Exam Techniques for the First Cranial Nerve for Neurosurgery Residents
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Examination Techniques of the First Cranial Nerve: What Neurosurgical Residents Should Know
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Leonard Leong Sang Xian, Vasu Nallaluthan, Yong De Jun, Ooi Lin-Wei, Sanihah Abdul Halim, Chee Yong Chuan, Zamzuri Idris, Abdul Rahman Izaini Ghani, Jafri Malin Abdullah
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Examination Techniques of the First Cranial Nerve: What Neurosurgical Residents Should Know
Year: 2020 | Doi: 10.21315/mjms2020.27.5.12
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Olfactory dysfunction, although prevalent, is frequently disregarded by clinicians. In Malaysia, there is a notable absence of standardized and reliable tests for assessing olfactory function, unlike in developed countries where tests such as the Sniffin' Sticks Test (SST) and the University of Pennsylvania Smell Identification Test (UPSIT) are established. These tests, however, are not easily accessible or affordable in Malaysia. It is essential to conduct olfactory examinations, as these evaluations can not only ascertain the validity of a patient's complaints but also assist in monitoring their condition and establishing compensations for potential disabilities.
Importance of Odour Detection Threshold Testing
A critical component of assessing olfactory function is the odour detection threshold test, which can be performed using an alcohol sniff test (AST). This test differentiates between normosmia, hyposmia, and anosmia, categorizing patients based on their ability to detect odours. The technique involves exposing patients to the scent of 70% isopropyl alcohol while measuring the distance from which they can perceive the smell. The results help identify whether olfactory issues stem from peripheral or central nervous system problems, enabling clinicians to tailor further investigations or treatments appropriately.
Conclusion
In conclusion, evaluating olfactory complaints is of great significance and should not be underestimated. A systematic olfactory assessment will help clarify the legitimacy of a patient's concerns, aid in tracking their olfactory function over time, and inform any necessary disability coverage. Establishing an accessible olfactory examination framework in Malaysia using the methods described can enhance patient care and awareness of the importance of this often-overlooked aspect of health.
FAQ section (important questions/answers):
What are the consequences of olfactory or smell dysfunction?
Olfactory dysfunction can negatively affect a person's quality of life by altering the taste of food and beverages. Additionally, it poses risks by preventing the detection of gas leaks, smoke, or spoiled food, impacting both personal and occupational safety.
What are the standard tests for olfactory function in Malaysia?
Currently, Malaysia lacks standardized olfactory nerve examination tests. Common tests in developed countries, such as the Sniffin’ Sticks Test and the University of Pennsylvania Smell Identification Test, are not readily available and may be too costly.
How can olfactory dysfunction be assessed effectively?
Olfactory dysfunction can be assessed through tests measuring odour detection, discrimination, and identification, using commonly available materials. This approach can identify peripheral olfactory problems and cerebral cortex issues.
Why is olfactory function examination important for patients?
Examining olfactory function is crucial to validate a patient's complaints, monitor their progress, assess disability for insurance purposes, and characterize the specific nature of the olfactory problem, ensuring proper management and care.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Exam Techniques for the First Cranial Nerve for Neurosurgery Residents”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In the context of the article, 'Table' refers to an organized presentation of data or information, particularly about the types of substances used in olfactory tests. It simplifies understanding by summarizing complex information, allowing clinicians and researchers to quickly grasp essential details regarding the materials being tested.
2) Disease:
'Disease' highlights medical conditions that can affect olfactory function or lead to smell disorders. Understanding diseases related to olfactory dysfunction is crucial for diagnosing and treating patients. The paper discusses connections between smell loss and neurodegenerative diseases, emphasizing the need for olfactory assessments in medical evaluations.
3) Substance:
'Substance' refers to the specific materials or chemicals used in olfactory testing, including various odors. Their identification and characteristic properties are essential for conducting accurate smell tests. The choice of substances directly influences the efficacy of olfactory assessments and helps clinicians determine the nature of smell impairments.
4) Nostril:
'Nostril' is significant in olfactory examinations as it serves as the entry point for odors in the nose. The article emphasizes testing each nostril separately to identify potential issues. This anatomical feature plays a critical role in understanding localized olfactory function and diagnosing conditions affecting smell perception.
5) Roman (Roma):
'Roman' does not explicitly appear relevant within the provided context. However, it may refer to ancient practices in medical examinations or might signify methodologies in historical studies related to olfactory function. Its usage could symbolize the long-standing interest in smell across cultures and periods, indicating the depth of olfactory research.
6) Landi (Lamdi):
'Landi' could indicate an author referenced in the research cited within the article, possibly contributing to the understanding of olfactory functions. Author names denote credibility in scientific works, guiding readers to the original sources for in-depth exploration of olfactory dysfunction, its assessments, and related studies.
7) Hand:
'Hand' is relevant in the context of conducting olfactory tests, particularly regarding contamination from personal odors. Ensuring that both the clinician's and patient's hands are odor-free is critical for valid test results, as any residual scents could significantly alter the outcomes of the smell assessments performed.
8) Post:
'Post' often refers to after a particular event or procedure. In the context of this study, it may relate to outcomes following olfactory examinations or conditions and symptoms arising after incidents, like upper respiratory infections that may lead to smell loss, guiding future therapeutic approaches.
9) Measurement:
'Measurement' is a key concept in assessing olfactory function, including the establishment of detection thresholds. Accurate measurement is crucial for diagnosing olfactory dysfunction and evaluating treatment efficacy. The systematic approach to measurement helps create standardized protocols to improve clinical practice in smell assessments.
10) Allergy:
'Allergy' is relevant in assessing olfactory function as allergic conditions can lead to nasal congestion and, consequently, smell dysfunction. Understanding the interplay of allergies and olfactory capabilities aids clinicians in diagnosing the cause of smell issues and prescribing appropriate treatments for affected individuals.
11) Science (Scientific):
'Science' represents the systematic study of olfactory functions and dysfunctions presented in the article. The scientific approach ensures reliable data collection methods, contributes to understanding mechanisms leading to smell impairment, and highlights the importance of research in developing standardized tests for olfactory evaluation.
12) Potter:
'Potter' likely refers to an author mentioned in the references, contributing knowledge regarding olfactory impairments. Notable contributions from various authors enhance the paper's reliability, linking their previous works on olfactory dysfunction and establishing connections beneficial for readers seeking deeper insights into this area of research.
13) Nature:
'Nature' is significant in connoting the inherent qualities or characteristics of olfactory function and dysfunction. Understanding the nature of smell perception informs clinicians about underlying mechanisms, helping them interpret results of olfactory tests and better recognize associated diseases or disorders affecting olfactory abilities.
14) Study (Studying):
'Study' denotes a structured investigation aimed at gaining knowledge about olfactory function. This article summarizes findings from previous studies to emphasize the importance of conducting standardized examinations for olfactory assessment, which can lead to insights into sensory processing and its implications in health and quality of life.
15) Food:
'Food' is relevant as smell plays a crucial role in flavor perception. Olfactory dysfunction can adversely impact the enjoyment and safety of food consumption, leading to significant lifestyle challenges. The article highlights how smell loss affects dietary habits, health, and overall life quality for individuals.
16) Discussion:
'Discussion' allows researchers to explore interpretations of their findings, addressing gaps in knowledge and highlighting clinical implications. It’s a critical section offering insights on olfactory dysfunction's relevance in diseases and emphasizing the necessity of standardized olfactory tests to improve patient care and outcomes.
17) Epilepsy:
'Epilepsy' is mentioned in relation to conditions affecting olfactory function, illustrating the complex relationship between neurological disorders and smell perception. Recognizing olfactory disturbances as potential indicators of epilepsy can enhance diagnostic methods, guiding clinicians toward early interventions and improving the patient's overall management of their condition.
18) Jasmine:
'Jasmine' is likely mentioned as an example of an odor utilized within smell identification tests. Different scents evoke varying responses; knowledge about jasmine and its characteristics aids in the accurate assessment of olfactory discrimination and identification, which are fundamental for comprehensive smell evaluations in patients.
19) Music:
'Music' probably serves as a metaphorical reference to the complexity of olfactory processing akin to auditory experiences. Just as music involves various elements harmonizing together, olfactory perceptions require intricate interactions of stimuli, neurological signaling, and interpretations, underscoring the necessity for thorough olfactory function evaluations.
20) Rules:
'Rules' in the context of clinical testing refer to guidelines and protocols established for conducting olfactory examinations. Adhering to specific rules ensures consistency, reliability, and accuracy in results, ultimately enhancing the diagnostic capabilities concerning olfactory dysfunction and providing trustworthy assessments for clinicians.
21) Vasu:
'Vasu' refers to a contributor mentioned in the acknowledgments, likely indicating their contribution to producing related materials, such as videos demonstrating olfactory examination techniques. Recognizing contributors signifies the collaborative effort behind scientific work, which often involves interdisciplinary team members for effective knowledge dissemination.
22) Wine:
'Wine' may be referenced in relation to specific scents used in olfactory tests. Exploration of various scents, including those associated with wine, can be essential for evaluating olfactory discrimination. Understanding how individuals perceive scents connected to wine can enhance assessments of smell dysfunction within populations.
23) Pose:
'Pose' indicates the challenges or problems presented by olfactory dysfunction. The article underscores how impaired smell can pose safety risks and impact a person's daily life, emphasizing the importance of thorough evaluation and management of olfactory complaints for improved quality of life.
24) Wall:
'Wall' likely refers to the non-physical barrier that may separate the examiner and the patient during olfactory assessments. This helps prevent inadvertent cueing during tests, stressing the importance of minimizing contaminating factors, making accurate olfactory evaluations vital to effective diagnosis and subsequent treatment decisions.
25) Milk:
'Milk' could be highlighted as an example of a familiar substance whose scent is typically tested during olfactory evaluations. Using common odors like milk can aid patients in identifying smells during assessments, showing the relevance of using relatable or common materials in olfactory tests for improved accuracy.
26) Drug:
'Drug' is significant when discussing olfactory dysfunction as certain medications can adversely affect smell perception or cause anosmia. Understanding the relationship between drug use and smell impairment aids healthcare providers in recognizing and managing olfactory side effects; it fosters better patient care and tailored therapeutic interventions.
27) Life:
'Life' embodies the overall experience of individuals affected by olfactory dysfunction. Loss of the sense of smell can greatly diminish enjoyment and safety in everyday life. The article advocates for better understanding and assessment of olfactory functions to enhance life quality for those facing such challenges.
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