List Diagnostics – E
A person suffering from nasal breathing problems can be identified at first glance. If this deficiency has accompanied him since early childhood (chronic adenoiditis), then signs of nasal respiratory failure are detected with a quick examination of the face.
Examination of the head may be important primarily due to changes in the sense organs. Changes in the shape of the head (usually congenital) in the form of microcephaly and macrocephaly are possible. Head tremors are observed in various diseases, for example, in Parkinsonism, in the elderly.
Dysphagia is difficulty swallowing, the passage of food through the esophagus. Pharyngeal dysphagia is difficulty swallowing a bolus of food (sometimes with coughing), it is usually caused by neuromuscular disorders.
The examination of facial nerve functions begins with an assessment of the symmetry of the patient's face at rest and during spontaneous facial expressions. Particular attention is paid to the symmetry of the nasolabial folds and eye slits.
The hypoglossal nerve innervates the muscles of the tongue (except for m. palatoglossus, supplied by the X pair of cranial nerves). The examination begins with an examination of the tongue in the oral cavity and when it is protruded. Attention is paid to the presence of atrophy and fasciculations. Fasciculations are vermiform rapid irregular twitching of the muscle.
XI pair: accessory nerve (n. accessorius) - a purely motor nerve that innervates the sternocleidomastoid and trapezius muscles. The study of the function of the accessory nerve begins with an assessment of the outline, size and symmetry of the sternocleidomastoid and trapezius muscles. Usually it is enough to compare the right and left sides.
The motor branches of the trigeminal nerve innervate the muscles that provide movement of the lower jaw (masticatory, temporal, lateral and medial pterygoid; mylohyoid; anterior belly of the digastric); the muscle that tenses the tympanic membrane; the muscle that tenses the soft palate.
Visual acuity is determined by ophthalmologists. To assess visual acuity at a distance, special tables with circles, letters, and numbers are used. The standard table used in Ukraine contains 10-12 rows of signs (optotypes), the sizes of which decrease from top to bottom in an arithmetic progression. Vision is examined from a distance of 5 m, the table must be well lit.
Olfaction is tested both in the presence of complaints about impaired perception of smells, and without them, since often the patient himself does not realize that he has olfactory disorders, but complains of taste disorders (full taste sensations are possible only if the perception of food aromas is preserved), as well as if there is a suspicion of a pathological process in the area of the bottom of the anterior cranial fossa.
The motor branch of the glossopharyngeal nerve innervates the stylopharyngeus muscle (m. stylopharyngeus). The autonomic parasympathetic secretory branches go to the otic ganglion, which in turn sends fibers to the parotid salivary gland. The sensory fibers of the glossopharyngeal nerve supply the posterior third of the tongue, the soft palate, the pharynx, the skin of the external ear, and the mucous membrane of the middle ear.
Coma is the deepest depression of consciousness, in which the patient is unable to make speech contact, follow commands, open eyes, and respond to painful stimuli in a coordinated manner. Coma develops with bilateral diffuse damage (anatomical or metabolic) to the cortex and subcortex of the cerebral hemispheres, the brain stem, or with combined damage at these levels.
Only a broad and deep medical education with a good knowledge of the clinical picture of the main patterns of development of internal diseases can be the foundation on which one or another narrow specialist is then formed.
The goals of esophagogastroduodenoscopy are to detect lesions of the mucous membranes of the esophagus, stomach and duodenum in acute and chronic infectious diseases, other diseases or complications. Carrying out therapeutic measures. Evaluation of the effectiveness of treatment.