XII Hypoglossal Nerve
The hypoglossal nerve is motor to the tongue.
- observe for tongue atrophy or enlargement.
- do not overcall tongue fasciculations. It is very
difficult to relax the tongue.
- ask the patient to protrude the tongue.
- ask the patient to push the tongue into each cheek
or alternatively to protrude the tongue and push it
laterally against a tongue depressor.
- ask the patient to move the tongue quickly from
side to side.
- if there is facial weakness, correct this by supporting
the upper lip on the side of weakness, otherwise there
may appear to be deviation of the tongue but once
the facial weakness is corrected for, the tongue will
no longer appear to deviate.
- the tongue should be able to protrude relatively
straight. Minimal degrees of deviation (i.e. only
millimeters) affecting only the tip are insignificant.
- with tongue weakness, the tongue deviates towards
the weak side.