Oro Motor exam:

1. Facial muscle strength and symmetry (Cranial nerve VII - Facial nerve) - Assess the
strength and symmetry of the facial muscles by asking the patient to perform various facial
movements, including smiling, frowning, raising eyebrows, puffing cheeks, and closing eyes
tightly.

2. Lip strength and mobility (Cranial nerve VII - Facial nerve) - Evaluate the strength and
mobility of the lips by asking the patient to purse their lips, smile broadly, and pucker their
lips as if kissing.

3. Tongue strength and mobility (Cranial nerve XII - Hypoglossal nerve) - Assess the
strength and mobility of the tongue by having the patient protrude their tongue, move it
from side to side, and touch it to their nose or chin. Observe for any weakness, tremors, or
deviations in tongue movement.

4. Tongue strength against resistance (Cranial nerve XII - Hypoglossal nerve) - Ask the
patient to push their tongue against the inside of their cheek while you apply resistance
with a tongue depressor or gloved hand. Assess the strength and coordination of the tongue
muscles.

5. Palate elevation and uvula deviation (cranial nerves IX (Glossopharyngeal) and X

(Vagus) -
Have the patient say "ah" or yawn to observe the elevation of the soft palate and the
position of the uvula. The soft palate should rise symmetrically, and the uvula should remain
midline.

6. Gag reflex cranial nerves IX (Glossopharyngeal) and X (Vagus) -

Stimulate the patient's soft palate and posterior pharynx with a tongue depressor or cotton
swab to assess the presence and strength of the gag reflex. Be cautious and attentive to the
patient's comfort during this part of the exam.

7. Swallowing assessment Cranial nerves V - Trigeminal nerve, VII - Facial nerve, IX -

Glossopharyngeal nerve, X - Vagus nerve, XI - Accessory nerve, and XII - Hypoglossal
nerve - Observe the patient as they swallow various liquids, such as water or a contrast
material. Look for signs of difficulty or abnormal movements during swallowing, such as
coughing, choking, or aspiration.

8. Speech evaluation Cranial nerves V - Trigeminal nerve, VII - Facial nerve, IX -

Glossopharyngeal nerve, X - Vagus nerve, XI - Accessory nerve, and XII - Hypoglossal
nerve - Assess the patient's speech clarity, articulation, and coordination. Ask them to
pronounce different sounds, syllables, and words, and listen for any slurring, nasal quality,
or difficulty producing specific sounds.