Transcription of Muscle Strength Grading Scale (Oxford Scale)
1 Sory and nerveconsists of the oph-thalmic, maxillary andmandibular branches,each of which controls adifferent portion of theface. Test the sensoryportion of CN V by lightlybrushing the patient sforehead, cheeks andchin with a piece of cotton or soft tissuewhile his or her eyes are closed. When evalu-ating an unconscious patient, the sensoryportion of CN V can be detected by elicitingthe corneal motor portion of the trigeminal nerveinnervates the temporal and masseter mus-cles. To assess the Strength of the massetermuscle, have the patient clench the teethwhile you palpate the angle of the facial nerve (cranial nerve VII, or CNVII) also has motor and sensory motor portion innervates the muscles ofthe face and scalp.
2 Testing the CN VIIinvolves asking the patient to smile, frown,open the eyes wide, raise the eyebrows,wrinkle the forehead, show the teeth, puffout the cheeks and purse the lips (Table 3).The sensory portion of CN VII supplies thesense of taste on the anterior two-thirds ofthe tongue and sensation to the ear canal andbehind the ear. Like the sense of smell, tasteis not routinely tested. If an abnormality inCN VII is present, further testing would beappropriate. Evaluation of CN VII involvesplacing salt or sugar on the lateral aspects ofthe tongue and asking the patient to identifythe acoustic nerve (cranial nerve VIII, orCN VIII) includes the cochlear branch, whichcontributes to hearing.
3 The vestibular branchinfluences equilibrium. Hearing loss can bescreened in the office setting. Have thepatient cover one ear, then rub your fingerstogether a few inches from the opposite hearing is most accurately mea-sured with audiometric devices, you can28 ADVANCEfor Nurse Practitioners July 2002CE 5 Muscle Strength Grading Scale ( oxford Scale )20/5No contraction 1/5 Visible/palpable Muscle contraction but no movement2/5 Movement with gravity eliminated3/5 Movement against gravity only4/5 Movement against gravity with some resistance5/5 Movement against gravity with full resistanc
