Hi, hello, my name is Sabrina. I'm going to be your student physical therapist for today. How are we doing today?
Good, good. Alrighty, so today what we're going to be doing is we're going to be performing a cranial nerve exam. So what we're going to be doing is making sure that everything is functioning properly. Are we going to be okay with that? Yes.
Okay, perfect. Alright, so the first thing we're going to be doing is testing cranial nerve 1, which is the olfactory nerve. So what we're going to be testing is starting off as we're going to have our eyes closed. I'm going to have you have one finger covering one nostril.
What I'm going to be doing is I'm going to be bringing the scent right on over and then I want you to let Let me know what you're smelling there. Okay, I'm going to do one on each side. Okay.
All right, so I'm going to have you close your eyes, and I'm going to go ahead and close one nostril. I'm going to go ahead and bring one on over. I'm going to go ahead and let me see.
Tell me what you smell. Okay. Okay, perfect. All right, so we're going to go ahead, and now we're going to close our eyes again, and now we're going to close that other nostril.
Let me know. Apple juice? Okay, perfect.
Alright, so for that we're trying to make sure that we see that you are able to distinguish and actually smell something from two different smells on each side of those nostrils. Okay. Anything abnormal would be you not being able to smell anything.
Okay. Okay, next we're going to be doing... is we're going to be testing cranial nerve to the optic.
So what we're going to be doing is using a Snellen chart. So what we're going to have you do is we're going to have a ride on up here. If you can go ahead, we're going to cover one eye. And if you can read the third line for me, please. T-O-Z.
Perfect. And then if we're going to cover that other, can you read that next line for me? P-E-D.
Perfect. I can see it's right there. And from here, we're just making sure if you are able to focus in and read those lines here.
If you weren't able to, then that's when the abnormal findings would be. Okay. Okay, so next thing that we're going to go ahead and be doing, let me grab this right here. We're going to be testing that ocular motor nerve, cranial nerve 3. What I'm going to be doing is shining this pen light.
I'm going to bring it right up to the edge of your eyes. I'm going to be covering one side. side to see how our pupils react. This does also see cranial nerve too as well.
So I'm going to go ahead and have one hand right on over. I'm going to bring this. There you go. Go on to the other side. There we go.
All right, so then from here, we are seeing if those pupils are able to constrict to that response of light. That would be the normal finding. Anything abnormal would be no responses to that.
Okay. Next right now, what we're going to be doing is testing cranial nerve 4, which is the abducens nerve. So what I'm going to be doing here is we're going to go ahead and be having this pen. I'm going to have it right here and I'm going to want you to try and follow it just going through a pattern I'm going to be doing, okay?
Okay. So starting here, keeping those eyes right on to this point. Hold on. There you go. Good.
And then we're going to go ahead and do the other side. There we go, perfect. And from here we're just making sure that we do have that normal smooth pursuit as well and you're able to follow up with both eyes throughout that entire time.
Okay, next what we're going to be doing here is we're going to be testing for cranial nerve 5, the trigeminal nerve. So what I'm going to be have, let me pull out here, we're going to have a card, I'm going to use my finger as well. With your eyes closed, I'm going to be doing various little taps across your face and I want you to let me know if you feel dull or sharp.
So dull is going to be my finger, so it's going to feel just like that. And then with sharp, we're going to have that corner and you're going to feel that. So I'm going to go ahead and have you close your eyes, we're going to be doing some taps and let me know what you feel.
Dull? Sharp. Don't.
Don't. Sharp. Sharp.
Sharp. Don't. Okay, perfect.
You can go ahead and open your eyes. And go into those normal climbers to be able to feel and distinguish those different from that light and that sharp touch there. Perfect. Alright, next we're going to be doing is testing cranial lymphocytes.
So you have two sets here, which helps those eyes go out to the side here. So what I'm going to have is I'm going to have this pen right here on this side, and I'm going to have my finger on this side. So we're going to be performing saccade.
So when I say to look at the pen, I want you to look at the pen. When I say my finger, I'm going to look at my finger. So we're going to try our best to move our eyes without moving our head.
Try to keep your head stationary. Ready? We're going to start at that pen.
I'm going to go to my finger. Pen. Finger. Pen. Finger.
Pen. Perfect. And from here, those normal findings is that you're able to transition smoothly, and also you're able to achieve that target without overshooting or undershooting throughout that time. Move that to that side here. Next, we're going to be testing for cranial nerve 7. So what we're going to be doing is looking at...
some little facial movements here. So what I first want you to do is we're going to raise our eyebrows nice and high. There you go. Relax with that.
We're going to squeeze, close those eyes. There you go. You can open. First I want you to smile for me.
There you go. Then we're going to go ahead and frown. There you go.
And then I want you to puff out your cheeks just like perfect. Alright, and for there we want to make sure that you're able to complete those movements. Some symmetry is within as well.
Anything abnormal would be unable to complete that. Okay, next we're going to be going on to cranial nerve 8, which is the vestibular trochlear nerve. So what I'm going to be doing is I'm going to be putting some little sound next to your ears, and I want you to tell me if you can hear it. me which side you're hearing that if you are hearing anything at all. Okay so I'm gonna have you close your eyes so I'm gonna go ahead right right okay perfect all right and so from there we do want to make sure you are able to distinguish that there is is sound coming out on both sides.
And anything abnormal would be not being able to hear anything. Okay. Okay, next what we're gonna be doing is testing out cranial nerve nine, which is the glossopharyngeal. So for that one, we're gonna be doing taste testing at that posterior one third of your tongue. So what I'm gonna have you do is run that with our eyes closed.
We're gonna stick out your tongue. And then I'm gonna go ahead and put a little bit of liquid right onto your tongue. And then I want you to tell me what you're tasting. Okay. So I'm gonna go ahead and have you close your eyes.
We're gonna stick out our. Right here. Healthy? Healthy? Yep.
Perfect. I'm going to go right onto the other side and stick out your tongue. Sweet.
Okay. All right, perfect. And from there, we do want to make sure that you are able to distinguish those different types of tastes in there. The abnormal would be not being able to taste or distinguish between those. Okay, next we're going to be testing is the vagus nerve, so cranial nerve 10. So for that one, I want you to...
we're going to open our mouth and go ah so i'm going to have you go ahead and do that for me there you go there you go you can relax with that so for there we want to make sure that the roof of that mouth has a symmetrical raise and that there's no asymmetries because they asymmetries would be considered abnormal. Okay, next what we're going to be doing is going to be testing for cranial nerve 11. So what I'm going to have you do is we're going to raise our shoulders a lot. You're going to apply some pressure right here, a little bit down. Perfect.
So I'm going to have you turn your head to the right, then to the left. There you go, perfect. And from here, we want to make sure that you see normal signs of no atrophy, there's no muscle wasting, and you're able to complete those movements with ease. Okay, and then our final cranial nerve we'll be testing is cranial nerve 12. which is the hypoglossal one.
So I'm going to have you go ahead and stick your tongue out for me, just straight on out like that. There we go. I'm going to have you move it to the right if you can. Here you go, then to the left. There you go, perfect.
And you can relax with that. And from there, we're looking to see if there's any asymmetry, if your tongue is deviating to one side or the other, but we do want to see that symmetrical movement all the way around. And from there, we have completed our cranial nerve examination. Okay? Thank you.