Anatomy · USMLE Step 1

USMLE Anatomy: Cranial Nerves

Cranial nerve origins, functions, and lesion presentations tested on USMLE Step 1.

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What is the primary function of the olfactory nerve (CN I)?
Smell (olfaction)
Through which skull opening does CN I pass?
Cribriform plate of the ethmoid bone
What is the primary function of the optic nerve (CN II)?
Vision
Through which skull opening does CN II pass?
Optic canal
A lesion of CN II causes what visual deficit?
Monocular blindness in the affected eye
Which extraocular muscles does CN III innervate?
All extraocular muscles except the lateral rectus and superior oblique
Through which skull opening does CN III pass?
Superior orbital fissure
Describe the classic resting eye position in a complete CN III palsy.
The eye is deviated down and out
A CN III palsy with a dilated, nonreactive pupil suggests what type of cause?
Compressive lesion, such as a posterior communicating artery aneurysm
A CN III palsy that spares the pupil suggests what type of cause?
Ischemic or microvascular cause, such as diabetes
Which muscle does CN IV innervate?
Superior oblique
A CN IV lesion causes difficulty with what eye movement?
Looking down and inward, causing vertical diplopia
What is the general sensory function of CN V?
Sensation of the face and anterior scalp
Besides sensation, what motor function does CN V provide?
Muscles of mastication (chewing)
Through which opening does the ophthalmic division (V1) of CN V pass?
Superior orbital fissure

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