I’m currently in the process of preparing for an OSCE exam I have on Monday. While reviewing the neurological exam, I remembered something I thought was a pretty nifty test for cranial nerves X (vagus), XII (hypoglossal), and VII (facial).

If you say the word “calamity” aloud while enunciating each syllable, you are invariably testing the motor function of cranial nerves 7, 10, and 12. Why is this? Let’s analyze each syllable. 🙂

The “kuh” sound produced by the first syllable tests your ability to elevate your palate (cranial nerve X’s job) independently of your tongue and lips. Asking a patient to repeat “kuh-kuh-kuh-kuh-kuh” in rapid succession is the bedside test. Next, the “la” syllable (as in singing “la-la-la-la-la”) involves using one’s tongue (testing cranial nerve XII). Finally, the third syllable, “mi” (“mi-mi-mi-mi-mi”) requires one to use his or her lips (testing cranial nerve VII’s ability to innervate muscles like orbicularis oris).

While I don’t actually utilize the aforementioned tests in the neurological exam, I thought it was pretty cool. Then again, neuro exams are always interesting. 😉

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    • Oh my gosh, there are way too many to list! 😀 The cool thing about neurology is how unique some of the clinical findings are. For example, Parkinson’s patients tend to have this pill-rolling tremor coupled with a festinating gait which is unmistakable! Patients with Horner’s syndrome will have a droopy eyelid, constricted pupil, and lack of sweat on only one side of their face. Imagine that! And if a patient presents suddenly with a blown (dilated) pupil and one of their eyes is in a fixed “down and out” position, you’ll be worried about an uncal herniation (and better fix it… fast!)

      What I found most interesting about neurology is getting to act like a detective who pieces together all these clinical findings and tries to localize the problem to, if possible, a single place in the cerebral cortex, brainstem, spinal cord, or periphery. It requires a lot more logical thinking and less of the mundane memorization you find in other subjects. 😀


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