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Cranial nerves cheat sheet: all 12 nerves and how to test them

Cranial nerve questions ask two things: what the nerve does and how you test it.

Run CN I to XII in the same order every time so you never skip one. A classic mnemonic for the order is "On Old Olympus' Towering Top, A Finn And German Viewed Some Hops."

NerveFunctionHow to Test
CN I OlfactorySmell
  • Occlude one nostril
  • ID scent, eyes closed
CN II OpticVision
  • Snellen chart
  • Confrontation visual fields
CN III OculomotorEye movement, pupil, eyelid
  • Check PERRLA
  • 6 cardinal gazes
  • Lid elevation
CN IV TrochlearDownward/inward eye movement
  • Look down and in toward nose
CN V TrigeminalFacial sensation; chewing
  • Test face sensation
  • Palpate jaw while clenching
CN VI AbducensLateral eye movement
  • Look laterally to the side
CN VII FacialFacial expression; anterior taste
  • Smile, frown, raise brows
  • Puff cheeks, shut eyes tight
CN VIII VestibulocochlearHearing and balance
  • Whisper test
  • Weber & Rinne tuning fork
CN IX GlossopharyngealPosterior taste; swallow; gag
  • Test gag reflex
  • Say 'ah' with CN X
CN X VagusGag, swallow, voice; parasympathetic organs
  • Uvula rises midline
  • Check for hoarseness
CN XI AccessoryShoulder shrug, head turn
  • Shrug shoulders vs resistance
  • Turn head vs resistance
CN XII HypoglossalTongue movement
  • Stick out tongue
  • Should protrude midline

RN pearl: Run CN I to XII in order every time; 'On Old Olympus...' keeps you from skipping one on exam day.

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Frequently asked questions

Which cranial nerve controls facial expression?

CN VII, the facial nerve. Bell's palsy affects this nerve, causing one side of the face to droop.

How do you test the vagus nerve?

Ask the client to say "ah" and watch the uvula rise in the midline, check the gag reflex, and listen for hoarseness.

Which cranial nerves move the eyes?

CN III (oculomotor), CN IV (trochlear) and CN VI (abducens).

Keep studying

Sources

  1. Clinical Nursing Skills, 26.2 Physical Assessment, OpenStax
  2. Medical-Surgical Nursing, 15.1 The Cerebrovascular System and Cerebral Vascular Accidents, OpenStax
  3. Cranial Nerve Testing, StatPearls, NCBI Bookshelf

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