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Patient Problems
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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:

 
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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Section: Patient Problems
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