Hello and welcome to the cranial nerve examination.
I'm going to start with a smell test, present some aromas just under the nose.
Let me know what you think you can detect.
Okay eyes closed
First aroma.
Inhale through the nose.
Give yourself a moment.
What are you detecting there?
Okay eyes closed again
Second scent.
Inhale through the nose
What are you picking up there?
Interesting
Third and final one.
Eyes closed again
Breathe in through the nose again
Okay, open your eyes
What did you think about the third smell?
Okay, let's record those results.
Okay let's move on to the eyes and everything associated with them.
Start with a vision test.
You need to cover the left eye gently with the palm, no pressure against the globe.
A little vision chart here.
Starting from the top, read down along the rows as far as you can please.
Good.
Okay cover the other eye
and just go again from the top, please reading out
Okay, lovely
Okay, we're going to check the eye muscles as you follow a target.
Head still.
Follow the bird here please
you need to report any double vision of the target in any area
Super
I'm going to take a measurement of the pupils using this scale here.
Going to rest against the forehead, looking into this eye please
this eye
thank you
Going to rest this on the bridge of the nose, just like so.
I want you to look at the line and then locate the spot.
I'm going to bring it closer.
I want you to tell me if the line goes into double as it approaches
keep following
Good.
Any double vision?
Still single?
Good convergence there.
Both eyes open.
We're going to look at your colour vision.
Say the numbers you see on the page please
Doing well
Also tell me if you don't see any digits
Good final few plates
Looking good
Record those results vision right eye and left eye
Pupils.
Pupil size.
Just looking straight.
Let's go back to the pupil reactions there
Okay
Motility was full.
No double vision.
A couple more things, with the eyes
Focus on the policeman and then find his hat.
Keep looking at his hat please, just going to do a cover test, add near
and then we're just going to swing the cover from eye to eye
Good, okay, looking between my eyes
Maintain your gaze please
Good
I'm going to have a look inside your eyes with the ophthalmoscope, focusing on cranial
nerve number two, which is the optic nerve head.
Just going to check the appearance.
Look straight
Clicking is just a focusing wheel
Its pink.
It's defined
Make a note of the cupping there
Vascular arrangement
bayonetting or notching
No pallor.
All pink
No drusen.
Lovely, that's the right
Keep looking straight.
Let's observe the optic nerve head in the left eye.
Okay point four
Its pink and defined.
There's no optic nerve head drusen.
No pits
Vessels are defined at the crossing
No evidence of notching or bayonetting
Okay, lovely
Okay so that concludes the ocular portion of the cranial nerve examination, let's just
wrap up those results.
Cover test morthophoric distance and near.
In terms of your optic nerve head, it's pink and defined it's looking for any druzen or
pits any indistinctness of the margins which is negative, evidence of ppa, has no notching
or bayonetting.
All the abnormal things that we look for were not present.
Good.
Okay, what have we got next?
Oh yes.
You need to look up ever so slightly.
I have a wisp of cotton wool here, it's going to gently touch the front of the eye checking,
uh for your eye sensitivity, specifically the cornea.
Keep looking up.
Good just a little dab, like so and I will observe the reaction, which was normal.
For the left, looking up, little dab, good.
Okay
I kind of just have a little feel on the sides of the face.
I want you to clench the jaw for me please.
Really tight
Okay open your mouth like so.
Just resist me pushing your mouth closed
Excellent
Okay, what do we have next?
We have the touch test of the face.
I have two applicators.
This is the dull and this is the sharp.
I'm going to alternate between the two.
I want you to tell me whether the sharp or the dull applicator touch your face.
Just say sharp or dull.
And close the eyes for me please
Excellent.
Thank you
We're going to move on to the taste test now.
We have two little applicators I'm going to ask you in a moment to stick your tongue out.
Place the applicator just gently against the tongue a little dab keep the tongue out after
I have applied the applicator and then tell me what do you think you can taste okay.
Tongue out
keep it out
okay tongue in, what do you detect there?
And for the next one tongue out
keep it out
What are you picking up there?
Okay, let's record our results there
Okay, finally we're going to do some facial expressions, so I'm going to ask you to first,
raise both eyebrows please
Okay.
raise your right eyebrow
Raise the left
Blink the right eye
blink the left okay.
Just smile now.
Okay, smile on one side
and the other side
okay give me a frown
okay lower the jaw
Clench the jaw, lovely.
i'm pleased to say that you've passed every test and I will send a copy of the results
to you.
Fantastic work and I'll see you in the clinic next time