List Diagnostics – I
A full-fledged study of the patient's neuropsychic status can be carried out only if the doctor knows the symptomatology of nervous and mental illnesses well, knows well the special research methods used in neurology and psychiatry.
The sublingual nerve innervates the muscles of the tongue (except for M. Palatoglossus, supplied with X pair of cranial nerves). The study begins with a survey of the tongue in the oral cavity and when it protrudes. Pay attention to the presence of atrophy and fasciculations. Fasciculations are wormlike, rapid irregular twitching of the muscle.
XI pair: an additional nerve (n. Accessorius) is a purely motor nerve that innervates the sternocleidomastoid and trapezius muscles. The investigation of the function of the additional nerve begins with the evaluation of the shape, size and symmetry of the sternocleidomastoid and trapezius muscles. It is usually enough to compare the right and left sides.
Investigation of the functions of the facial nerve begins with the evaluation of the symmetry of the patient's face at rest and with spontaneous facial expressions. Particular attention is paid to the symmetry of nasolabial folds and eye slits.
The motor branches of the trigeminal nerve innervate the muscles that provide the movements of the lower jaw (chewing, temporal, lateral and medial pterygoids, maxillofacial, the anterior abdomen of the two-abdominal); muscle that strains the eardrum; muscle stretching the palatine curtain.
The motor branch of the glossopharyngeal nerve innervates the shigellar muscle (M. Stylopharyngeus). Vegetative parasympathetic secretory branches go to the ear ganglion, which in turn sends the fibers to the parotid salivary gland. The sensory fibers of the glossopharyngeal nerve supply the posterior third of the tongue, the soft palate, the pharynx, the skin of the outer ear, the mucosa of the middle ear
Visual acuity is determined by ophthalmologists. To assess visual acuity in the distance use special tables with circles, letters, numbers. The standard table, used in Ukraine, contains 10-12 rows of signs (optotypes), the sizes of which are reduced from top to bottom by arithmetic progression. Vision is examined from a distance of 5 m, the table should be well lit.
The sense of smell is also checked in the presence of complaints of a violation of perception of odors, and without such, as often the patient himself does not realize that he has a sense of smell, but complains of a violation of taste (full taste sensations are possible only if the perception of food aromas is preserved) suspicion of a pathological process in the area of the anterior cranial fossa.