Have pt: Read from a card or newspaper, one eye at a time. Cover one eye, focus on pt nose, ID number of fingers examiner is holding up in each of four visual quadrants.
Shine light on each pupil, check accommodation by moving examiner's finger toward patient's nose, pupils should constrict and converge. Check EOM's by having pt look up, down, laterally, and diagonally.
pt look down and in
Pt hold mouth open while examiner try to close it. Move jaw laterally against examiner's hand. Pt closes eyes, examiner touches face with cotton and have pt ID the area touched. (In Comatose patient's, brush cornea with a wisp of cotton: the patient should blink)
move eyes side to side
Smile, raise eyebrows, keep eyes and lips closed while examiner tries to open. ID salt or sugar placed on tongue (usually deferred).
Use tuning fork/rub fingers together by ear of patient. Can they hear equally in both ears?
Gagging reflex tested, touch back of throat w/sterile tongue depressor
Gagging reflux tested and vocal quality
XI Spinal Accessory
Pt shrug shoulders, turn head from side to side
Pt stick out tongue, move it internally from cheek to cheek.
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