Cranial Nerve Exam
Gain confidence with one of the most integral parts of the neurological exam and streamline your note-taking during the exam with Carepatron’s dedicated Cranial Nerve Exam template.
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What is a Cranial Nerve Exam?
The Cranial Nerve Exam forms an important part of the complete neurological examination and involves examining the functioning of the cranial nerves; twelve pairs of nerves connecting directly to the brain and terminating at various locations throughout the body.
Each cranial nerve is assigned a number according to its position along the longitudinal axis of the brain and is commonly denoted “CN”, followed by the Roman numeral of the cranial nerve number, e.g. “CN X” for the tenth cranial nerve, also called the vagus nerve (Martini, 2017).
A Cranial Nerve Exam is a structured examination designed to check each cranial nerve in turn, using various methods that can usually be completed with equipment readily available in a hospital environment (Reese, 2023). Although this exam can be completed relatively quickly without specialized equipment, it has many different parts that must be completed in succession to assess each of the cranial nerves thoroughly – and that's where Carepatron's Cranial Nerve Exam template can help. Just keep reading to find out how!
Printable Cranial Nerve Exam
Download this Cranial Nerve Exam and effectively conduct a neurological exam.
How to use this Cranial Nerve Exam Template
Need a quick memory refresh on how to examine each cranial nerve? We've got you covered with our concise cranial nerve exam how-to based on the Oxford Medical Education Cranial Nerve Examination guidelines (Oxford Medical Education, 2015).
Olfactory nerve (CN I)
Assessment of the olfactory nerve is conducted via questioning. Question the patient on any recent change in sense of taste or smell, or formally assess using smelling bottles, e.g. coffee or peppermint occluding one nostril at a time.
Optic nerve (CN II)
The optic nerve is assessed through vision tests. Test visual acuity using a Snellen chart at 6m covering one eye in turn. Test peripheral fields by confrontation and check visual neglect.
Oculomotor nerve (CN III), trochlear nerve (CN IV), and abducens nerve (CN VI)
These three nerves are tested at once. Check primary position, diplopia (double vision), smooth pursuit, and saccadic eye movements, consider a PERRLA test for testing pupillary light reflex.
Trigeminal nerve (CN V)
For the trigeminal nerve tests, assess ophthalmic, maxillary, and mandibular sensory branches with a piece of cotton wool. Inspect for wasting of the masseter and temporalis muscles and check for jaw resistance strength. Check corneal and jaw-jerk reflexes.
Facial nerve (CN VII)
To assess the functioning of the facial nerve, ask the patient to scrunch up their eyes, look upwards and raise their eyebrows, puff out their cheeks, show their teeth, and inspect for facial asymmetry.
Vestibulocochlear nerve (auditory) (CN VIII)
Perform gross hearing assessment followed by a Rinne test, Weber's test, otoscopy, and audiometry if hearing loss is detected.
Glossopharyngeal nerve (CN IX) and vagus nerve (CN X)
Assess for dysarthria or dysphonia as part of the glossopharyngeal and vagus nerves testing. Ask the patient to say “aah” and inspect the soft palate and uvula. Perform a swallow assessment or assessment of gag reflex.
Spinal accessory nerve (CN XI)
Ask the patient to raise their shoulders then turn their head and keep them there while you provide resistance.
Hypoglossal nerve (CN XII)
To test the hypoglossal nerve, inspect the tongue for wasting and fasciculations, ask the patient to protract their tongue and inspect for deviation, test the tongue strength against each cheek.
Once you have completed the testing for each of the cranial nerves, the next steps will depend on your clinical findings, and the results of any further testing or imaging they have undertaken. Ensure you store your patient's cranial nerve exam notes securely in their medical record.
Cranial Nerve Exam Example (Sample)
For examples of the sorts of things you could write for each stage of the cranial nerve exam, look no further than our example Cranial Nerve Exam template. This example is based on a fictional, normal cranial nerve exam and should illustrate how to use this template when conducting a cranial nerve exam. Take a look at the sample template below, or download the PDF version to save it locally.
Download this Cranial Nerve Exam Example (Sample) here:
When would you typically use a Cranial Nerve Exam?
While the cranial nerve exam aims to test the proper functioning of the cranial nerves, its broader purpose is to localize neuropathology as part of a complete neurological exam.
Clinical indications for a cranial nerve exam include (Reese, 2023):
- Trauma or traumatic brain injury (TBI)
- Unconsciousness or coma
- Intracranial hemorrhage
- Stroke
- Cerebral aneurysm
Who can use this printable Cranial Nerve Exam?
The cranial nerve exam is part of the complete neurological examination and requires training and skill to perform correctly and efficiently. As such, the only professionals who should be performing cranial nerve exams are qualified healthcare practitioners with formal training in physical and neurological examination, or students/trainees of one of these professions under appropriate supervision. Those who may find this template particularly useful include:
- Medical or Nursing students and trainees
- Physicians
- General Practitioners / Primary Care physicians
- Emergency Medicine Physicians
- Neurologists and Neurology Residents.
Benefits of free Cranial Nerve Exam Template
Structure your cranial nerve exam
This template has the dual purpose of serving as a pre-formatted record for your clinical findings, but also as a structure for the exam itself. Each row separates the nerve or group of nerves that must be assessed and can help keep you on track and ensure you don't accidentally skip any during the examination.
Keep your findings organized
Staying organized is a superpower for busy clinicians. Our cranial nerve exam template will help you keep your notes from the cranial nerve exam clearly laid out and understandable.
Easily share results with other practitioners
Your colleagues will thank you for using a clearly formatted cranial nerve exam template, as they can quickly understand your findings and move on to making informed treatment decisions rather than spending time decoding a chaotic exam note.
Standardize your cranial nerve exams
It's essential you offer all your patients the same high level of care, and the cranial nerve exam is no different. By using the same template for each exam, you can demonstrate your efforts to standardize your practice and deliver the same high-quality examination to every patient.
Go fully digital
Finally, this exam template can be filled out and shared entirely digitally; no more printing and scanning is needed! This has huge benefits for you and your colleagues in time-saving, as well as improving your information security.
Why use Carepatron for your Cranial Nerve Exam software?
Our cranial nerve exam template isn't the only way Carepatron can save general practitioners time.
Carepatron is the perfect partner to reduce your practice's admin work. Utilize Carepatron's AI-powered dictation software and get your clinic notes down in record time, or offer your patients their own portal within Carepatron to access digital documentation and their medical records.
Strike the perfect balance between accessibility and security with Carepatron's mobile and desktop platforms, each equipped with HIPAA-compliant, bank-level data encryption- meaning your patients' documentation will be secure, and available whenever you need it.
And best of all, join a community of over 10,000+ motivated healthcare professionals contributing to Carepatron's library of resources ranging from progress notes to intake forms all designed to take your practice to the next level.
References
Damodaran O, Rizk E, Rodriguez J, Lee G. (2014) Cranial nerve assessment: a concise guide to clinical examination. Clin Anat. 27(1):25-30.
Martini, F., Ober, W., Nath, J., Bartholomew, E., & Petti, K. (2017). Visual Anatomy and Pathology. New York: Pearson Education Inc.
Reese V, M Das J, Al Khalili Y. Cranial Nerve Testing. [Updated 2023 Sep]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Cranial Nerve Examination. (2015) Retrieved from Oxford Medical Education:https://oxfordmedicaleducation.com/clinical-examinations/cranial-nerve-examination
Commonly asked questions
Like with any clinical examination, there is some variation in how you choose to assess each of the cranial nerve exams, but some things should remain constant every time you conduct an assessment. These include gathering the required equipment, checking the patient’s name and date of birth, introducing yourself, explaining the examination in understandable language, and gaining consent to proceed with the examination.
There are some contra-indications for the cranial nerve exam such as facial trauma or swelling that may prevent proper assessment of, for example, CN III, CN IV, and CN IV. With advances in imaging technology, the results of a cranial nerve exam are no longer the sole method for diagnosing lesions, however, the cranial nerve exam remains an important part of the neurological exam and one that can be performed quickly with minimal equipment.
This will depend on the findings of the cranial nerve exam. The next steps following the cranial nerve exam could include further neurological testing, formal hearing assessments, speech examinations, or neuroimaging.
