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HEALTH ASSESSMENT
Neurological Assessment
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Cards (39)
12 Cranial Nerves & Their Functions
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Acoustic
/
Vestibulocochlear
Glossopharyngeal
10. Vagus
11. Spinal Accessory
12. Hypoglossal
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Cranial Nerve 1 -
Olfactory
Carries smell impulses from
nasal mucous
membrane to
brain
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Cranial Nerve 1 -
Olfactory
Procedure
1. Have client sit in comfortable position
2. Ask client to
clear nose
3.
Close eyes
, occlude one nostril, identify scented object
4.
Repeat
for other nostril
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Cranial Nerve 1 -
Olfactory Normal
Client correctly identifies
scents
Older clients may have
decreased
sense of smell
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Cranial Nerve 1 -
Olfactory
Abnormal
Neurological Anosmia -
inability
to
smell
Neurogenic Anosmia - olfactory tract lesion, frontal lobe tumor, congenital, nasal/sinus problems, nerve tissue injury,
smoking
,
cocaine
use
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Cranial Nerve
2
-
Optic
Carries
visual
impulses from eye to
brain
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Cranial Nerve 2 - Optic Procedure
1. Use
Snellen
chart to assess vision
2. Ask client to read paragraph to assess
near
vision
3. Assess visual fields by
confrontation
4. Use ophthalmoscope to view
retina
and
optic
disc
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Cranial Nerve 2 - Optic Normal
20/20
vision, reads at 14 inches,
normal
peripheral vision, normal retina and optic disc
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Cranial Nerve 2 -
Optic
Abnormal
Difficulty reading Snellen chart, missing letters,
squinting
, reads print by holding closer/further, loss of
visual fields
, papilledema, optic atrophy
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Cranial Nerves 3, 4, 6 -
Oculomotor
, Trochlear,
Abducens
Control
eye
movements
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Cranial Nerves 3, 4, 6 Procedure
1.
Inspect eyelids
2. Assess
extraocular
movements
3. Assess
pupillary
response to
light
and accommodation
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Cranial Nerves 3, 4, 6 Normal
Eyelids
cover 2mm of
iris
, eyes move smoothly in all directions, pupils constrict simultaneously
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Cranial Nerves 3, 4, 6 Abnormal
Ptosis,
myasthenia gravis
, abnormal eye movements,
pupil
abnormalities
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Cranial Nerve
5
-
Trigeminal
Carries sensory impulses of pain, touch,
temperature
from face to brain, influences
jaw
movements
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Cranial Nerve 5 Procedure
1. Test motor function by
palpating temporal
and
masseter
muscles
2. Test sensory function by touching
face
with
sharp
/dull stimuli
3. Test
corneal reflex
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Cranial Nerve 5 Normal
Temporal
and masseter muscles contract bilaterally, can correctly identify sharp/dull and light touch,
corneal
reflex present
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Cranial Nerve
5
Abnormal
Decreased
muscle contraction, inability to feel
facial
stimuli, absent corneal reflex
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Cranial Nerve 7 - Facial
Stimulates
facial movements
and expressions, provides taste sensation to
anterior tongue
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Cranial Nerve 7 Procedure
1. Test
motor
function by having client
smile
, frown, etc.
2. Test
sensory
function by touching anterior tongue with
flavored
stimuli
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Cranial Nerve 7
Normal
Symmetric
facial
movements, can correctly identify
flavors
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Cranial Nerve 7 Abnormal
Inability to close eye, wrinkle forehead, or raise eyebrow, paralysis of lower face, inability to identify flavors
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Cranial Nerve
8
- Acoustic/Vestibulocochlear
Contains sensory fibers for
hearing
and
balance
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Cranial Nerve 8 Procedure
1. Test
hearing
ability, perform
Weber
and Rinne tests
2. Perform
Romberg
test to assess
equilibrium
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Cranial Nerve
8
Normal
Client hears
whispered
words, Weber test lateralizes equally, Rinne test AC>BC, maintains balance with
eyes
closed
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Cranial Nerve
8
Abnormal
Weber test lateralizes to good
ear
, AC<BC, loss of
balance
with eyes closed
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Cranial Nerves 9 & 10 -
Glossopharyngeal
,
Vagus
Influence
swallowing
,
gag
reflex, and voice
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Cranial Nerves 9 & 10 Procedure
1. Test
motor
function by having client say "ah"
2. Test gag
reflex
3. Observe ability to
swallow
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Cranial Nerves 9 & 10 Normal
Soft palate rises bilaterally,
gag
reflex present,
swallows
without difficulty
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Cranial Nerves 9 & 10 Abnormal
Soft
palate
does not rise, absent gag reflex, dysphagia or
hoarseness
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Cranial Nerve 11
-
Spinal Accessory
Innervates neck muscles that promote
shoulder
and
head movement
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Cranial Nerve 11 Procedure
Assess
strength
of
trapezius
and sternocleidomastoid muscles
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Cranial Nerve 11
Normal
Symmetric
, strong muscle
contraction
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Cranial Nerve 11 Abnormal
Asymmetric
muscle
contraction
, atrophy, fasciculations
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Cranial Nerve 12 -
Hypoglossal
Innervates
tongue
muscles that promote movement of
food
and talking
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Cranial Nerve 12 Procedure
Assess
strength
and
mobility
of tongue
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Cranial Nerve 12
Normal
Symmetric
, smooth tongue movement and
bilateral
strength
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Cranial Nerve
12
Abnormal
Fasciculations, atrophy,
deviation
of
tongue
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Level
of Consciousness
Alert, Lethargic, Stuporous, Comatose
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Glasgow
Coma Scale
Measures eye opening, verbal, and motor responses
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