laboratory and clinical booklet - Fort Scott Community College

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IX. Glossopharyngeal: a. Function: Sensory & Motor b. Action: Taste and the ability to swallow and move tongue c. Testing Method: Listen to voice, ask client to swallow, elicit gag reflex with tongue depressor. Have client identify salty, sweet, sour or bitter taste. X. Vagus: a. Function: Motor & Sensory b. Action: Sensation of the pharynx, ability to swallow, movement of the vocal cords c. Testing Method: Have client say “ah” or yawn while you look at the pharynx and observe pharyngeal movement. Elicit gag reflex with tongue depressor. XI. Spinal Accessory a. Function: Motor b. Action: Movement of the head and shoulders c. Testing Method: Place hands on client‟s shoulders and ask him/her to shrug them against your hands. Note strength of the trapezius muscle. Place hand against the client‟s face, ask him/her to turn his/her head against your hand. Note contraction of opposite sternocleidomastoid muscle and note strength of movement against your hand. XII. Hypoglossal: a. Function: Motor b. Action: Position of tongue c. Testing Method: Look at the tongue for atrophy or fasiculations. Have the client stick out his/her tongue and look for atrophy or deviation. Ask client to move his/her tongue from side to side. Note symmetry of movement. 14
III. Motor 1. Assess position sense and coordination a. Assess gait, have client walk across the room back. Look for lack of balance and coordination. b. Have client walk heal to toe in a straight line, then on toes and then heels. Assess antiflexion and dorsiflexion of ankles and balance. c. Have client hop in place on each foot in turn. d. Have client do shallow knee bends, one leg, then the other. e. Perform Romberg Test. Have client stand with feet together and eyes closed. Watch for swaying. Protect client from falls. f. Perform pronation drift. Have client stand with arms outstretched with palms up, have the client close his/her eyes. Maintain position for 20-30 seconds. g. With hands and arms in the same position and eyes closed, tap his/her arms in brisk downward motion. Arms should return to the horizontal position. h. Have the client raise his/her arms over his/her head with palms forward. He/she should be able to hold this position 20-30 seconds. Drifting is abnormal. TO FURTHER ASSESS COORDINATION: a. Ask client to repeat movements as rapidly as possible. First pat knee with palm up, then palm down. Watch for speed and coordination. b. Have him/her tap thumb‟s distal joints with index finger as rapidly as possible. Observe speed and smoothness. c. Do point to point testing. Have client alternate touching her index finger and her nose several times. d. To assess point to point on legs, have the client place one heel on the opposite knee and slide his/her heel down the leg to the toes. Repeat with other leg. e. To assess involuntary movement, observe the client throughout the exam. 2. Assess Muscle Bulk: Look at the size and contours of the muscles. Flatten contours with fasciculations may indicate lower motor neuron disease. 15
Page 1 and 2: LABORATORY AND CLINICAL BOOKLET FOR
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EVALUATION: 1 - SHORT TERM: Met Not
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