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Cranial Nerves 1-12: name, type, function, and basic test for compliance.


Cranial Nerve I
Type: Sensory
Function: Sense of Smell
Test: Ask Pt. to close their eyes, then hold an alcohol swab up to nose and inquire about ability to smell.


Cranial Nerve II
Type: Sensory
Function: Sense of Sight
Test: Ask Pt. to cover one eye, then hold up a number of fingers and ask Pt. to announce number or fingers seen. Repeat for opposite eye.


Cranial Nerve III
Type: Motor
Function: Eye movement, Pupil constriction
Test: Have Pt. hold head still while following your finger in H pattern. Test pupil response with penlight.
Diagnosis: Pinpoint pupils suggest opiate OD or trauma to pons; Dilated pupils suggest anxiey, seizure, or stimulant use (coke, meth, etc); Sluggish or fixed pupils suggest brain injury or swelling.


Cranial Nerve IV
Type: Motor
Function: Downward gaze
Test: Have Pt. hold head still while following your finger in H pattern, then inwards to touch nose.


Cranial Nerve V
Type: Sensory and Motor
Function: (S) Facial sensation, branching to the forehead, cheek, and lower jaw. (M) Chewing
Test: Ask Pt. to open wide, then clench jaw while palpating lower jaw muscles. Touch each side of forehead, cheek and lower jaw to determine sensory ability.


Cranial Nerve VI
Type: Motor
Function: Lateral Eye Movement
Test: Have Pt. hold head still while following your finger in H pattern, then inward to touch nose.


Cranial Nerve VII
Type: Sensory and Motor
Function: (S) Taste (M) Secretion of saliva, facial expressions
Test: Assess facial movement during interrogation, ask Pt. to smile, raise eyebrows, blow up cheeks. Any assymmetrical movement is bad, usually indicative of a stroke at the middle cerebral artery.

Acoustic (Vestibulocochlear)

Cranial Nerve VIII
Type: Sensory
Function: Senses of hearing and balance
Test: Stand behind Pt. then rub fingers together near each ear and inquire as to which side the sound is coming from.


Cranial Nerve IX
Type: Sensory and Motor
Function: (S) Taste sensation from posterior tongue and pharynx (M) Muscles of swallowing and gag reflex
Test: Ask Pt. to open mouth wide and say "Ah" while inspecting uvula. Pull to one side indicates possible stroke affecting CN9 on side opposite to uvula pull.


Cranial Nerve X
Type: Sensory and Motor
Function: (S) Gag reflex and stretch receptors in gut (M) Decreases heart rate, increases peristalsis, contracts muscles for voice production.
Test: Test gag reflex by tickling back of throat, however not usually necessary and prone to create vomitus!

Spinal Accessory

Cranial Nerve XI
Type: Motor
Function: Shoulder movements, turning of head, and movements of viscera.
Test: Evaluate muscle strength against resistance in the trapezius and sternocleidomastoids via shrugging and looking left and right respectively.


Cranial Nerve XII
Type: Motor
Function: Tongue Movements
Test: Ask Pt. to protrude tongue then move it in all four cardinal directions. Note favoring of one side or absence of smooth, fluid motions.

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