gracyespino@uc-bcf.edu.

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 General Survey
•Is the first step in a
head-to-toe assessment.
 General survey
• Appearance and Mental Status- observe build
and height and weight in relation
• to client's age, posture and gait, standing,
sitting and walking, overall hygiene
• and grooming, body and breath odor, facial
expression, attitude, affect and
• mood quantity and quality of speech,
relevance and organization of thoughts
Cranial Nerve assessment
 What are cranial
nerves?
Cranial nerves are pairs of
nerves that connect your
brain to different parts of
your head, neck, and trunk.
 Mnemonic Type of
Cranial nerves (Type of Nerves Function
Nerves)
I. Olfactory S - some Sensory Smell
II. Optic S - say Sensory Sight

III. Oculomotor M - marry Motor eye movement

IV. Trochlear M- money Motor Moves eye to look at nose

V. Trigeminal B - but Both Face sensation, mastication

VI. Abducens M - my Motor Abducts the eye

VII. Facial B - brother Both Facial expression, taste

VIII. Vestibulocochlear S - says Sensory Hearing, balance

IX. Glossopharyngeal B - Bad Both Taste, swallow
X. Vagus B - Business Both Heart rate, digestion
XI. Accessory M - marry Motor Moves head

XII. Hypoglossal M -money Motor Swallowing, speech, moves tongue

1. The Olfactory Nerve (CNI)
The olfactory nerve is responsible for the sense of smell.
 2. The Optic Nerve (CNII)

• The optic nerve is the sensory nerve that

involves vision.
The optic nerve is tested in five ways:
• Visual Acuity
• Visual Fields
• Visual Reflexes
• Accomodation
• Funduscopic exam
Visual acuity:
 Common refractory error:

• Hyperopia – Farsightedness
• Myopia – Nearsightedness
• Astigmatism - blurred vision
• Presbyopia - is the gradual loss of your
eyes' ability to focus on nearby objects.
It's part of aging.
Pupillary response to
accommodation.
 Documenting tips for pupils
PERRLA Remember the Cs and Ds
for expected findings for
P - Pupils are accommodation
E - Equal Pupils Constrict when
R - round and focusing on a Close object
Pupils Dilate when
R - Reactive to focusing on a Distant
L - Light and object
A - Accommodation
Confrontation visual field
testing
Pupillary light reflex
Fundoscopy
3. The Oculomotor Nerve (CNIII)
• The oculomotor nerve has two different motor
functions: muscle function and pupil response.
• Muscle function. Your oculomotor nerve
provides motor function to four of the six
muscles around your eyes. These muscles help
your eyes move and focus on objects.
• Pupil response. It also helps to control the size
of your pupil as it responds to light.
Testing Extraocular Muscles (III, IV, VI)
Nystagmus
 4. CN IV: The Trochlear Nerve

• The trochlear nerve controls your

superior oblique muscle.
• This is the muscle that’s responsible
for downward, outward, and inward
eye movements.
Diplopia
 5. CN V: The Trigeminal Nerve
• The trigeminal nerve is the largest of your cranial nerves
and has both sensory and motor functions.

• The trigeminal nerve has three divisions, which are:

• Ophthalmic. sends sensory information from the upper
part of your face, including your forehead, scalp, and upper
eyelids.
• Maxillary. communicates sensory information from the
middle part of your face, including your cheeks, upper lip,
and nasal cavity.
• Mandibular. has both a sensory and a motor function. It
sends sensory information from your ears, lower lip, and
chin. It also controls the movement of muscles within your
jaw and ear.
Test the sensory branches
Test the motor supply
6. CN VI: The Abducens Nerve
• The abducens nerve controls another
muscle that’s associated with eye
movement, called the lateral rectus
muscle.
• This muscle is involved in outward eye
movement.
• For example, you would use it to look to
the side.
 7. CN VII: The Facial Nerve
• The facial nerve provides both sensory and
motor functions, including:
• moving muscles used for facial expressions as
well as some muscles in your jaw
• providing a sense of taste for most of your
tongue
• supplying glands in your head or neck area, such
as salivary glands and tear-producing glands
• communicating sensations from the outer parts
of your ear
How to test the Facial Nerve
Facial nerve Palsy
8. CN VIII: The Vestibulocochlear
Nerve
• also called the auditory vestibular nerve, is
responsible for hearing and balance.
• It consists of two parts, the cochlear portion and
vestibular portion:
• Cochlear portion. This generates nerve impulses
that are transmitted to the cochlear nerve.
• Vestibular portion. This information is
transmitted to the vestibular nerve and used to
adjust your balance and equilibrium.
Otoscopy
Whisper test
Finger friction test
9. CN IX: The Glossopharyngeal
Nerve
• The glossopharyngeal nerve is
partially responsible for the
sensation of taste, pharyngeal
sensation, as well as for the
gag reflex.
 How to test the
Glossopharyngeal Nerve
10. CN X: The Vagus Nerve

• The Vagus nerve innervates the hearts, lungs,

and digestive tract, along with a few muscles.
• Most noticeably, it controls the heart rate, GI
motility, sweating, and speech.
• It is also partially responsible for the gag reflex
(along with cranial nerve IX).
 11. CN XI: The Accessory Nerve
• is a purely motor branch
to the trapezius and
sternocleidomastoid
muscles:
• Sternocleidomastoid can
be assessed by asking the
patient to turn their head
to each side, against the
examiner's resistance
 11. CN XI: The Accessory Nerve

• Trapezius can be
assessed by asking
the patient to
shrug their
shoulders, against
the examiner's
resistance
12. CN XII: The Hypoglossal
Nerve
• The hypoglossal nerve controls
most of the movement of the
tongue.
• This means it is highly responsible
for speech and swallowing.
How to test the Hypoglossal
Nerve