HNS

Question 1

Test the general sensory functions of the three divisions of the trigeminal nerve by stimulating the appropriate dermatomes with a pin.

Answer 1

1. Tell patient you’re going to tap on different parts of their face to test sensation
2. Ask patient to close their eyes and say yes whenever they feel me touching them
3. Gently tap pin on each side above the eye brows to test ophthalmic
4. Gently tap pin on each side between eye and nose
5. Gently tap pin on each side between mouth and jaw
6. Ask patient if it felt the same on both sides

Question 2

Test motor function of the mandibular part of the trigeminal nerve

Answer 2

Tell patient you’re going to be feeling their chewing muscles
Ask them to clench their jaw
Feel masseter and temporals muscle

Question 3

Test motor function of the facial nerve

Answer 3

Ask patient to raise eyebrows
Ask patient to squeeze eyes shut
Ask patient to smile/show teeth
Ask patient to puff out cheeks
Ask patient to grimace

Question 4

Recall testing of glossopharyngeal nerve

Answer 4

Ask patient to open their mouth and gently touch touch depressor on back of tongue to evoke a gag reflex

Question 5

Test motor function of vagus nerve

Answer 5

Ask patient to open their mouth and say ahh
Observe elevation of uvula
Deviation from midline would be away from the lesioned side

Question 6

Test motor function of hypoglossal nerve

Answer 6

Ask patient to protract their tongue

Deviation from the midline would be towards the lesioned side