Nutrition and Oral Medicine (Nutrition and Health)

355VII. Facial a S Taste anterior 2/3 of tongue, palate. S Test taste sensation of sweet, salt, S Altered taste.MFacial expressions, muscles of lips and sour. MFacial asymmetry, unequal nasolabialand cheeks. M Have patient smile to show teeth, folds, poor lip seal.A Secretion of lacrimal, sublingual, raise eyebrows, close eyelids • Droolingand submandibular glands. tightly. • Pocketing of foodDecreased saliva.• Increased oral preparatory stage.VIII. Vestibulocochlear S Sensation from cochlea for hearing S Rub hair or fingers near patient’s S Deafness, vertigo.(Acoustic) and from semicircular canals and ears.vestibule for equilibrium.IX. Glossopharyngeal a S Taste posterior 1/3 of tongue; sensa- S Test taste sensation of bitter. S Altered taste.tion to pharynx, tonsils, soft palate. Gag reflex: Touch posterior No pharyngeal elevation.MElevation of soft palate; swallowing. pharynx with a cotton swab. • Increased risk of aspiration.A Secretion of parotid gland. Look for pharyngeal elevation MLimited palate elevation.and tongue retraction.• Pocketing• Prolonged eating timebilateral soft palate elevation and A Decreased saliva.midline uvula.M Have patient say “AH.” Look forX. Vagus a S Taste base of tongue and epiglottis. Test IX and X together. (See above.) (See above.)Sensation to soft palate, upper larynx.MMovement of soft palate, pharynx,and larynx.XI. Spinal Accessory MMotor function to vagus, sternoma- M Test neck range of motion. Have MLimitation in ability to raise shouldersstoid, and trapezius muscles. patient lift shoulders with and with- or turn head, muscle atrophy andout pressure. Have patient turn head weakness.with and without pressure.XII. Hypoglossal a M Movement of tongue. M Protrude tongue. Should be midline. MLimitation in tongue movement orTest tongue strength with tongue deviation.blade.S Sensor response; M motor response; A autonomic response; a CN involved in dysphagia screening.From Norman, W. Cranial Nerves. Website: (http://mywebpages.comcast.net/wnor/cranialnerves.htm). Accessed October 24, 2003.AAppendix D / Cranial Nerve Assessment 355