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5 wrz 2010 · A step-by-step approach to cranial nerve examination in an OSCE setting, with an included video demonstration and interactive OSCE checklist.
OSCE Checklist: Cranial Nerve Examination Introduction 1 Gather equipment 2 Wash your hands and don PPE if appropriate 3 Introduce yourself to the patient including your name and role 4 Confirm the patient's name and date of birth 5 Briefly explain what the examination will involve using patient-friendly language
Visual acuity is tested using a Snellen chart positioned 6m away from the patient and covering each eye in turn. Ask the patient to dictate the letters on the smallest line that they can read. A normal visual acuity of 1.0 is considered when the patient can read the 6/6 line from 6m away.
With the patient’s eyes closed, use a cotton wool ball ± a neurological pin to test sensation over the ophthalmic, maxillary and mandibular distributions of the trigeminal nerve. Ask the patient to tell you when they feel it and if it feels the same on each side.
The cranial nerve examination has the most complicated structures of all the physical examinations as it is based on the anatomical sequence of cranial nerves, rather than function. Therefore, it is vital that you know the correct sequence, names, and functions of the cranial nerves BEFORE embarking on trying to master this examination.
OSCE Checklist: The Cranial Nerve Examination Introduction Introduce yourself Wash hands Briefly explain to the patient what the examination involves CN I Change in sense of smell CN II Visual Acuity (with a Snellen chart) Visual Fields Fundoscopy CN III, IV and VI Pupillary light reflex Pupillary accommodation
Inspect pupils. Visual acuity. Stand the patient at 6 metres from the Snellen chart. If the patient normally uses distance glasses, ensure these are worn for the assessment.
