facial nerve examination

The facial nerve is a mixed nerve. It is attached to the brain in the lateral part of the medullary pons. It enters the inner ear canal through the inner ear, passes through the curved facial nerve tube in the bone of the humerus, and finally the stem of the stem is removed from the skull. The facial nerve contains (1) special visceral efferent fibers mainly dominate the expression muscle; (2) general visceral efferent fibers; (3) special visceral afferent fibers; (4) general visceral afferent fibers; (5) general somatosensory fibers. Facial nerve examination (facialnerveexamination) includes two parts of exercise and taste examination. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: Relax the facial muscles during the examination, don't be too nervous, and actively cooperate with the doctor's work. Normal value Facial muscle movement and taste are normal. Clinical significance Abnormal results facial nerve paralysis is divided into central type and peripheral type. 1. Central type: caused by damage to the tissue on the nucleus (including cortex, cortical brain stem fiber, internal capsule, pons, etc.), and the paralysis of the muscles in the lower part of the facial surface appears. From the top to the bottom, the nasolabial fold becomes shallow, and when the tooth is degenerated, the mouth angle is drooping (or the angle of the mouth is toward the side of the lesion), and whistling and drumsticks cannot be whistled. More common in cerebrovascular disease, brain tumors and encephalitis. 2, the surrounding type: caused by facial nerve nucleus or facial nerve damage, the same side of the lesion on the same side of the tendon. From top to bottom, it can not wrinkle, frown, close eyes, corneal reflex disappears, nasolabial fold becomes shallow, can not show teeth, drumsticks, whistle, sagging mouth (or mouth angle to the opposite side of the lesion). More common in cold, ear or meningeal infections, peripheral facial paralysis caused by neurofibroma. In addition, 2/3 taste dysfunction in front of the tongue can also occur. People who need to be examined: Patients with symptoms of facial paralysis and loss of taste. Precautions Taboo before inspection: 1. Do not eat irritating foods such as peppers and garlic before the taste test. 2, before the taste test should be prepared to prepare different test solutions, such as sugar water, salt water, acetic acid solution, etc., the temperature of the test solution should be appropriate. Requirements for inspection: 1. The taste test is to tell the examiner the taste that has been tasted. 2. In the taste test, in order to prevent the taste before the test solution from affecting each other, the test solution should be checked after each test solution is finished. Inspection process First, exercise inspection When examining facial expression muscles, first observe whether the two sides are symmetrical, including forehead wrinkles, eye cracks, nasolabial folds, and mouth angles. Then the patient is lifted, frowned, closed eyes, toothy, drumsticks and whistling. The facial paralysis caused by facial nerve damage on one side is characterized by the disappearance of the ipsilateral frontal pattern, the large opening of the eye, the closure of the nasolabial fold, or the disappearance of the nasolabial fold, or the lowering of the mouth. Muscle spasms can be found in tooth decay, drumsticks and whistling. The central facial paralysis caused by one side of the cortical medullary bundle damage is mainly characterized by the lower semitendinosus. That is, only the nasolabial folds become shallower and the mouth angle becomes lower, and the muscles are paralyzed when the teeth, the drumsticks and the whistle are whistling, while the wrinkles and closed eyes are still normal, or may be slightly weaker than the contralateral side, because the upper facial muscles are affected. Both sides of the cerebral cortex dominate. Second, the taste test Prepare different test solutions (such as sugar water, salt water, acetic acid solution, etc.), and lick the patient's tongue. The examiner will take the test solution separately with a cotton swab and gently apply it to the patient's tongue to make it taste. After each test side, you need to rinse your mouth and try it on both sides. Not suitable for the crowd Inappropriate crowd: a comatose patient. Adverse reactions and risks Nothing.