{"id":2298,"date":"2024-03-12T15:11:13","date_gmt":"2024-03-12T19:11:13","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/cn-ix-and-x-glossopharyngeal-and-vagus-nerve-2\/"},"modified":"2024-05-31T10:50:56","modified_gmt":"2024-05-31T14:50:56","slug":"cn-ix-and-x-glossopharyngeal-and-vagus-nerve-2","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/cn-ix-and-x-glossopharyngeal-and-vagus-nerve-2\/","title":{"raw":"CN IX and X - Glossopharyngeal and Vagus Nerve","rendered":"CN IX and X &#8211; Glossopharyngeal and Vagus Nerve"},"content":{"raw":"<ol>\r\n \t<li style=\"font-weight: 400\">To test taste related to CN IX, use the same steps as step 3 in the previous section related to CN VII, except introduce the substance to the posterior third of the tongue. This test is only done when there are specific concerns.<\/li>\r\n \t<li style=\"font-weight: 400\">To test gag reflex as related to CN IX and CN X, use a tongue depressor to tap near the lateral side of the pharynx near the tonsillar pillars or at the lateral posterior side of the soft palate. While doing this, use a penlight to illuminate the inside of the mouth and pharynx. Test on both sides of the mouth. See <strong>Video 14.<\/strong>\r\n<ul>\r\n \t<li style=\"font-weight: 400\">Normally the client will gag, meaning that the pharynx will constrict\/contract and the uvula and midline of the soft palate will move upward.<\/li>\r\n \t<li style=\"font-weight: 400\">Abnormal findings include an absent or decreased gag reflex, as well as an overactive gag reflex.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\">Next, ask the client to open their mouth and inspect the soft palate and uvula, and then have the client stick out their tongue and say \u201cahh.\u201d\r\n<ul>\r\n \t<li style=\"font-weight: 400\">Normally the soft palate is symmetrical and uvula is midline. When they say \u201cahh,\u201d the soft palate should elevate and the uvula should elevate while remaining midline.<\/li>\r\n \t<li style=\"font-weight: 400\">Abnormal findings include an asymmetrical palate, a deviating uvula, and a palate that does not move upward.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\">You may ask the client to swallow, or to take a sip of water and swallow, to ensure they have no difficulty swallowing.<\/li>\r\n \t<li style=\"font-weight: 400\">Throughout this assessment, continually listen to the client\u2019s speech to ensure there is no hoarseness or difficult speaking.<\/li>\r\n \t<li style=\"font-weight: 400\">Note the <strong>findings<\/strong>:\r\n<ul>\r\n \t<li style=\"font-weight: 400\">Normal findings might be documented as: \u201cGag reflex present, soft palate and uvula symmetrical and mobile with no dysphagia, dysphasia or hoarseness.\u201d<\/li>\r\n \t<li style=\"font-weight: 400\">Abnormal findings might be documented as: \u201cGag reflex absent. Client unable to clearly form words.\u201d<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<a href=\"https:\/\/www.kaltura.com\/index.php\/extwidget\/preview\/partner_id\/816122\/uiconf_id\/44640261\/entry_id\/0_8oeftziy\/embed\/dynamic\" target=\"_blank\" rel=\"noopener\">Gag reflex link (from kaltura)<\/a>\r\n\r\n<strong>Video 14<\/strong>: Gag reflex","rendered":"<ol>\n<li style=\"font-weight: 400\">To test taste related to CN IX, use the same steps as step 3 in the previous section related to CN VII, except introduce the substance to the posterior third of the tongue. This test is only done when there are specific concerns.<\/li>\n<li style=\"font-weight: 400\">To test gag reflex as related to CN IX and CN X, use a tongue depressor to tap near the lateral side of the pharynx near the tonsillar pillars or at the lateral posterior side of the soft palate. While doing this, use a penlight to illuminate the inside of the mouth and pharynx. Test on both sides of the mouth. See <strong>Video 14.<\/strong>\n<ul>\n<li style=\"font-weight: 400\">Normally the client will gag, meaning that the pharynx will constrict\/contract and the uvula and midline of the soft palate will move upward.<\/li>\n<li style=\"font-weight: 400\">Abnormal findings include an absent or decreased gag reflex, as well as an overactive gag reflex.<\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\">Next, ask the client to open their mouth and inspect the soft palate and uvula, and then have the client stick out their tongue and say \u201cahh.\u201d\n<ul>\n<li style=\"font-weight: 400\">Normally the soft palate is symmetrical and uvula is midline. When they say \u201cahh,\u201d the soft palate should elevate and the uvula should elevate while remaining midline.<\/li>\n<li style=\"font-weight: 400\">Abnormal findings include an asymmetrical palate, a deviating uvula, and a palate that does not move upward.<\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\">You may ask the client to swallow, or to take a sip of water and swallow, to ensure they have no difficulty swallowing.<\/li>\n<li style=\"font-weight: 400\">Throughout this assessment, continually listen to the client\u2019s speech to ensure there is no hoarseness or difficult speaking.<\/li>\n<li style=\"font-weight: 400\">Note the <strong>findings<\/strong>:\n<ul>\n<li style=\"font-weight: 400\">Normal findings might be documented as: \u201cGag reflex present, soft palate and uvula symmetrical and mobile with no dysphagia, dysphasia or hoarseness.\u201d<\/li>\n<li style=\"font-weight: 400\">Abnormal findings might be documented as: \u201cGag reflex absent. Client unable to clearly form words.\u201d<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.kaltura.com\/index.php\/extwidget\/preview\/partner_id\/816122\/uiconf_id\/44640261\/entry_id\/0_8oeftziy\/embed\/dynamic\" target=\"_blank\" rel=\"noopener\">Gag reflex link (from kaltura)<\/a><\/p>\n<p><strong>Video 14<\/strong>: Gag reflex<\/p>\n","protected":false},"author":34,"menu_order":14,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[],"contributor":[88],"license":[56],"class_list":["post-2298","chapter","type-chapter","status-publish","hentry","contributor-june-2024-cu3e0lrwrt","license-cc-by-nc"],"part":2261,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/2298","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/2298\/revisions"}],"predecessor-version":[{"id":2299,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/2298\/revisions\/2299"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/2261"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/2298\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=2298"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=2298"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=2298"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=2298"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}