cranial-nerve

Cranial Nerve Assessment

Cranial Nerve Assessment

Normal Assessment Findings

A normal cranial nerve (CN) assessment evaluates the function of the 12 cranial nerves, ensuring sensory, motor, and autonomic functions are intact. Below are the expected normal findings for each cranial nerve based on standard nursing assessment techniques:

  • CN I (Olfactory): Patient identifies familiar odors (e.g., coffee, vanilla) with each nostril separately, indicating intact smell sensation.
  • CN II (Optic): Visual acuity normal (e.g., 20/20 on Snellen chart or reads fine print); visual fields full by confrontation test; color vision intact (e.g., identifies colors on Ishihara plates).
  • CN III (Oculomotor): Pupils equal, round, reactive to light and accommodation (PERRLA); eyelids open symmetrically; extraocular movements smooth and full in all directions without nystagmus.
  • CN IV (Trochlear): Eyes move downward and inward smoothly during extraocular movement testing (e.g., following an H-pattern).
  • CN V (Trigeminal): Facial sensation intact to light touch and pinprick in all three branches (forehead, cheeks, chin); corneal reflex present (blinks when cornea lightly touched); jaw strength equal bilaterally when biting down.
  • CN VI (Abducens): Lateral eye movement smooth and full (e.g., eyes track outward during H-pattern test).
  • CN VII (Facial): Facial movements symmetrical (e.g., smiling, puffing cheeks, raising eyebrows); taste sensation on anterior two-thirds of tongue intact (e.g., identifies sweet/salty).
  • CN VIII (Vestibulocochlear): Hearing intact (e.g., hears whispered words or finger rub); balance normal (e.g., no swaying during Romberg test or normal gait).
  • CN IX (Glossopharyngeal): Gag reflex present; patient swallows without difficulty; taste on posterior third of tongue intact.
  • CN X (Vagus): Uvula and soft palate rise symmetrically on saying “ahh”; voice clear, not hoarse; swallowing intact.
  • CN XI (Accessory): Shoulder shrug and head turn against resistance strong and symmetrical, indicating intact trapezius and sternocleidomastoid muscles.
  • CN XII (Hypoglossal): Tongue protrudes midline; no fasciculations or tremors; tongue strength normal when pushing against cheek or tongue depressor.

These findings indicate normal cranial nerve function. Any deviations (e.g., asymmetry, weakness, or sensory loss) should be documented and reported for further evaluation.

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