Summary McTimoney College of Chiropractic - Clinic Entrance & Exit Exam (ALL Testing)
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McTimoney Chiropractic - Clinic Exam
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University Of Ulster
This master summary contains every test you will need to know for your clinic entry and exit exam. This document includes everything from Neuroscience, Clinical Neurology, MSM and CM2 (Systems). Combined with the conditions this is everything you need to know to pass clinic entrance and exit.
, Cranial Nerves
Mnemonic No. Name Nuclei Type Sensory function Motor function Parasympathetic function Muscle Innervation
On I Olfactory Cerebrum Sensory ● Smell (olfactory)
On II Optic Cerebrum Sensory ● Vision
On III Oculomotor Midbrain Motor + ● Movement of eyeball ● Accommodation = rounding of ● Superior/medial/inferior rectus
parasymp. ● Eyelid elevation lens for near/far vision by ● Inferior oblique
contracting ciliary muscles ● Levator palpebrae superioris (eyelid)
● Pupillary constriction by
sphincter pupillae
They IV Trochlear Midbrain Motor ● Movement of eyeball: downwards & ● Superior oblique
inwards
Travelled V Trigeminal Pons Both ● Facial sensation (incl. anterior 2/3rd of tongue): ● Mastication ● Muscles of mastication: masseter,
soft touch & pin-prick (+ corneal reflex) temporalis, pterygoid
● Proprioception (somatosensory)
And VI Abducens Pons Motor ● Movement of the eyeball: lateral ● Lateral rectus
rotation (abduction)
Found VII Facial Pons Both + ● Taste: anterior 2/3rd of tongue (gustatory) ● Facial expression ● Secretomotor innervation: ● Muscles of facial expression: frontalis,
parasymp. ● Sensation of posteromedial outer ear ● Sound dampening salivary (submandibular & orbicularis oculi, buccinator, orbicularis
● Raising of hyoid bone sublingual), lacriminal & oris, platysma
nasal/palatine glands ➔ dry ● Stapedius (sound)
eye/mouth ● Stylohyoid & digastric (hyoid)
Voldemort VIII Vestibulocochlear Pons Sensory ● Hearing (auditory)
● Balance inner ear (vestibular)
Guarding IX Glossopharyngeal Medulla Both + ● Taste: posterior 1/3rd of tongue (gustatory) ● Swallowing ● Secretomotor innervation: ● Stylopharyngeus of pharynx (upper
parasymp. ● Sensation to posterior 1/3rd of tongue, tonsils, salivary gland (parotid) ➔ dry part throat)
pharynx, tympanic area mouth
● Gag reflex
● Visceral sensation to carotid body
(chemoreceptors: blood O2/CO2/pH) & carotid
sinus (baroreceptors: arterial BP)
Very X Vagus Medulla Both + ● Sensation to ear, pharynx & larynx ● Branchiomotor innervation to laryngeal ● Parasympathetic motor supply ● Pharyngeal & laryngeal muscles
parasymp. ● Visceral sensation to thoracic/abdominal (neck) & pharyngeal (throat) muscles ➔ to smooth muscle & glands of (lower parts throat)
viscera (heart/GIT) voice, resonance, swallowing pharynx, larynx, ● Soft palate
● Taste: epiglottis & tongue root (gustatory) ● Gag reflex thoracic/abdominal viscera
Ancient XI Accessory Medulla Motor ● Head movement: cervical rotation, ● Sternocleidomastoid (neck)
flexion/extension & lateral flexion ● Trapezius (shoulder)
● Shoulder movement: scapula rotation,
retraction, elevation & depression
Horcruxes XII Hypoglossal Medulla Motor ● Tongue movement ➔ swallowing, ● Muscles of tongue
speech articulation
,1. CN I - Olfactory
o Smell
2. CN II - Optic
o Vision
3. CN III - Oculomotor
o Movement of eyeball, eyelid, lens & iris
4. CN IV - Trochlear
o Movement of eyeball ➔ downwards & inwards
5. CN V - Trigeminal
o Facial sensation ➔ soft touch + pin prick
o Proprioception
o Mastication
6. CN VI - Abducens
o Movement of eyeball ➔ lateral rotation (abduction)
7. CN VII - Facial
o Taste ➔ anterior 2/3rd of tongue
o Outer ear sensation & sound dampening
o Facial expression
o Secretomotor innervation ➔ salivary (except parotid) & lacrimal glands
8. CN VIII - Vestibulocochlear
o Hearing
o Balance/equilibrium in inner ear
9. CN IX - Glossopharyngeal
o Taste ➔ posterior 1/3rd of tongue
o Sensation ➔ tonsils, pharynx, tympanic area, carotid body & sinus
o Gag reflex (sensory)
o Swallowing
o Secretomotor innervation ➔ parotid gland
10. CN X - Vagus
o Sensation ➔ ear, pharynx, larynx & thoracic/abdominal viscera
o Branchiomotor innervation ➔ laryngeal (neck) & pharyngeal (throat) muscles ➔ swallowing, voice & resonance
o Gag reflex (motor)
o Parasympathetic motor supply ➔ pharynx, larynx & thoracic/abdominal viscera
11. CN XI - Accessory
o Head movement
o Shoulder movement
12. CN XII - Hypoglossal
o Tongue movement ➔ allows swallowing & speech articulation
, Cranial Nerve Test Abnormal
CN1: Olfactory Smell (not routinely tested) • Anosmia = loss of sense of smell ➔ could be due
• Q: Have you recently experienced any changes to your sense of smell? to common cold or head injury
• Test 1 nostril at the time, using strong scents (coffee, chocolate, ammonia) • Temporal lobe epilepsy = olfactory hallucination
CN2: Optic Responsible for visual acuity (how clear vision is) Visual acuity
• Use Snellen chart or a newsprint (small font) • Look for blurring (scotoma)
• Keep glasses on ➔ not testing for myopia (near-sight) & hyperopia (far-sight) Four quadrants
Confrontation test / Visual fields test / Four quadrants test • Loss full visual field (monocular blindness)
• Ask PT to cover right eye + keep their gaze on you + tell you when they see your finger • Loss of half visual field (hemianopia)
• Stand in front of PT and mirror image • Loss of a quadrant (quadrantanopia)
• Start with hand behind PT head with 2 fingers sticking out & move hand towards yourself • Enlargement of blind spot
• Test both sides (1 for lateral/peripheral & 1 for medial field of vision) at head & waist height • Tunnel vision = loss of peripheral vision
• First view should be just in front of PT shoulder (for lateral field) Visual neglect
Visual neglect test • PPC (posterior parietal cortex) lesion = loss of
• Ask PT to cover 1 eye + tell you when you are moving your finger & point to which hand half of the world, particularly during bilateral
• Stand further from PT, make bunny ears with hands, move each hand individually, then simultaneously stimulus
Refer to fundoscopy Fundoscopy
• Uses an ophthalmoscope to find papilledema’s • Papilledema = optic disc swelling caused by
increased intracranial pressure (ICP)
CN3: Oculomotor Visual observation Visual observation (CN3)
CN4: Trochlear • Check eyelid & pupil size • Ptosis = eyelid drop
CN6: Abducens Smooth pursuit • Anisocoria = unequal size of pupils
• Testing eye movement • Miosis = excessive constriction of pupils
• Ask PT to hold head still + follow your finger with their gaze + ask if it causes double vision • Mydriasis = dilation of pupils
• Stand in front of PT, far enough that PT can’t “kick you” & draw a ‘H’ with slowly with your finger • Strabismus = misalignment of eyes
• Movements should be full, smooth & coordinated in full ROM Smooth pursuit / convergence / saccadic / VOR:
Convergence test • Saccade = jumping eye movements between 2
• Immediately after smooth pursuit end point, bring finger slowly to PT face & back points (also with VOR)
• Eyes should converge/constrict when getting closer & divergence/dilation when moving away • Diplopia = double vision (CN4)
Saccadic test • Nystagmus = involuntary eye oscillations
• Ask PT to look at object, then instruct to look R/L/up/down rapidly & fixate back on object (dancing eyes)
• Eyes should fixate immediately. No slow initiation, slow speed or inaccurate fixation • Reduced ROM, uncoordinated
Vestibulo-ocular reflex (VOR) Abduction problem = CN6
• Ask PT to look at fixed distant point Intorsion problem = CN4
• Turn head L/R/up/down, gaze should be maintained Rest = CN3
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