Gag reflex cranial nerve 9 and 101/23/2024 ![]() Sensory exam. Your child's healthcare provider may also do a sensory test that checks your child's ability to feel. Your child's joints may also be checked simply by passive (done by the healthcare provider) and active (done by the child) movement. Balance may be checked by assessing how the child stands and walks or having the older child stand with his or her eyes closed while being gently pushed to one side or the other. The child may be asked to squeeze fingers or hop, skip, or jump. Motor function and balance. This may be tested by having the older child push and pull against the healthcare provider's hands with his or her arms and legs. This is usually done by your child's healthcare provider just by observing the child during normal interactions. The older child will also be observed for clear speech and making sense while talking. Mental status. Mental status (the child's level of awareness and interaction with the environment) may be assessed by watching the infant interact with the parent, or by asking the older child to follow directions or answer questions appropriately. The following is an overview of some of the areas that may be tested and evaluated during a neurological exam: In infants and younger children, a neurological exam includes the measurement of the head circumference. The circulation to the brain, arising from the arteries in the neck, is also frequently examined. The nervous system regulates the muscles. The nervous system consists of the brain, spinal cord, 12 nerves that come from the brain, and the nerves that come from the spinal cord. The nervous system is very complex and controls many parts of the body. Use of the neurological exam subtests for the vestibulocochlear nerve illuminates the changes a patient may go through.During a neurological exam, your child's healthcare provider will test the functioning of the nervous system. Additionally, within a single patient, the symptoms and signs may change as the disease progresses. From patient to patient, the exact presentation of the disease can be different. The patient can suffer from vertigo, a low-frequency ringing in the ears, or a loss of hearing. ![]() Ménière's disease is a disorder that can affect both equilibrium and audition in a variety of ways. Damage to structures near the two nuclei can result in deficits to one or both systems.īalance or hearing deficits may be the result of damage to the middle or inner ear structures. Deficits in one or both systems could occur from damage that encompasses structures close to both. Though they are part of distinct sensory systems, the vestibular nuclei and the cochlear nuclei are close neighbors with adjacent inputs. They both emerge from the inner ear, pass through the internal auditory meatus, and synapse in nuclei of the superior medulla. ![]() ![]() The sensory nerves from these two structures travel side-by-side as the vestibulocochlear nerve, though they are really separate divisions. The cochlea is responsible for transducing sound waves into a neural signal. The vestibule is the portion for equilibrium, composed of the utricle, saccule, and the three semicircular canals. Within the petrous region of the temporal bone is the bony labyrinth of the inner ear. Problems with balance, such as vertigo, and deficits in hearing may both point to problems with the inner ear. Though the two senses are not directly related, anatomy is mirrored in the two systems. The vestibulocochlear nerve (CN VIII) carries both equilibrium and auditory sensations from the inner ear to the medulla. Those fibers are conveying peripheral visual information to the opposite side of the brain, so the patient will experience “tunnel vision”-meaning that only the central visual field will be perceived. If the pituitary gland develops a tumor, it can press against the fibers crossing in the chiasm. The pituitary gland is located in the sella turcica of the sphenoid bone within the cranial floor, placing it immediately inferior to the optic chiasm. ![]()
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