Cranial Nerve Exam (OSCE)

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Contents

[edit] CN I (Olfactory)

Ask for any abnormality in smell Test with menthol containing ointment

[edit] CN II (Optic)

[edit] Pupils

  • size, shape, symmetry
  • reactivity to light and accommodation
  • direct and consensual response

[edit] Acuity

  • tested with near card or Snellen chart (with corrective lenses)

[edit] Visual Field

[edit] Fundoscopy

  • red reflex
  • vessels, optic discs, optic disc margin

[edit] CN III (Oculomotor), IV (Trochlear), VI(Abducens)

  • Mnemonic LR6SO4
    • Lateral rectus muscle by CN VI, superior oblique by CN IV

[edit] Position

  • eyelid (penlight in front of patient), move in an H pattern
  • eye position in primary gaze

[edit] Eye Movement

  • nystagmus

[edit] CN V (Trigeminal)

[edit] Sensation

  • all three divisions of CN V bilaterally
    • stroke across forehead, cheek and chin with a cotton wool

[edit] Motor

  • clench teeth - palpate bulk of masseter and temporalis
  • open mouth - inspect symmetry (pterygoids, masseter)

[edit] CN VII (Facial)

[edit] Motor

  • raise eyebrows to wrinkle forehead - frontalis
  • close eyes tight - orbicularis oculi
  • puff your cheeks out - orbicularis oris
  • tense neck muscles - platysma

[edit] CN VIII (Auditory/Vestibulocochlear)

  • whisper test
  • Rhinne
  • Weber

[edit] CN IX (Glossopharyngeal), X (Vagus)

  • swallowing
  • say “pa” (labial VII)
  • “ta” (lingual IX, X, XII)
  • “ka” (palatal IX, X)
  • say “ah” - check for symmetrical movement of palate and uvula

[edit] CN XI (Accessory)

  • sternocleidomastoid - have patient turn head against your hand
  • temporalis
  • Shoulder shrugging

[edit] CN XII (Hypoglossal)

  • position of extruded tongue in neutral position
  • side to side tongue movements
  • note any fasciculations

[edit] Other OSCE Modules

v • d • e
Observed structured clinical examination

Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence

[Category:OSCE]]

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