CN Name Site of Exit from Skull Fxn Lesions How to test

I Olfactory Cribiform plate Smell

Cribiform fx
Kallmans syndrome
Smell something
II Optic
Optic canal

Vision
(1) Snellen eye chart
(2) Test peripheral vision too
III Oculomotor Superior orbital fissure
Parasympathetic to ciliary &
sphincter m.
Innervates:
superior rectus m.
inferior rectus m.
medial rectus m.
inferior oblique m.
Uncal (transtentorial)
herniation
Diabetes
Webers syndrome: form of
stroke characterized by
presene of CN III palsy &
contralateral hemiparesis
(1) H in space test
(2) Convergence
(3) Pupillary light reflex test
IV Trochlear Superior orbital fissure Superior oblique m. Head trauma H in space test
V

1
st
branch:
Ophthalmic n.
Superior orbital fissure

Provides sensory from medial
nose & forehead
Trigeminal neuralgias Facial sensation test
2
nd
branch:
Maxillary n.

Foramen rotundum
Provides sensory from lateral
nose, upper lip, buccal area
Facial sensation test
3
rd
branch:
Mandibular n
Foramen ovale
(1) Motor fxn to muscles of
mastication
(2) Provides sensory from
lateral lip to lower border of
mandible
Jaw deviates to side of lesion
(1) Opening & closing jaw (2)
Facial sensation test

VI Abducens n Superior orbital fissure Innervates lateral rectus m.
Medial inferior pontine
syndrome: contralateral
hemiparesis, contralateral loss
of tacile & vibration
H in space test
VII Temporal n Parasympathetics to: Bells palsy: paralysis of (1) Wrinkle forehead
Zygomatic n Sublingual gland and
Submandibular gland

Muscles of facial expression
(stapedius, stylohyoid,
posterior belly of digastric m)

Sensory & taste for anterior
2/3 of tongue

muscles on one side of face

(2) Puff out cheeks
(3) Close eyes tighly
(4) Say Mimimimi to test lip
fxn

Buccal n
Marginal
mandibular n
Cervical n
VIII Vestibulocochlear Internal Acoustic meatus Equilibrium & hearing
(1) Acoustic schwannoma
(2) vertigo (n/v)
(1) Hearing test
(2) Nystagmus test
IX Glossopharyngeal Jugular foramen
Parasympathetic to paroid
gland
Innervates:
Stylopharyngeus m
Sensory from pharynx, middle
ear, auditory tube, carotid
body & sinus, external ear

Sensory & taste for posterior
1/3 of tongue

Posterior inferior cerebellar
artery (PICA) infarct:
Test by gag reflex
Listen for hoarseness
X Vagus Jugular foramen
Parasympathetic to body
viscera
Laryngeal & pharyngeal m
Sensory from trachea,
esophagus, viscera, external
ear, epiglottis
Thyroidectomy injury
PICA infarct

Uvula deviates AWAY from
side of lesion (weak side
collapses)
Gag reflex
Elevate palate w/ Ah
XI Spinal accessory Jugular foramen
Innervates
Sternocleidomastoid m
Trapezius m
PICA infarct
Turning head
Shrugging shoulders
XII Hypoglossal Hypoglossal canal Intrinsic tongue muscles
Anterior spinal artery infarct

Deviates TOWARD lesion
Anterior tongue protrusion

Muscles that close jaw = masseter m, temporalis m, medial pterygoid m
Muscles that open jaw = lateral pterygoid m

To distinguish b/w Bells palsy & a stroke:
usu Bells palsy will involve forehead, stroke does not.

Facial nerve runs thru parotid gland but does NOT innervate it.