix-Hallpike maneuver

Simple test of hearing (whisper
test)
Rinne’s test
X

Weber’s test
X
Sensory, Motor
Sensory
Taste ability to identify sour and bitter
tastes over posterior 1/3 of tongue
Motor
Test gag reflex
Have patient swallow
CN IX is simultaneously tested during evaluation of the vagus (CN X) for nasopharyngeal sensation (gag
reflex) and motor function of swallowing
Sensory, Motor,
Parasympathetic
Sensory
Sensation behind ear and part of external
ear canal
Motor
Vocal cords: voice quality
Swallowing ability
Parasympathetic
Secretion of digestive enzymes;
peristalsis; carotid reflex; involuntary
action of heart, lungs, and digestive tract
Have patient open mouth, stick out
tongue, and say “Ahh”
 Uvula should be midline
 Uvula and Soft palate should rise
Provoke Gag Reflex
X
CN XI Spinal Accessory Nerve
Motor
Sternocleidomastoid: ask patient to turn
head against resistance applied to the
side of the face
Trapezius: ask patient to shrug shoulders
while applying downward
CN XII Hypoglossal Nerve
Motor
Stick out tongue: tongue should be
midline
 Check symmetry
 Check atrophy
 Any fasiculations (tremors)
Check tongue strength: push tip of
tongue into inside of either cheek while
you push from outside
Inspect tongue movement toward nose
and chin
Tongue movement for lingual speech
sound articulation (l, t, d, n)
Notes