inspect size and shape of pupils
test reactions to light and near response
CN 3, 4, 6 - ANS Oculomotor, Trochlear, Abducens
Test extraocular movements in 6 cardinal directions of gaze
lid elevation
check convergence
CN 5 - ANS Trigeminal
palpate temporal and masseter muscles while pt clenches teeth
test forehead, cheeks and jaw for sharp and dull
test corneal reflex (involuntary blinking w/ stimulus)
CN 7 - ANS Facial
facial symmetry
tics and abnormal mvmts
raise eyebrows
frown
close eyes tightly
show teeth/grimace
smile
puff both cheeks
CN 8 - ANS Acoustic
, test hearing
lateralization
air and bone conduction
CN 9 and 10 - ANS Glossopharyngeal and Vagus
hoarse voice?
swallow
movement of palate "say ah"
gag reflex
CN 11 - ANS Spinal Accessory
apply force and have pt:
shrug
turn head against hand
CN 12 - ANS Hypoglossal
protrude tongue
move tongue side to side
- Thick, white, curd-like discharge
- Severe pruritus
- Normal pH (<4.5)
- Normal KOH whiff test
- Wet prep shows yeast spores and budding hyphae
- Very common
- in diabetics
- after use of antibiotics
- not sexually transmitted - ANS Candida Vaginitis
- gray-white vaginal discharge
- Itching
- pH >4.5
- fishy odor with KOH wet prep
- semen or blood can cause the fishy odor (fluids with a basic pH)
- vulva and vaginal mucosa usually appear normal
- No lesions
- No lymphadenopathy
- Wet prep will show clue cells
- Epithelial cells with borders stippled by bacteria - ANS Bacterial vaginosis
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