#realmature

Today we had a lecture on examining the twelve cranial nerves. Cranial nerves IX and X are responsible for the gag reflex and one of the various methods of testing this is to simply put a tongue depressor on the back of the tongue and put the end of a wooden stick at the back of the throat. When the lecturer said "Some of you have had this tested, but via different means", my friend and I burst into peals of laughter at the back of the lecture theatre.

While we're here, I might as well revise through the tests for the cranial nerves:
I (olfactory nerve): test sense of smell in each nostril
II (optic): confrontation (visual fields), Snellen chart (visual acuity), opthalmoscopy (fundi)
III (ocularmotor), IV (trochlear) and VI (abducents): pupil size, shape and symmetry, light and accomodation reflex, lid drooping present? eye movements
V (trigeminal): responsible for sensation (of pin-prick, light touch and temperature) in three divisions - (i) opthalmic nerve branch (ii) maxillary nerve branch (iii) mandibular nerve branch AS WELL AS motor (jaw opening and closure, jaw jerk and corneal reflex).
VII (facial): facial muscles so make them grimace, close their eyes, wrinkle their forehead AND taste in the anterior 2/3rds of the tongue
VIII (vestibulocochlear): test hearing in each ear by blocking one ear and whispering a number, which you then get them to repeat OR put a watch up to their ear and see if they can hear it. Can also use the Rinne test (using a tuning fork, see if they find the noise louder in front or behind with the tuning fork resting on the mastoid bone - obviously, should be louder when the tuning fork is directly in front of the ear) or Weber test (putting the tuning fork on the patient's forehead and asking them if they feel an equal vibration in both ears)
IX (glossopharyngeal) and X (vagus): palatal movement (saying aaaah and seeing if the uvula moves), the gag reflex, swallowing
XI (accessory): controls sternomastoid and trapezius muscles sooo test sternocleidomastoid by getting the patient to push their forehead forward against your hand and the trapezius can be tested by testing their force against resistance to their shoulder shrug
XII (hypoglossal): controls tongue, so test resistance to force, get them to poke tongue out and inspect the appearance

There is a whole wikipedia page devoted to mnemonics devoted to the cranial nerves. Some of them are quite funny:

• Only Owls Observe Them Traveling And Finding Voldemort Guarding Very Ambiguous Horcruxes

Some are just inappropriate:

• On Occasion, Olsen Twins Try Anal Fucking And Great Vaginal Sex Hammering