Presented by

Tommy J Numberi

Supervised by :
dr.Rahmat Andi Hartanto, Sp.BS(K)
 Sense of smell should be tested by the
patient sniffing through each nostril as the
other is compressed.
 The Optic nerve should be tested by :

◦ Visual acuity

◦ Visual fields

◦ Fundal Examination
 Visual Acuity
 Visual fields
 Fundal Examination
 Usually examined together
 As these cranial nerves are involved in
innervation of the extraoccular muscles
 This examined involves assesment :
◦ The position of the eyelids
◦ The pupils
◦ Extraocular movement
 The position of the eyelids
 Ptosis is due to paralysis of the
levator palpebra superior  3rd CN
lession

 Or due to weakness of the tarsal

muscle due to sympathetic lession
(horner’s syndrome).

 Lid Retraction
◦ The pupils
 Should be made of the pupil size,
shape and equality.

 Reaction to light

 Reaction to convergence and

accommodation for near vision
 Extraocular movement
 Testing by assesing facial sensation over the
three division of CN
 Motoric function of the 5th nerve can be
tested by palpating while patient clenches
their jaw.
 Somatic Motor - facial
expressions
 Autonomic Motor -
salivary and lacrimal
glands, mucous
membranes of nasal
and palatine mucosa
 Special Sensory - taste
on anterior 2/3’s of
tongue
 Damage produces
sagging facial muscles
and disturbed sense of
taste (no sweet and
salty)
 Special Sensory

 Provides hearing (cochlear branch) and sense of

balance (vestibular branch)

 Damage produces deafness, dizziness, nausea,

loss of balance and nystagmus
 The Cochear Nerve  Hearing :
◦ Scwabah
◦ Rine test
◦ Weber’s test
 The vestibular nerve :
◦ Testing by assesing romberg test
◦ Pendular Walking
 The glossopharyngeal and vagus can be most
easlily assessed by testing palatal movement
and sensation of the pharyng palate.
•Somatic motor – Swallowing and voice production via pharyngeal
muscles
Autonomic motor - salivation, gagging, control of BP and respiration
Sensations from posterior 1/3 of tongue including taste
Sensations from baroreceptors and chemoreceptors
Damage results in loss of bitter and sour taste and impaired swallowing,
blood pressure anomalies (with CN X).
◦ STERNOCLEIDOMAST
OID M.
◦ TRAPEZIUS MUSCLE
TONGUE STRENGTH
RIGHT XII THRUSTS TONGUE TO LEFT