med study partner

All examinations

Neurological Examination – Cranial Nerves

Source-faithful checklist for examination of the cranial nerves.

Neurology · Self-paced

Step 1. Introduction

  1. Hand hygiene

    Hand wash/rub

  2. Introduce yourself

    Introduce self

  3. Explain the purpose

    Explain purpose

  4. Consent

    Obtain consent

  5. Position the patient

    Position patient

Step 2. General Inspection

  1. Orientation

    Orientation

  2. Comfort or distress

    Comfort/distress

  3. Facial symmetry

    Facial symmetry

  4. Eyes

    Eyes (pupils, squint)

  5. Scars

    Scars

  6. Skin changes

    Skin changes

  7. Report findings

    Report findings correctly

  8. Vital signs

    Mention vital signs

Step 3. CN I – Olfactory Nerve

  1. Smell and taste

    Enquire about smell/taste

  2. Report findings

    Report findings

Step 4. CN II – Optic Nerve

  1. Visual acuity

    Visual acuity

  2. Visual fields

    Visual fields

  3. Report findings

    Report findings

  4. Additional tests

    Comment on additional tests (fundoscopy)

Step 5. CN II & III – Eye Reflexes

  1. Light reflex

    Light reflex

  2. RAPD

    RAPD

  3. Accommodation

    Accommodation

  4. Report findings

    Report findings

Step 6. CN III, IV & VI – Eye Movements

  1. H-pattern eye movements

    Eye movements in H pattern

  2. Diplopia

    Ask about diplopia

  3. Report findings

    Report findings

Step 7. CN V – Trigeminal Nerve: Facial Sensation

  1. Light-touch sensation

    Light-touch sensation

  2. Pain sensation

    Pain sensation

  3. Technique and landmarks

    Correct technique and landmarks

  4. Report findings

    Report findings

  5. Corneal reflex — comment only

    Comment only on corneal reflex

Step 8. CN V – Trigeminal Nerve: Muscles of Mastication

  1. Masseter bulk

    Inspect and palpate masseter bulk

  2. Power of elevation

    Power of elevation (masseter, medial pterygoid, temporalis)

  3. Power of depression

    Power of depression (lateral pterygoids and suprahyoid muscles (C1))

  4. Jaw jerk

    Jaw jerk

  5. Report findings

    Report findings

Step 9. CN VII – Facial Nerve

  1. Raise both eyebrows

    Raise both eyebrows – frontalis (temporal branch)

  2. Close eyes tightly

    Close eyes tightly – orbicularis oculi (temporal branch)

  3. Smile

    Smile – zygomaticus major (zygomatic and buccal branches)

  4. Puff out cheeks

    Puff out cheeks – orbicularis oris (buccal branch)

  5. Report findings

    Report findings

Step 10. CN VIII – Vestibulocochlear Nerve

  1. Pinnae and otoscopy

    Inspect and palpate pinnae; comment on otoscopy

  2. Whisper test

    Whisper test

  3. Weber test

    Weber test

  4. Rinne test

    Rinne test

  5. Report findings

    Report findings correctly

Step 11. CN IX, X & XII

  1. Palate and tongue inspection

    Inspect palatal symmetry, tongue wasting and fasciculations

  2. Say “Ah”

    Patient says "Ah" – levator veli palatini (vagus)

  3. Protrude and move the tongue

    Patient protrudes and moves tongue (hypoglossal n.)

  4. Cough

    Cough – recurrent laryngeal n. (vagus)

  5. Gag reflex

    Gag reflex – afferent: glossopharyngeal; efferent: vagus

Step 12. CN XI – Accessory Nerve

  1. Bulk and torticollis

    Inspect bulk and torticollis

  2. Shrugging

    Power: shrugging (superior trapezius)

  3. Head turn

    Power: head turn (sternocleidomastoid)

  4. Report findings

    Report findings

Step 13. Conclusion

  1. Thank the patient

    Thank patient

  2. Hand hygiene

    Hand rub/hand wash

  3. Communication

    Appropriate communication

Enable JavaScript to use the interactive checklist. Sign in to save your examination progress across devices.