Cranial Nerve 9 & 10 Examination | Glossopharyngeal & Vagus Nerve Assessment for Physiotherapists

Summary

This video demonstrates how to assess the glossopharyngeal and vagus nerves (cranial nerves IX and X), which primarily innervate the tongue, pharynx, and larynx. The assessment includes checking for swallowing difficulty, examining the uvula for symmetry, evaluating the voice and cough for signs of nerve impairment, and testing the gag reflex. The video also promotes additional learning resources like an ebook, mobile app, and online courses for further cranial nerve assessments. Viewers are encouraged to subscribe for more educational content on clinical assessments.

Takeaways

• 😀 The glossopharyngeal (IX) and vagus (X) nerves are often assessed together due to their shared functions in the tongue, pharynx, and larynx.
• 😀 Clinical diagnostic accuracy for these cranial nerve assessments is not well-established, so their diagnostic value is uncertain.
• 😀 Difficulty swallowing is a common complaint from patients, which can be assessed by asking them to sip water.
• 😀 No delay or difficulty should be present when the patient swallows after taking a sip as part of the assessment.
• 😀 The uvula should elevate symmetrically when the patient is asked to say 'ah' with their mouth wide open.
• 😀 Hoarse voice or a bovine cough can indicate vagus nerve impairment, often due to vocal cord dysfunction.
• 😀 The gag reflex can be tested using a tongue depressor or a cotton wisp, touching the back of the tongue or soft palate.
• 😀 If the gag reflex is absent or abnormal, it could signal dysfunction in the glossopharyngeal or vagus nerves.
• 😀 A hoarse voice or bovine cough are symptoms of vagus nerve issues, related to the inability to properly close the vocal cords.
• 😀 Additional resources like an assessment ebook, mobile app, and online course are available through the video description for further learning.

Q & A

What cranial nerves are being assessed in this video?

The ninth and tenth cranial nerves, namely the glossopharyngeal and vagus nerves, are being assessed.

What areas do the glossopharyngeal and vagus nerves innervate?

The glossopharyngeal and vagus nerves primarily innervate the muscles of the tongue, pharynx, thorax, abdominal viscera, and larynx.

What symptoms might a patient experience that could indicate an issue with the glossopharyngeal or vagus nerve?

A patient may report difficulty swallowing, which can be assessed as part of the examination of these nerves.

How can you assess swallowing function in this examination?

You can ask the patient to take a sip of water on your command and observe for any delay or difficulty in swallowing.

What does a hoarse voice or bovine cough indicate during the assessment?

A hoarse voice or bovine cough can indicate vagus nerve impairment due to a lack of proper closure of the vocal cords, leading to a hollow sound.

How can you assess the uvula's response during the exam?

Ask the patient to say 'ah' with their mouth wide open, and check if the uvula elevates symmetrically. Any asymmetry may indicate a problem with the nerves.

What is the purpose of checking the gag reflex during this assessment?

The gag reflex is checked to assess the integrity of the glossopharyngeal and vagus nerves. A lack of gag response can indicate nerve dysfunction.

How can the gag reflex be tested?

You can test the gag reflex by using a tongue depressor to touch the back of the tongue on both sides, or by using a wisp of cotton to touch the soft palate.

What is the clinical value of assessing the glossopharyngeal and vagus nerves?

While diagnostic accuracy studies for these assessments are not available, they provide useful clinical insights, especially in cases where patients report difficulty swallowing or voice changes.

Where can viewers find additional resources related to this cranial nerve assessment?

Viewers can find additional resources, including an ebook, mobile app, and online course, through links in the video description.