Nurse Practitioner (NP)
Advanced Physical Health Assessment
Head-To-Toe Assessments
Cranial Nerves I and II Assessments

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Cranial Nerves I and II Assessments

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Cranial Nerves I and II Assessments

Brainstems with #1 Foam Finger and (2) Tutu with Assess-man
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.
Cranial Nerve I - Olfactory Nerve
Brainstem with Number (1) Foam-finger in Nose and the Ol' Factory

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.

Use Familiar Attainable Smells
Smelling Alcohol Wipe

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.

Note Any Sense of Smell Asymmetry
Smell Asymmetry

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.

Cranial Nerve II - Optic Nerve
Brainstem with (2) Tutu and Optics Nerve-guy

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.

Test Visual Fields
Visual Fields Test

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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