A cranial nerve examination systematically tests the 12 pairs of cranial nerves (I-XII) to assess neurological function, including olfactory (smell), optic (vision), oculomotor (eye movements), facial (facial expressions and taste), vestibulocochlear (hearing and balance), glossopharyngeal (taste and swallowing), vagus (visceral function), accessory (head/shoulder movements), and hypoglossal (tongue movements) nerves, using various tests such as smell identification, visual acuity charts, tuning fork hearing tests, reflex hammer assessments, and sensory discrimination tests.
Deep Dive
Prerequisite Knowledge
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Deep Dive
ASMR Realistic Medically Accurate CRANIAL NERVE EXAM | Hearing Test,Eye Exam,Taste,Smell,ReflexesAdded:
Hello.
Are you here for your cranial nerve exam?
Okay. So, come on in.
No, you're exactly on time.
How are you doing today? How are you feeling?
Okay. Well, let me confirm some of your personal data first. I promise it won't take long. just to be on the safe side.
We seem to have all your info in our system, but your first name.
Okay. Your last name would be okay. Now, your home address, is it still the same?
Okay.
Your phone number.
It's quite convenient.
Yeah. We can send you the results, reminders about your appointments and stuff like that.
We promise not to spam. Mhm.
You can trust us on that.
Yeah. So, okay. Now, your date of birth.
Well, yeah, I suppose it remains unchanged.
Okay. Wonderful. So, have you had any complaints as of lately or is it just a regular chuck up?
Yeah.
Right.
Any kind of headaches can be the often reason. Mhm. Can be the frequent reason for that. So yeah, when it comes to the headache on the scale from 1 to five, how would you evaluate the approximate? I know it's never accurate and it might be even hard to tell, but still if you tried to evaluate it approximately, what would it be?
Okay. How would you describe it? Is it ramen seeding?
Right. What about your neck? Have you had any injuries?
Anything I should know of?
Let me have a quick look at you. Okay.
Just a second. I'll put on my latex gloves.
I will touch your head, your face really slightly. I'll be very gentle. I promise. So, please no worries about that.
One moment, please.
I do not necessarily put on the latex gloves. It's enough to wash and sanitize your hands, but still to be on the safe side.
Might be good to take all possible precautions.
So, all right, just give me another moment.
Here we go.
Okay.
Please do let me know in case you feel any kind of discomfort or pain or any kind of unpleasant feelings. I will stop immediately. Okay? But it shouldn't hurt. It's not supposed to at least.
Okay? So, let me look at your head.
What if I press right here above your eyes?
Is it okay?
Do you feel any kind of pain?
All right. Now, what if I up here right below? Is it still all right?
Okay.
Now, around your chin, your neck right now.
Okay. Could you please look at me? be straight in the eye.
Okay. Now, could you please frown at me?
Let's check your facial expressions and your muscle movements.
Yeah, your facial nerve is actually responsible for that. So, we'll check how it works right away.
It's one of the 12 pairs of cranial nerves.
Right. So now, could you raise your eyebrows as if you're really surprised or astonished?
Good. Now, could you please smile at me and give me the widest smile possible?
Okay, perfect.
Good.
Now shrug your shoulders please.
Just like that. And now could you please rock them and keep them like in the high position. I will try to press them down using my hands.
You have to resist me. Okay. Just try your best not to give in to me. Okay. So let's do it.
Good. Okay. Now, could you please tilt your head right like as if you want to reach your shoulder with your ear? Can you do that?
Okay, perfect.
Fine. Now, please do it again. And I will also put my hand right on your head.
I will try to press it down. You try to resist me and put your head back into straight position. Okay.
So tilt it like that.
Good.
Perfect. You did well. Now let's try the other side to check if it's all symmetric on both sides.
So please tilt your hand like that.
I will put my hand on it.
And now let's try to put it back into straight posession. Good. Okay.
Now, have a look at me once again. Could you chin up for a moment? Check your thyroid.
Have you ever had any problems with that? Any hormonal dispenses?
Okay.
Oh, yeah. That might be the reason for many many things, many symptoms including insomnia and absolutely that's more about your endocrinologist.
So they're supposed to do this kind of research. So I can only give you a referral to one. We have really good doctors at our clinic. So no worries.
Mhm. Okay. Now, please have a look straight at me. And now follow my fingers.
That's where we start checking the nerves which are responsible for your eye movements.
Okay. But you've got to trace my fingers with your eyes only.
Don't move your head. Mhm. That's really important. Okay, let's try again.
Now focus on my nose only and please tell me if my fingers are in your felt the vision or not.
Good. Okay. And now once again.
Okay. Good.
Okay.
Now we will do some more test to check your eyesight. That's just the beginning. But before that, let's check your balance really quickly.
So I will ask you to close your eyes and try to reach the tip of your nose with your pointing finger. Mhm. First straighten both of your arms, please.
Good. And now close your eyes. Just relax. It's fine.
And exactly. Good. Okay. Now, let's make it a bit more challenging. Could you do that now with your middle finger?
Yeah.
Okay, good.
And now your other hand. Just the same kind of thing, but with your other hand, the same index finger. Just straighten your arms, please. Mhm.
Good.
Perfect.
Okay, great. Now, could you please stand up for a moment?
Uhhuh. And just stand on one foot.
Mhm. That's just at least for three seconds.
One, two, three. Okay. And now the than with the other one.
Good. Well, I don't see anything disturbing when it comes to your balance and coordination.
So, it's just fine. Now, going back to your face, could you please clench your jaw for a moment?
Mhm. Just like that. I will try to push your chin down.
Yeah. You don't let me do that. Mhm.
Okay.
Good.
Perfect. Now, please puff your cheeks for me.
Mhm.
Okay, that will do. And now puff them again. I will try to close them again.
Resist me. Okay. Just I dare you. Okay.
Good. Wonderful. Oh, you're doing really great. So, I will take off those gloves for now.
It's okay.
Let me just register the results, the process.
Okay. Oh, now speaking of your cranial nerves, many people wonder how they work. And u if you like, I can give you a really short brief lecture regarding that. So at least you would know what exactly I am doing and what I'm checking. It might lower your anxiety if you have any. I know that when I am a patient, it usually makes it easier for me, when um uh the doctor comments on what they are doing. Yeah. You know, so when you comment on that and explain everything uh what exactly you're doing at the moment, what you're checking, what it's supposed to mean, it's somehow easier for a patient. Doesn't matter what kind of doctor it is the dentist, urologist, like gynecologist, whatever. Right? So in such cases, if you are a bit anxious or worried, which we often tend to be when we are having some kind of appointments with doctors. So it makes it a bit easier. Right. Well, let's have a look at this chart first and then I'll show you some more. I have some pictures. So, well, like I said, you have those 12 pairs of cranial nerves.
Mhm. And the first one, all factory, which is responsible for your sense of smell. Mhm. We're going to check it really soon. All our patients enjoy those tests immensely. They're fun. Well, anyway, I know that for many people who have suffered from some particular um kind of particular stray of viruses, uh they might have troubles with their sense of smell and taste. Sometimes mostly temporarily, but some cases it might take quite a long time to get them fully recovered. So yeah, unfortunately it does happen. Okay. Well, now the second one would be optic and it's more about your visual acuity. So it's usually easier to check with a smelling chart, stuff like that. So it's exactly about how well you can see the objects in what details from different distance and stuff like that. Mhm. We haven't checked that yet. Then ocular motor is more about your eye movement and pupil dilation.
So with your eye movements, we have checked it partially, but we're going to proceed with that a little bit more. And pupil dilation, we haven't checked it yet. It's usually easier to do with the light apparently. Okay. Then draw clear again related to your eye movements but this time vertical eye movements like up and down. Mhm. Then what else we've got?
Like uh we were talking about your facial expressions and beside the facial nerve there is another one which is responsible for that and it is a triminal nerve. Okay. So it's more about your facial expressions which we have already checked and your facial sensations which we are about to check still have to do that. We can usually use some kind of a brush. Yeah. So you will have to tell me when you feel it touch your face. So nothing particularly challenging about that. Now next one. What else? We got abductance again about eye movements but this time lateral to the right to the left. So when I was using my fingers like drawing some infinitive symbols in the air I was actually checking both of your vertical and horizontal lateral eye movements.
uh it is also important when it comes to your side vision or peripheral side.
Mhm. Okay. Then facial nerve we have already discussed it briefly. It's about your facial expressions but it is also responsible for your sense of taste partially because there are a few nerves few pairs of nerves which are responsible for your sense of taste.
So, we're going to test all of them by testing your sense of taste, obviously.
Um, again, our patients enjoy those tests. Yeah. So, you've got to try different substances. It's mostly like starches syrup with different flavors.
Mhm. Usually nice ones.
Yeah. Okay. Then besides facial we have auditory or it can also be called vast vestibular clay nerve. Mhm. So yeah it's not just about your hearing but also about your balance. Well the word vestibular yeah it um gives a hint to that. Yeah. So we have already checked your balance but we haven't checked your hearing yet. So we um can say that we have partially chucked this nerve. Then glass of fingel is also responsible for your sense of taste.
Uh maybe you have seen the picture where there are different zones like areas on your tongue which are responsible for different kinds of um flavors like bitter, sour, sweet, spicy and stuff.
So yeah, basically uh that's because there are a few different nerves which are responsible for your sense of taste, not just one.
Okay. So like I said we had um this facial nerve then glossopherial.
It is responsible for your taste and also for swallowing. Mhm. And then also vagus nerve it can be responsible for your sense of taste as well partially.
But vagus nerve h it's called this way because um it is basically uh it has many many like branches if we can say so. Yeah. And and it's pretty long. So it connects your um organs different parts of your body to your brain. So if you can see it's also about paristhetics in your stomach. It's also about your heart sensations in your throat and visceral muscles, vocal cords and other stuff. So you know it's like quite a lot. And then finally we have accessory nerve which is responsible for head and shoulder movements which we have already tested and hypoglossal also your tongue movements. Well glossal kind of gives a hint. Yeah. Okay.
Anyway, I hope that was helpful. Now, I will just show you a few more pictures on where exactly they are located.
If that helps, you can see all of them in different colors. It's very convenient. Like I said, they are they work in pairs, so you can see them. Look, they're symmetric.
Well, then we have another picture. Oops, I'm a bit fuzzy. I'm sorry.
Well, what else can we see here?
Here you see again the picture of your brain. I like this one better. It's more fun than the previous one, but it's basically like exactly the same. maybe different colors used but yeah here you can still see how they are located and how it all works.
Then we have another chart which we are supposed to use a bit later and then one more chart showing your cranial nerves.
So as you can see we have quite a lot of them our neurology office. Yeah. And again so here there are some explanations given but I have already told you everything that uh is related to your cranial nerves. Well at least some general information which is not uh like overwhelmed with different medical terms and I suppose it was still quite interesting for you. Well, now let me also take your files, okay? Cuz uh it is still related to your cranial nerves and to your general well-being.
So, it's a must.
All righty. Are you ready?
Mhm. Let's do it.
Good.
So, could you please press in for me and press out right away?
Good. Now, once again, please breath in and out.
Now once again in and out.
Now please turn around.
Good. Let's do it this way.
Now I will ask you to hold your breath for a moment.
So breath in, hold there and out.
Okay, perfect. And now once again in.
Hold there for a moment.
And out.
Okay, now let me listen to your stomach just for a moment.
Just relax. You can press in and out and exhale really slowly, but it's all right.
Okay, now just one more second.
Okay. Okay.
No, you're doing totally fine. It's all right.
Just give me a moment.
Okay.
Thanks for your patience.
Like I said, it's totally okay. Now, let me take your pulse for a second. Okay.
Okay, that will do. So, all the parameters are totally fine. Let me just I can add them into the system.
Yeah.
Good. Well, now we can actually switch to the rest of the test. And I guess that just for fun will do these smell and taste ones. Okay, if you don't mind.
Good.
Well, let's see what we've got here.
Okay. Well, let's start with your sense of smell.
Before we do the test, let me have a quick look at your nose. Okay.
Also, your mouth and your throat. Turn up a little.
Perfect.
Fine.
And now open your mouth.
Just play for that.
Stick out of your tongue and say a Okay. Good. Good.
Now let's check one more thing if you have any kind of nasal congestion.
So usually the stream of air is supposed to pass freely through your nostrils.
I will ask you to close one of your nostrils and just press in and breathe out. I'll put this tiny brush close to your nose. So if it sways a little, we'll be able to actually see it visually. That's your nose can breath that you don't have any kind of nasal congestion. So please close one nostril.
Exhale.
Perfect. It's sway a little. And now with the other one.
and breath in and out.
Okay, good. So, I don't see any problems there. So, we have a few different testers.
Actually, have quite many, but that's okay.
Mostly we use like really basic ones.
They can let us understand that everything is just fine with your sense of smell. I'll get the cuticle.
Okay. The cotton swab. It will make it easier to conduct the test.
Okay, that will do, I suppose. Let's give it a try. Let's take a smell.
Take a sniff.
So, What do you think it is?
Okay.
Chocolate. Right. Your, like I said, a pretty standard one. Not like some kind of luchi or mango, some exotic fruits or stuff, but usually these are the scents that everybody can recognize.
That makes sense, right? Okay. Okay.
Now, let's get another kitty and another bottle.
with the tester.
So, just a second. I will close this previous one. And now, let's get a new one. Got all two.
They all look pretty much the same. Not to give you any visual hints. Yeah. In terms of colors and stuff.
So, It's okay.
I think that's enough.
Relax.
Mhm.
So, you got any idea of what it is? What it smells like?
Peppermint.
It's hard to confuse mix up with something else, right?
And now third time is a charm, right?
Let's do one more test. Sometimes even two are enough. We can see that patient can differentiate between different kinds of smells, but let's just do a really thorough checkup today.
Who knows? Okay, so one more. Here we go.
Okay, I'm a bit clumsy tonight. Sorry.
So, let's take a smile.
That will do. So, what does it smell like to you?
Rose. Okay. Very common flower, right?
So, everybody knows what they smell like.
Okay, good. Now, your sense of taste.
Just give me a moment.
Good. So, Please open your mouth. Stick out your tongue just a little bit for me to be able to drop some amount of this substance syrup onto your tongue.
No need to say a but you can if you want to. Let's do it. Okay.
Give it some time.
There is no hurry really.
So it's okay.
Good.
So, what does it taste like?
Grapefruit.
Yeah, it has a pretty distinctive citrusy taste. Um, and yeah, it is actually grapefruit, but even if you said orange, you would be really close.
Grapefruit is just a bit less sweet.
Yeah, it's like there are some bitter notes to that. But that's very accurate actually. Thank you. Okay, now one more.
You're ready.
Good.
Okay.
again. Give it some time. There's no rush.
So what do you think it is?
Coffee, right? Yeah. Okay. And one more time.
Let's do it.
There you go.
Okay, relax. It's okay. Once again, even if you make mistake, it's totally fine.
There's nothing weird or embarrassing about it.
So, what's your verdict?
Talking out of this. Good.
Let me just pack them in quickly. Okay. to introduce the results so they are so that I don't miss on anything.
Okay, now let me test your reflexes really quickly. Before we skip to your eyes, not ears.
That's a percussion hammer. You might have seen it already.
So, what I'm going to do is to use it to check if your flexes work the way that you're supposed to. So, knee jolex, could you please put one block over the other? Bend them in the knees.
Mhm. And I'll be quick.
You see, it's not that scary after all.
Now, switch them, please.
Okay.
Again. Now, let me have a look at your wrists.
Good. The other hand.
Mhm. And your elbows.
Good.
Yeah, like your limbs are supposed to make this jerking movement. That's why it's called like knee jerk flex for example uh when being hit by this percussion hammer. If it doesn't move, that's the problem. If it doesn't respond to this. So, yeah. Okay. What color is this percussion hammer, by the way?
Red. Right. Yeah. What about my stylescope?
Mhm. Okay. Good. Well, we'll check your color vision in more detail.
And let's do it now.
What color is this?
Okay.
What about this one?
I might have tricked you, but now when I put them together, can you see any difference between them?
That's the point. Okay. So, which one is more like closer to neon color?
Okay, good. Wonderful.
Now, what about this color?
Exactly.
This orange, of course.
Now, what about this one?
Yeah, it's still red. The same as my cushion hammer and this beauty.
Exactly. Wonderful. Well, I have some good news for you. You're not color blind.
I mean, even if you were, that's not such a big deal, but you're perfectly healthy in that respect. Now, let's check your pupil dilation like I promised.
So, I will flash the bright light in your eyes. You might feel a bit uncomfortable, but it will only take a few moments.
So, relax.
Good. Now, let me check. Another way you have a look at the other eye.
Okay.
Same way.
All right. Now, can you follow the light for a few moments for me?
Mhm.
With your eyes only. You remember?
Okay. Wonderful. Now, look at my nose and tell me when the light appears in your field of vision.
Right. Here it is. Okay.
Now once again.
That's right.
Once again.
Good.
So, your side motion seems to be just fine. Let's just do one more test for that. Okay. Tell me when you see my fingers wiggle on either side. But again, don't look at them. Don't look at my hands. Look at my nose. Okay, good.
Okay, perfect. Now it's not uncharted, right?
Like I said, this way we'll be able to test your vision acuity, which means that we'll see how your optic nerve works.
So, please tell me, could you please read this whole line for me? Line number three.
Line number four.
Line number five.
Line number six.
And let's try line number seven. Okay.
That's all right.
Almost.
Good.
Okay. What letter is this?
What about this one?
What about this one?
And these and this.
Okay, you're doing good. I didn't see the point in keeping on working with the snow chart. It's possible we could do that, but it's not your specialized eye exam after all.
So, we have already checked everything we had to and only your nerves are working just fine.
Now, you're hearing. So, please tell me, do you know what it is? It's a tuning fork. I can even hear the sound a little. Okay. Now I will produce kind of sound. It might be followed accompanied with a vibration.
Um and I will put this turning fork right behind your ear on that bone behind your ear. Yep.
So what you are supposed to do is to let me know when the sound and vibration actually fade away when they stop.
So just try to relax. It's fine.
Has stopped.
Okay. Now once again but at the other ear. Okay.
stopped.
Okay, good. And now one more test with a tuning fork. I will put it right on the top of your head. You will also let me know when it stops and also if the sound was symmetrical on both sides. Okay.
You will know it, I'm sure.
Mhm. So, how was it?
Okay, good.
Now let's check your hearing in a few more ways.
I will whisper some words to you. You will let me know if you manage to hear them. Okay.
So microphone notebook pizza.
Do you like pizza?
Oh, I think everybody does, but okay. There might be some exceptions.
Okay.
exception and there's dollar blue moon.
Okay, you're doing great.
It's totally fine.
Now before we forget, I also promised you to test your face sensations. Mhm.
So let's do it. Uh we can do it in different ways.
Let me know. You will close your eyes and I will poke you slightly whether this kind of wood wouldn't stick.
So you will let me know when you can just feel it on your skin. Nothing special, nothing too challenging. Right, let's do it.
Relax and close your eyes.
Okay, good.
And now one more test which is called sharp or dull. This wooden stick has two tabs.
One is a bit sharper. The one that we used before. One is really like not soft but it's dull. Yes. So it doesn't have this sharp end.
What I'm going to do is to use either tip of this wooden stick. You won't know which one because you will have your eyes closed.
And such way we're going to check if you can feel if the item touching you is sharp or dull. Okay, let's do it.
Close your eyes.
Okay. Right.
That was rather dull. Okay. Once again.
That was sharp. And one more time.
That was rather tall. Good.
You're doing great. Like I said, just a second. Okay.
Wow. Okay.
So, we have checked all of your cranial nerves. Yeah. So, your sense of smell done. Then visual acuity, your eye movements in all directions, pupil dilation, everything. Then your facial sensations and expressions.
Then your sense of taste and again your facial expressions. Then your hearing and your balance. Then uh your like I listen to your heart, your heartbeat, to your lungs, to your stomach. Everything seems to be just fine. Which means that your vagus nerve is working okay too. Well, of course, if even if it wasn't working the way it's supposed to, I mean those systems and organs, it doesn't mean that there isn't in the nerve itself, but at least that would give us a hint. Okay. Where to look for the problem in an accessory and hypoglossal nerves? Again, we have tested them all.
Okay. So, do you have any questions?
Are you sure that you don't?
That's all right. Well, then I guess that's I have to let you go.
Absolutely.
You have a good one.
I'll see you soon.
Right.
See you.
Bye.
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