PPT on cranial nerves function, situation and test of cranial nerves.

1. Dr. Bhawna
MPT (Pediatrics)

2. Equipment Needed:
 Cotton ball, safety pin, snellen chart
 Tongue blade
 Tuning fork
 Reflex hammer
 pen light
 pencil and paper
 sweet/sour substances
 Familiar aromatic substance (coffee, vanilla)

3.  To learn how to examine the functions of the 12 pairs
of cranial nerves.
 To understand the functions of the 12 pairs of cranial
nerves.
 12 pairs of cranial nerve supply muscles of eyeball, face,
palate, pharynx, larynx, tongue and two large muscle of
neck.
 Control special senses like smell, sight, hearing, taste and
touch.

4. 1. Olfactory
2. Optic Forebrain
3. Oculomotor
4. Trochlear Midbrain
5. Trigeminal
6. Abducent Pones
7. Facial
8. Vestibulocochlear
9. Glossopharyngeal
10. Vagus Medulla
11. Accessory
12. Hypoglossal

7. CN I: Olfactory
 Sensory: smell
 Apply simple odors to
one nostril at a time
 Do not test unless
history indicates.

8. CN II: Optic
 Sensory:- vision
 Function :- sight
 Test :- visual activity.
 Check visual field.

9. CN III: Oculomotor
 Motor nerve
 Supply five Extrinsic muscles of the eyeball except
for superior oblique and lateral rectus muscle.
1. Superior rectus – looking up and out.
2. Inferior rectus – looking down and out.
3. Inferior oblique – looking up and in.
4. Medial rectus – medial movement.
5. Levator palpebrae superioris – extraocular muscle.

10. CN IV: Trochlear
 Motor nerve.
 Supply
Superior oblique muscle – looking down and in.

11. CN V: Trigeminal
 Mixed nerve.
 Sensory: face, teeth and tongue.
 Motor: muscle of mastication.
 Tactile and pain sensation on entire face.
 Test –
1) corneal reflex; sense of touch, pain, and
temperature; clench teeth; move mandible
side to side.
2) Sneeze reflex.
3) Jaw jerk reflex.

12. CN VI: Abducens
 Motor nerve
 Supply :-
Lateral Rectus Muscle – lateral movement.

13. CN VII: Facial
 Sensory supply :-
Taste to anterior 2/3 of tongue
 Motor supply :-
Ability to frown
Smile, show teeth
Puff out checks
whistle, close eyes

14.  Motor supply :-
muscles of facial expression
 Secretion of saliva
 Tears .

15. Test :-
 Observe patient as he talks and smile.
1. Eye closer
2. Asymmetrical elevation of one corner of mouth.
3. Nasolabial fold.
 Forehead wrinkles( frontalis )
 Tight closer of eye ( orbicularis oculi)
 Whistling ( buccinator )
 Pursuing the mouth (orbicularis oris )

16.  Taste :-
tested by using sugar and tartaric acid.

17. CN VIII:Vestibulocochlear
 Sensory supply:
Hearing, balance and
posture.
 Rinne’s test: on
mastoid process
 Weber’s test: on center
of forehead or vertex.
 Rhomberg test

18. CN IX: Glossopharyngeal
 Sensory:
- Taste, secretion of saliva.
 Motor:
- Able to swallow
- Gag reflex ( )
Gag reflex (afferent IX, efferent X)

19. CN X: Vagus
 Sensory
 listen to person talk (hoarseness)
 Motor
 ask person to say “ah” (soft palate contract and uvula stays
midline)
 senses aortic blood pressure
􀂄 slows heart rate
􀂄 stimulates digestive organs
􀂄 taste [Gag reflex (afferent IX, efferent X)]

20. CN XI: Spinal Accessary
 Motor:
 Turn head side to side
 shrug shoulders with
resistance

21. 1. Sternocleidomastoid
 Press a hand against the patient's jaw and have the
patient
 Rotate the head against resistance. Pressing against
the right.
 Compare power and muscle bulk on each side.
2. Trapezius
 Have the patient shrug shoulders against resistance
and assess
 Weakness and compare power on each side.

22. Sternocleidomastoid
Trapezius muscle

23. CN XII: Hypoglossal
 Motor:
 protrude tongue
 move tongue from side
to side with resistance