Nursing Assessment of Cranial Nerves

Introduction

• Presentation by Sarah from RegisteredNurseRN.com
• Video covers cranial nerves 1 through 12
• Importance of providing privacy, performing hand hygiene, and explaining procedures to the patient

Cranial Nerve 1: Olfactory Nerve

• Function: Sense of smell
• Test:
  • Have patient close eyes
  • Present a pleasant smelling substance under the nose
  • Patient identifies the smell (e.g., vanilla extract)

Cranial Nerve 2: Optic Nerve

• Tests:
  1. Confrontation Visual Field Test
     • Assess peripheral vision
     • Patient covers one eye; examiner covers the opposite eye
     • Identify number of fingers in different visual fields
  2. Visual Acuity Test
     • Using a Snellen chart, patient stands 20 feet away
     • Test with and without glasses
     • Patient reads the lowest line possible
     • 20-20 vision explained

Cranial Nerves 3, 4, 6: Oculomotor, Trochlear, Abducens

• Tests:
  1. Nystagmus
     • Use a pin light
     • Check for involuntary eye movement in six cardinal fields
  2. Pupillary Light Reflex
     • Dim lights, have patient focus on a distant object
     • Shine light from side to observe constriction
  3. Accommodation
     • Lights on, pin light moved towards nose
     • Observe constriction and eye crossing
  • Documentation: PERRLA (Pupils Equal, Round, Reactive to Light and Accommodation)

Cranial Nerve 5: Trigeminal Nerve

• Function: Mastication, facial sensation
• Tests:
  • Clench teeth, palpate masseter and temporal muscles
  • Open mouth against resistance

Cranial Nerve 7: Facial Nerve

• Functions: Facial expressions
• Tests:
  • Close eyes tightly, smile, frown, puff cheeks

Cranial Nerve 8: Vestibulocochlear Nerve

• Function: Hearing
• Test:
  • Occlude one ear, whisper two words, patient repeats

Cranial Nerve 9: Glossopharyngeal Nerve

• Function: Gag reflex, uvula movement
• Tests:
  • Say "ah," observe uvula movement
  • Elicit gag reflex

Cranial Nerve 10: Vagus Nerve

• Function: Speech, swallowing
• Test:
  • Check for hoarseness, swallowing ability

Cranial Nerve 11: Accessory Nerve

• Function: Shoulder and head movement
• Test:
  • Move head side to side, up and down
  • Shrug shoulders against resistance

Cranial Nerve 12: Hypoglossal Nerve

• Function: Tongue movement
• Test:
  • Stick out tongue, move side to side

Conclusion

• Comprehensive assessment of cranial nerves
• Recommendation to watch the head-to-toe nursing assessment video
• Encouragement to subscribe for more educational content