the client’s cornea with a cotton

wisp (this test may be omitted if

CRANIAL NERVE TEST the client is alert and
Cranial Nerve I: Olfactory ▪ Have the client close the eyes and blinking normally)
▪ Sensory occlude 1 nostril with a finger ▪ Check sensory function by asking
▪ Controls the sense of smell ▪ Ask the client to identify the client to close the eyes; lightly
nonirritating and familiar odors touch forehead, cheeks,
(e.g., coffee, tea, cloves, soap, and chin, noting whether the touch
chewing gum, peppermint) is felt equally on the 2 sides
▪ Repeat the test on the other Cranial Nerve VII: Facial ▪ Test taste perception on the
nostril ▪ Sensory and motor anterior two thirds of the tongue;
Cranial Nerve II: Optic ▪ Assess visual acuity with a Snellen ▪ Controls movement of the face the client should be able to
▪ Sensory chart and perform an and taste taste salty and sweet tastes
▪ Controls vision ophthalmoscopic exam sensation ▪ Have the client smile, frown, and
▪ Check peripheral vision by show the teeth
confrontation ▪ Ask the client to puff out the
▪ Check color vision cheeks
Cranial Nerves III, IV, and VI ▪ The motor functions of cranial ▪ Attempt to close the client’s eyes
Cranial Nerve III: Oculomotor nerves III, IV, and VI overlap; against resistance
▪ Motor therefore, they should be tested Cranial Nerve VIII: Acoustic or Assessing the client’s ability to hear
▪ Controls pupillary constriction, together Vestibulocochlear tests the cochlear portion
uppereyelid ▪ Inspect the eyelids for ptosis ▪Sensory ▪ Assessing the client’s sense of
elevation, and most eye movement (drooping); then assess ocular ▪ Controls hearing and vestibular equilibrium tests the vestibular
Cranial Nerve IV: Trochlear movements and note any eye function portion
▪ Motor deviation ▪ Check the client’s hearing, using
▪ Controls downward and inward ▪ Test accommodation and direct acuity tests
eye and consensual light reflexes ▪ Observe the client’s balance and
movement watch for swaying when he or she
Cranial Nerve VI: Abducens is walking or standing
▪ Motor ▪ Assessment of sensorineural
▪ Controls lateral eye movement hearing loss may be done with the
Cranial Nerve V: Trigeminal ▪To test motor function, ask the Weber or Rinne test
▪ Sensory and motor client to clench the teeth and Cranial Nerves IX and X ▪ Usually cranial nerves IX and X are
▪ Controls sensation in the cornea, assess the muscles of mastication; Cranial Nerve IX: Glossopharyngeal tested together
nasal then try to open the client’s jaws ▪ Sensory and motor ▪ Test taste perception on the
and oral mucosa, and facial skin, as after asking the client to keep them ▪ Controls swallowing ability, posterior one third of the tongue or
well as tightly closed sensation in pharynx; the client should be
mastication ▪ The corneal reflex may be tested the pharyngeal soft palate and able to taste bitter and sour tastes
by the health care provider; this is tonsillar ▪ Inspect the soft palate and watch
done by lightly touching
mucosa, taste perception on the for symmetrical elevation when the
posterior client says “aaah”
third of the tongue, and salivation ▪ Touch the posterior pharyngeal
Cranial Nerve X: Vagus wall with a tongue depressor to
▪ Sensory and motor elicit the gag reflex
▪ Controls swallowing and
phonation,
sensation in the exterior ear’s
posterior
wall, and sensation behind the ear
▪ Controls sensation in the thoracic
and
abdominal viscera
Cranial Nerve XI: Spinal Accessory ▪ The nurse palpates and inspects
▪ Motor the sternocleidomastoid muscle as
▪ Controls strength of neck and the client pushes the chin
shoulder against the nurse’s hand
muscles ▪ The nurse palpates and inspects
the trapezius muscle as the client
shrugs the shoulders
against the nurse’s resistance
Cranial Nerve XII: Hypoglossal ▪ Observe the tongue for
▪ Motor asymmetry, atrophy, deviation to 1
▪ Controls tongue movements side, and fasciculations
involved in (uncontrollable
swallowing and speech twitching); ask the client to stick
out the tongue (tongue should be
midline)
▪ Ask the client to push the tongue
against a tongue depressor, and
then have the client move
the tongue rapidly in and out and
from side to side