#Cranial #Nerve #Examination #OSCE #Guide #Latest
Hi there my name is Andrew one of the final year medical students coders confirm your name and age please yeah my name’s Robert Brown and 21 nice to meet you Robert today I’ve been asked to examine your cranial nerves these are the nerves that supply your face and your neck
Would that be okay yeah that’s fine brilliant you in any pain at all I’m in no pain okay first of all ah but I just like to check if you noticed any change in your sense of smell at all no okay now that to test your vision would that be okay
And I like to assess your visual acuity do you usually wear glasses Robert no okay if you could cover one eye with the palm of that hand and starting at the top I’d like you to read down as far as you can on the Snellen chart in front of you
E H n DF n PT x z u z dt f DF n PT h ph u NT d z n PX t ZD h fantastic if you could cover the other eye and do the same in H and D F n PT x z uz dt f DF n
PT h ph u NT d z NP x TZ f h brilliant I’d now like to assess your pupils this will involve shining a bright light into your eyes would that be okay yes brilliant if you could just pick a point on the wall in front of you and keep looking at that
That’s great and I like to swing the light between your eyes if you just keep looking at the point on the wall in front of you finally I’d like to assess the ability of your eyes to focus if you could look at the point on the wall in front of you
And now look at the pen that’s great Robert I’d now like to do some specific tests of the evasion if you could just keep looking into my eyes I’d like you to point the finger you see moving brilliant and I like to test your visual fields if you just cover one eye with
The palm of that hand for me I’m going to cover the opposite eye let me know when you see my finger moving keep looking into my open eye yes yes yes yes cover the opposite eye for me same again yes yes yes yes brilliant and I like to assess the movements of
Your eyes first of all have you got any double vision at the moment no okay do you let me know if you have any double vision throughout the exam but I need you to keep your head perfectly still and I’d like you to follow my finger
Javan a double vision at all no okay fantastic okay now I like to assess the sensation on your face first of all I’ll start with a piece of cotton wool and then a small newer tip would that be okay yes brilliant this is what the cotton wool
Feels like can you feel that brilliant if you could just close your eyes and let me know when you feel the cotton wool on your face No No now now No did it feel the same on both sides of your face yes it did that’s great I’m
Now going to assess it with this newer tip can you feel that yes fantastic again if you could close your eyes for me No No No No No No and again did it feel the same on both sides visited that’s great okay I’m now going to feel some of the muscles
Around your face now clench your jaw for me I’m relaxed clench your jaw for me and relax open your mouth and don’t let me close it and I’m going to assess a reflex that’s okay what I’d like you to do is just relax your jaw down slightly
For me I’m just going to place my finger on your chin fantastic you so I just like to assess some movements of facial expression now Robert first of all can you start by raising your eyebrows great and now if you can close your eyes as tight as you can and don’t
Let me open them you can pull out your cheeks don’t let me push them in you can push your lips for me and bay teeth that’s great thank you two quick questions for you Robert firstly if you noticed any change in your taste at all yeah okay and secondly
I’d be noticed that you’re hearing sounds louder than usual no good Robert an electro session hearing if that’s okay to start with I’m going to place one hand on one ear and with a whisper a number or a word into the other ear I’d just like you to repeat it okay 66
79 antastic and just the same on the other side 83 97 that’s great so I’m now going to use the tuning forks to assess your hearing first of all I’m going to place the tuning fork on the bone behind your ear like to let me know whether you
Can hear it and when you stop hearing it can you hear that yes let me know when it stops it stopped and can you hear that yes I’m just going to do the same on the other side so I’m now going to place the tuning fork in the middle of
Your forehead can you hear that Robert yes and is it loudest in one ear or the other or in the middle in the middle that’s great and I like to assess the nerve that assists with your balance and now I’ve got your standing up what I’d like you
To do is close your eyes and like you to march on the spot for me that’s great you can stop now you Robert if you could just call for me final if you could just take a sip of this water and when you’re ready swallow
So now I’d like to just assess the power in your shoulders in your neck Robert if you could just start by shrugging your shoulders for me and don’t let me push them down fantastic now if you could turn your head to the right against my hand and don’t let me stop you fantastic
Turn your head to the left against my hand and don’t let me stop you that’s brilliant so now I like to examine your tongue first of all if you can just open your mouth for me that’s brilliant and if you can stick your tongue out fantastic now
If you can just press your tongue into my fingers and the same on the other side today I did a cranial nerve exam on Robert Brown a 21 year old male on examination of cranial nerves 1 to 12 there were no abnormalities detected to complete my examination I’d like to do a
Motor and sensory exam of both the upper and lower limbs
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