Testing Gag Reflex and Swallow Function

18 Questions

Issues with swallowing can develop after vagus nerve damage in conditions like ________

Stroke

________ is primarily responsible for movement of the neck and shoulders

Accessory nerve

You can test the strength of the trapezius muscle by placing your hands on the client’s shoulders and exerting gentle resistance as they ________ their shoulders

shrug

Test cranial nerve XII, the hypoglossal nerve that innervates the ________

tongue

When testing motor function, you can also test cranial nerve X, the ________ nerve

vagus

Start by letting your client know you are going to test the ________ reflex

gag

To assess for a consensual response, shine a penlight into one eye and observe for constriction of the pupil. The opposite eye should also ______ along with the illuminated pupil.

constrict

Cranial nerve V, the trigeminal nerve, consists of three branches: Ophthalmic, maxillary, and ______ divisions.

mandibular

To check for accommodation, ask the client to focus on a distant object to dilate the pupil. Then, move your finger closer and ask them to focus on it. Normally, you should note pupillary constriction and inward rotation of the eyes, indicating their eyes may ______ slightly.

cross

A gradual loss of accommodation with age is called ______.

presbyopia

If one of the upper eyelids droops and partially covers the eye, ptosis is present, which may be due to neuromuscular weakness from conditions such as myasthenia gravis or damage to cranial nerve ______.

III

To test for motor function, check the extraocular movements by testing the function of cranial nerves III, IV, and VI. These are the oculomotor nerve, the trochlear nerve, and the ______ nerve.

abducens

To test motor function of cranial nerve VII, ask your client to make a series of facial expressions like smile while exposing their teeth; frown; raise their eyebrows; purse their lips; and puff out their ______.

cheeks

Assessment findings that indicate damage to the facial nerve include lack of movement, asymmetrical movement, drooping, a flat nasolabial fold, an eye that doesn't close or an eyeball that rolls up, a forehead that doesn’t wrinkle; or if they can’t raise their ______.

eyebrows

If your client is unable to repeat the whispered word, this can mean they have lost the ability to hear high frequency sounds; they may have an obstruction in their auditory canal, such as excessive cerumen, or they may have age-related hearing loss, or ______.

presbycusis

To test balance and equilibrium, use the ______ test, which can help identify neurological conditions like Bell's palsy or Lyme disease.

Romberg

To assess sensory function, apply sweet and salty taste solutions one at a time, with a cotton swab to the anterior third of the tongue, bilaterally. Your client should be able to identify each ______.

taste

Cranial nerve VIII is also known as the ______ nerve.

acoustic

Study Notes

Cranial Nerve X (Vagus Nerve)

Tests gag and swallowing function, which can be affected by conditions like stroke, head injury, or multiple sclerosis
To test:
- Ask client to open their mouth wide and say "ah" while compressing the tongue with a tongue depressor
- Observe the soft palate and uvula rising in the midline
- Gently touch the back of the throat to trigger the gag reflex
- Ask client to take a sip of water and swallow, observing for easy swallowing and no aspiration or passage of water into the nasal passages

Cranial Nerve XI (Accessory Nerve)

Responsible for movement of the neck and shoulders
To test:
- Place hands on the client's shoulders and exert gentle resistance as they shrug their shoulders
- Test the strength of the sternocleidomastoid muscle by asking them to turn their head from side to side while applying gentle resistance
- Expect bilateral equal strength; weakness may be due to muscle atrophy

Cranial Nerve XII (Hypoglossal Nerve)

Innervates the tongue
To test:
- Turn down the lights to allow the pupils to dilate
- Shine a penlight into one eye, observing for constriction of the pupil and consensual response in the opposite eye
- Repeat on the other eye

Cranial Nerve V (Trigeminal Nerve)

Consists of ophthalmic, maxillary, and mandibular divisions
To test accommodation:
- Ask client to focus on a distant object, which will dilate the pupil
- Move finger to 8-10 cm away from the nose and ask client to focus on it, observing for pupillary constriction and inward rotation of the eyes
- Note gradual loss of accommodation with age, known as presbyopia
To observe for ptosis:
- Note if one of the upper eyelids droops and partially covers the eye, which may be due to neuromuscular weakness from conditions like myasthenia gravis or damage to cranial nerve III

Cranial Nerves III, IV, and VI (Extraocular Movements)

To test:
- Ask client to make a series of facial expressions like smile, frown, raise eyebrows, purse lips, and puff out cheeks
- Listen to client's speech, noting any difficulty with making sounds like b, m, or p
- Assessment findings that indicate damage to the facial nerve include:
  - Lack of movement
  - Asymmetrical movement
  - Drooping
  - Flat nasolabial fold
  - Eye that doesn't close or eyeball that rolls up
  - Forehead that doesn't wrinkle
  - Inability to raise eyebrows

Cranial Nerve VIII (Acoustic Nerve)

To be tested (no specific details provided)

This quiz covers the procedure to test the gag reflex and swallowing function in a client. It includes steps to assess the soft palate, uvula, and throat reflexes using a tongue depressor and observation techniques.

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