How to test the cranial nerves
Other platforms explain it with text and video. In VMS you practice it on the patient.
Each cranial nerve has one or two quick tests. Do them in order and you will not miss one.
Step by step
I and II: smell and vision
Smell is optional with a familiar scent. Vision: acuity with a Snellen chart, fields by confrontation and a look at the fundus. [1]
II and III: pupils
Size and shape, direct and consensual light reaction, and accommodation. [1]
III, IV and VI: eye movements
Follow your finger in an H shape. Look for double vision, nystagmus and drooping eyelids. [1]
V: face sensation and chewing
Light touch on the forehead, cheek and jaw on both sides; clench the jaw and feel the muscles. [1]
VII: face movement
Raise the eyebrows, close the eyes tight, smile and puff out the cheeks. A stroke often spares the forehead; Bell's palsy does not. [2]
VIII: hearing
Rub your fingers by each ear; Weber and Rinne tests with a tuning fork. [1]
IX and X: palate
Say "ah": the uvula should rise in the middle. Note the voice and swallowing. [1]
XI and XII: shoulders and tongue
Shrug and turn the head against your hand; stick out the tongue and move it side to side. [1]
Common errors
- Testing the pupils in a bright room.
- Moving your finger too fast or too far for eye movements.
- Forgetting to compare forehead and lower face in facial weakness.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- Stanford Medicine 25 (bedside exam)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow Stanford Medicine 25 (bedside exam). VMS is not affiliated with these organizations. Updated: 2026-10-11.