Osce 6.1

ambirnba's version from 2016-01-30 23:18


Question Answer
test CN 1test one nostril at a time
test CN II - 3visual acuity (chart), test visual fields by confrontation, fundoscopy
what does fundoscopy asses?optic disc, health of the retinal vessels, macula, & retina.
test CN II, II (optic and oculomotor nn. - pupillary reactions)- 3inspect pupillary size/shape, observe direct and consensual pupillary response, pupillary accommodation( move finger towards pt nose)
test extraocular movements (CN III, IV, VI)H pattern
test CN V - 3corneal reflex, sharp vs. dull, place hands over masseter/ have pt bite down then open jaw against resistance
test CN VII - 6inspect at rest and during conversation, close eye against resistance, frown, show top and bottom teeth, smile, puff out cheeks
test CN VIII - 3auditory acuity (whisper at 2 ft), rinne, weber
rinne screens forconductive hearing loss
weber screens for sensorineural hearing loss and conductive
perform rinnetuning fork - mastoid bone until no longer hear it- then quickly move it to ear
normal rinneair conduction should be greater than bone conduction. pt should be able to hear the tuning fork next to the pinna
perform webertuning fork on forehead or on top of head. which ear is louder?
normal webersound heard equally in both sides
if the defective ear hears the Weber tuning fork louder, the finding indicates a conductive hearing loss in the defective ear
if the normal ear hears the tuning fork sound better, there is sensorineural hearing loss on the other (defective) ear
test CN IX, X (swallong and rise of palate, gag reflexInstruct pt to say “ah” and watch for palate elevation.
test XI spinal accessory - 2turn head against resistance, shrug against resistance
test XII (tongue symmetry and position) - 2inspect tongue in mouth, ask pt to protrude tongue and move it side to side

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