2. CLINICAL EXAMINATION OF OTHER CRANIAL
NERVES (I, VII, IX)
I - Olfactory
VII - Facial
IX - Glossopharyngeal
3. The first or the olfactory nerve
Smell is one of the special senses.
Clinical examination of smell is useful for
study of the 1st cranial nerve. Substances
used for clinical examination of smell :
Peppermint, eucalyptus, camphor,
asofoedita, oil of clove.
Irritants should not be used.
4. Procedure
1) Ask the subject to clean his nose.
2) Instruct him to close one of his nostrils.
3) Open one of the bottles and hand it to him.
4) Instruct him to close both his eyes.
5) Ask him to smell the substance in the bottle.
6) Ask him to identify the substance.
7) Repeat with each of the bottles.
8) Repeat the whole procedure with the other nostril.
5. Classification of Odorant
Common odours encountered are named as:
Aromatic or resinous odours, e.g. camphor, lavender and cloves.
Fragrant odours, e.g. perfumes and flowers.
Ethereal odours, e.g. ether, chloroform.
Garlic odours, e.g. garlic, onion and sulphur compounds.
Burning odours, e.g. tobacco, burning of feathers, meat and
bones.
Nauseating odours, e.g. excreta, decomposed meat and
vegetables.
Goat odours, e.g. sweat, ripe cheese.
Repulsive odours, e.g. odour of the bed bug.
Musky odours, e.g. musk.
6.
7.
8. The Ninth or Glossopharyngeal nerve, Tenth or
Vagus nerve, Eleventh or Accessory nerve
(Cranial portions):
Ninth nerve has sensory/special sensory, motor and
parasympathetic fibres.
Tenth nerve has sensory and motor functions and has
parasympathetic secretomotor fibres.
Cranial portion of Eleventh nerve is responsible for normal
phonation and swallowing.
9. Special sensory function of facial and glossopharyngeal nerve :
Taste is one of the special senses.
The clinical examination of taste helps us to test a special sensory
part of VII and IX cranial nerves.
Anterior 2/3 of tongue - Chordatympani branch of facial nerve.
Posterior 1/3 of tongue - Glassopharyngeal nerve.
Procedure:
1) Ask the subject to sit comfortably on the stool.
2) Ask him to gargle and clean the mouth.
3) Ask him to protrude the tongue.
4) Dip the applicator in one solution, take it out and drain the excess of
solution.
10. 5) Rub it gently on a part of tongue on one side.
6) Ask him to pick up the slip on which the name of
the taste he perceives is written.
7) Mop the solution and saliva with wet and then dry
gauze.
8) Repeat on different parts of the tongue on each of
the right and left side.
9) Repeat the same procedure with different
solutions.
10) Examine both the halves of the tongue separately.
16. References
Text book of Medical Physiology
Guyton & Hall
Hutchinson Clinical Methods
Practical Physiology Manual
A.K. Jain, C.L. Ghai, G.K. Pal
Net source for pictures