Master Cranial Nerves I and II Assessments with Picmonic for Nurse Practitioner

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The twelve cranial nerves (CN) can be assessed through a series of different tests. CNI is connected to a person’s sense of smell. To test this, have the person close their eyes and smell something familiar. CNII is the optic nerve, tested through visual acuity and visual fields. CNsIII, IV, and VI are the oculomotor, trochlear, and abducens nerves. Assess P.E.R.R.L.A, and extraocular movements through the six cardinal positions of gaze. CN V is the trigeminal nerve, assessed through motor and sensory functions. Motor function is tested by feeling the muscles of mastication (the temporal and masseter muscles as the person clenches their jaw), and sensory function is tested using a cotton wisp applied to the person’s face. CN VII is the facial nerve. Have the person animate (e.g. smile, frown) and look for facial symmetry and mobility.

5 KEY FACTS

Cranial nerve 1, the olfactory nerve, which is located just above the nasal cavity, relays smell. Impairment to this nerve may result in an impaired sense of smell. This could also accompany a loss of taste.

This test should not be performed on a regular basis. The test is performed by having the person close their eyes and smell a familiar scent. This smell should not be complicated. A good item to use is an alcohol wipe because they are easily accessible and smell familiar. Occluded air passages from rhinitis or obstruction could interfere with the assessment. Decrease or loss of smell is connected with tobacco smoking, allergic rhinitis, and cocaine use.

The person should be able to smell the scent equally on both sides of the nose. Have them push down on each nostril and smell. Unilateral loss of smell could indicate head trauma or a brain lesion.

The cranial nerve ll, the optic nerve, conveys sight. This nerve connects the retina to the brain’s visual cortex. Impairment to this area could result in blindness in part or all of a visual field.

To test a person's visual fields check their visual acuity and visual fields by confrontation. Visual field loss may be linked to papilledema from increased intracranial pressure, or optic atrophy.

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