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

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