Republic of the Philippines

NUEVA ECIJA UNIVERSITY OF SCIENCE AND

Cabanatuan City, Nueva Ecija, Philippines
ISO 9001:2015 CERTIFIED
COLLEGE OF NURSING

ASSESSING THE NEUROLOGICAL SYSTEM

The assessment of the 12 cranial nerves is crucial in diagnosing and treating various
neurological disorders. These nerves, originating from the brain, control sensory and motor
functions of the head and neck. Each nerve has a specific function, such as vision (optic nerve)
or facial expressions (facial nerve). Assessing these nerves involves evaluating their individual
functions through various tests, such as visual acuity tests or assessing muscle strength. A
thorough understanding of the definition and assessment of each cranial nerve is essential for
healthcare professionals to accurately diagnose and treat patients with neurological conditions.
This knowledge allows for targeted interventions that can improve patient outcomes and overall
quality of life.

Purpose of assessing the neurological system:

1. Assessing the cranial nerves allows for the detection of any sensory or motor deficits. By
evaluating each nerve individually, healthcare professionals can identify any impairments
in vision, hearing, taste, smell, or movement of facial muscles. This information is vital
in diagnosing conditions such as optic neuritis, Bell's palsy, or acoustic neuroma.
2. Assessing the cranial nerves aids in localizing lesions within the nervous system. Each
nerve has a specific anatomical pathway and innervation pattern. Therefore, if there is
dysfunction in a particular nerve or group of nerves, it can help pinpoint where the lesion
might be located.
3. Evaluating these nerves provides valuable information about brainstem function. The
majority of cranial nerves originate from nuclei within the brainstem; therefore,
abnormalities detected during assessment may indicate underlying brainstem pathology.
4. Assessing these nerves assists in monitoring disease progression and treatment
effectiveness. Regular evaluation can help track changes over time and determine if
interventions are improving or worsening symptoms.
5. Assessing the 12 cranial nerves contributes to patient education and understanding. By
explaining their significance and performing tests that patients can comprehend (such as
checking visual acuity), healthcare providers empower individuals to actively participate
in their own care.

INDEPEN COMPLE
INCAPAB
DENTLY TED
LE OF REMARKS
Preparation PERFOR WITH
DOING
MED HELP
4-5 2-3 1-0
1. Assemble equipment:
 Sugar, salt, lemon juice, quinine
flavors
 Tongue depressor (one broken
diagonally, for testing pain
sensation)
 Wisps of cotton, assess light torch
sensation
 Tuning fork

Snellen chart
Procedure
1. Introduce yourself, and verify
the client’s identity. Explain to
the client what you are going to
do, why it is necessary, and how
 Republic of the Philippines
NUEVA ECIJA UNIVERSITY OF SCIENCE AND
Cabanatuan City, Nueva Ecija, Philippines
ISO 9001:2015 CERTIFIED
COLLEGE OF NURSING
the client can cooperate.
2. Perform the hand hygiene, and
observe other appropriate
infection control procedures.
3. Provide for client privacy.
4. Inquire if the client has any
history of the following:
 Presence of pain in the head, back,
or extremities, as well as onset and
aggravating and alleviating
factors.
 Disorientation to time, place, or
person
 Speech disorders any history of
loss consciousness, fainting,
convulsions, trauma, tingling or
numbness, tremors or tics,
limping, paralysis, uncontrolled
muscle movements, loss of
memory, or mood swings
Problems with smell, vision, taste,
touch, or hearing.
Test the cranial nerves.
5. Cranial Nerve I – Olfactory

Ask client to close eyes and identify

different mild aromas such as coffee and
vanilla.
6. Cranial Nerve II – Optic

Ask the client to read Snellen’s chart;

check visual fields by confrontation,
and conduct an ophthalmoscopic
examination.
7. Cranial Nerve III – Oculomotor

Assess six ocular movements and

pupil reaction.
8. Cranial Nerve IV – Trochlear

Assess six ocular movements.

9. Cranial Nerve V – Trigeminal

While client looks upward, lightly

touch the lateral sclera of the eye to
elicit the blinx reflex. To test light
sensation, have the client close eyes,
and wipe a wisp of cotton over
client’s forehead and paranasal
sinuses. To test deep sensation, use
alternating blunt and sharp ends of
a safety pin over the same area.
10. Cranial Nerve VI – Abducens
Assess directions of gaze.
11. Cranial Nerve VII – Facial

Ask the client to smile, raise the

 Republic of the Philippines
NUEVA ECIJA UNIVERSITY OF SCIENCE AND
Cabanatuan City, Nueva Ecija, Philippines
ISO 9001:2015 CERTIFIED
COLLEGE OF NURSING

eyebrows, frown, puff out cheeks,

and close eyes tightly. Ask the client
to identify various tastes placed on
the tip and sides of tongue – sugar,
salt – and to identify areas of taste.
12. Cranial Nerve VIII – Auditory

Assess the client’s ability to hear the

spoken word and the vibration of a
tuning fork.
13. Cranial Nerve IX –
Glossopharyngeal

Apply tastes on the posterior tongue

for identification. Ask the client to
move tongue from side to side and
up and down.
14. Cranial Nerve X – Vagus

Assess with CN IX; assess the client’s

speech for hoarseness.
15. Cranial Nerve XI – Accessory

Ask the client to shrug shoulders

against resistance from your hands
and to turn head to the side against
resistance from your hand. Repeat
for the other side.
16. Cranial Nerve XII –
Hypoglossal

Ask the client to protrude tongue at

midline, then move it side to side.

Remarks:

Name and signature of the student: _________________________

Score: ________

Clinical Instructor: _______________________