Patient Problems - Response from the Clinical Expert
Patient Problem Five
To answer this question, the learner needs to identify the cranial nerves involved in this fundamental activity. The student should eat a small piece of food and note the movements in the oral cavity and pharynx if they have difficulty identifying the need to examine cranial nerves V, VII, IX, X, XI, and XII. It is also important to recognize that dysphagia most likely involves CN IX, X, XI, and XII, while dysarthria most likely involves CN VII, X, and XII.
Here are some examples: |
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As food is brought into mouth |
CN VII |
Chewing and manipulating food within the mouth |
CN V, VII, XII |
Tongue moving food to pharynx |
CN XII |
Swallow reflex initiated/food moves into pharynx |
CN IX |
Soft palate rises to prevent food from entering nasal cavity |
CN X |
Epiglottis covers trachea to prevent aspiration |
CN X |
Pharynx rises and falls during swallowing |
CN XI |
Peristalsis from pharynx through esophagus to stomach |
CN X |
Patient Problem Six
Postural control is related to the integrity and integration of the visual, proprioceptive, and vestibular systems. Therefore, it is important to test CN II, III, IV, VI, and VIII.
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