Practicals 1

Question 1

Rectus Superior
Rectus Inferior
Rectus Medialis
Inferior Oblique

Answer 1

• III
• Look at my finger & follow it with your eyes
• F: immediate tracking in a smooth motion over the full range. Completes full excursion of the test movement

Question 2

levator palpebrae superioris

Answer 2

• III
• Open your eyes wide. Hold them. Don’t let me close them
• F: completes normal range of movement and holds against examiners light manual resistance. Iris will be fully visible

Question 3

superior oblique

Answer 3

• IV (trochlear)
• Look at my finger & follow it with your eyes
• F: immediate tracking in a smooth motion over the full range. Completes full excursion of the test movement

Question 4

Jaw Opening

Answer 4

• V
• Lateral Pterygoid & suprahyoid muscles: mylohyoid, stylohyoid, geniohyoid, digastric
• open your mouth as wide as you can. Hold it, Don’t let me close it.
• F: Completes available range and holds against strong resistance. The mouth opening should accommodate 3-4 stacked fingers, or 35-40 mm. there is no deviation except downward

Question 5

Jaw Closure

Answer 5

• V
• Masseter, Temporalis, Medial Pterygoid
• clench your teeth together as tightly as you can, keeping your lips relaxed. Hold it. Don’t let me open your mouth
• F: Pt closes mouth tightly. Examiner should not be able to open the mouth

Question 6

Lateral Jaw Deviation

Answer 6

• V
• Lateral & Medial Pterygoid
• Please move your jaw towards the right then to the left and resist.
• F: Can move the center point of the lower teeth laterally over three upper teeth. The pt tolerates strong resistance

Question 7

Jaw Protrusion

Answer 7

• V
• Lateral & Medial Pterygoid
• Push your jaw forward. Hold it. Don’t let me push it back.
• F: Completes a range that moves the lower teeth in front of the upper teeth and can hold against strong resistance.

Question 8

Rectus lateralis

Answer 8

• VI (abducens)
• Look at my finger. Follow it with your eyes
• F: immediate tracking in a smooth motion over the full range. Completes full excursion of the test movement

Question 9

Orbicularis Oculi

Answer 9

• VII
• closing the eye
• Close your eyes as tightly as you can. Hold them closed. Don’t let me open them.
• Close your eyes against my finger
• F: Closes eyes tightly and holds against examiner’s resistance. Iris may not be visible.

Question 10

Corrugator Supercilii

Answer 10

• VII
• frowning
• Frown. Don’t let me erase it.
• F: Completes normal range (wrinkles are prominent) and holds against slight resistance.

Question 11

Occipitofrontalis

Answer 11

• VII
• raising of eyebrows
• Raise your eyebrows as high as you can. Don’t let me pull them down
• F: Horizontal wrinkles are prominent and tolerates considerable resistance

Question 12

Procerus

Answer 12

• VII
• wrinkling the bridge of the nose
• Wrinkle your nose as if to say yuck and resist
• F: Prominent creases, pt tolerates some resistance

Question 13

Lip closing

Answer 13

• VII
• Orbicularis oris
• purse your lips. hold it. push against the tongue blade
• F: Completely seals lips and holds against relatively strong resistance.

Question 14

Cheek compression

Answer 14

• VII
• Buccinator
• suck in your cheeks. hold. dont let me push them out
• use tongue depressor
• F: Performs movement correctly and holds against strong resistance

Question 15

Tongue Protrusion

Answer 15

• XII
• Genioglossus (Posterior Fibers)
• stick out your tongue. hold it. dont let me push it in.
• use tongue depressor
• F: Tongue extends cosiderably beyond lips

Question 16

Tongue Deviation

Answer 16

• XII
• Genioglossus and Other Muscles
• Stick out your tongue and move it to the right and resist (repeat for left side)
• use tongue depressor
• F: Tongue reaches some part of the cheek or lateral sulcus

Question 17

Tongue Retraction

Answer 17

• XII
• Genioglossus (Anterior Fibers), Styloglossus
• stick out your tongue. now pull your tongue back. dont let me keep it out.
• use gauze pad
• F: Tongue returns to rest position in mouth against resistance

Question 18

Posterior Elevation of Tongue

Answer 18

• Styloglossus (XII)
• Palatoglossus (X)
• push against this stick (move the stick down)
• F: Tongue rises so that superior surface reaches the hard palate against considerable resistance

Question 19

Channeling the Tongue

Answer 19

• XII
• Genioglossus, Intrinsic Tongue Muscles: superior & inferior longitudinal, transverse lingual, vertical
• make a tube with your tongue

Question 20

Tipping/Curling the Tongue

Answer 20

• XII
• Superior & Inferior Longitudinals
• Touch above your upper lip with your tongue & touch your tongue to your chin
• F: tongue protrudes and touches area between upper lip and nasal septum

Question 21

Elevation and adduction of the soft palate

Answer 21

• V, XI
• Levator veli palatini, tensor veli palatini, palatoglossus, musculus uvulae
• use a high pitched tone to say Ah a a a
• F: Uvula elevates and the palatoglossal and palatopharyngeal adducts to narrow the fauces

Question 22

Occlusion of the nasopharynx

Answer 22

• X
• Palatopharyngeus
• blow on my finger
• place mirror below nostrils and check for air escape (no air escape is normal)
• F: No leakage of air through nose

Question 23

Constriction of the posterior pharyngeal wall

Answer 23

• patient opens mouth wide and says ah h h with a high pitched tone
• use tongue depressor and cotton swab on the back of mouth
• F: Contraction of the posterior pharyngeal wall

Question 24

Elevation of the larynx in swallowing

Answer 24

• swallow
• press on the larynx and swallow
• F: Layrnx elevates at least 20 mm. The motion is quick and controlled

Question 25

Vocal cord abduction and adduction

Answer 25

- X - posterior and lateral cricoarytenoids - state your name, do re mi fa so la to di (low to high), akh akh akh (5x), cough