CLINICAL SKILLS OSCE S5 - CN IX, X, XI, XII

Question 1

Inspection

Answer 1

Observe trapezius and SCM for wasting

Question 2

CN IX (glossopharyngeal) and X (vagus)

Answer 2

• Open mouth, depress tongue, say aaaaah (no deviation, symmetrical uvula + palate)
• If deviated, might indicate lesion of vagus nerve
• Any difficulty swallowing?
• Gag reflex involves afferent CNIX, efferent CNX

Question 3

CN XI (accessory nerve)

Answer 3

• turn head against resistance (SCM)
• shrug shoulders, resist (trapezius)
• good muscle bulk and strength with no weakness or wasting

Question 4

CN XII (hypoglossal)

Answer 4

• open mouth, inspect tongue for wasting
• move tongue straight out (central) and then L/R
• push tongue against cheek, resist with finger
• say lalalalala (no spasticity of tongue)
• no deviation of tongue, no wasting or atrophy, good power