TAILIEUCHUNG - Chapter 030. Disorders of Smell, Taste, and Hearing (Part 3)

Approach to the Patient: Disorders of the Sense of Smell Unilateral anosmia is rarely a complaint and is only recognized by testing of smell in each nasal cavity separately. Bilateral anosmia, on the other hand, brings patients to medical attention. Anosmic patients usually complain of a loss of the sense of taste even though their taste thresholds may be within normal limits. In actuality, they are complaining of a loss of flavor detection, which is mainly an olfactory function. The physical examination should include a thorough inspection of the ears, upper respiratory tract, and head and neck. A neurologic. | Chapter 030. Disorders of Smell Taste and Hearing Part 3 Approach to the Patient Disorders of the Sense of Smell Unilateral anosmia is rarely a complaint and is only recognized by testing of smell in each nasal cavity separately. Bilateral anosmia on the other hand brings patients to medical attention. Anosmic patients usually complain of a loss of the sense of taste even though their taste thresholds may be within normal limits. In actuality they are complaining of a loss of flavor detection which is mainly an olfactory function. The physical examination should include a thorough inspection of the ears upper respiratory tract and head and neck. A neurologic examination emphasizing the cranial nerves and cerebellar and sensorimotor function is essential. Any signs of depression should be noted. Sensory olfactory function can be assessed by several methods. The Odor Stix test uses a commercially available odor-producing magic marker-like pen held approximately 8-15 cm 3-6 in. from the patient s nose. The 30-cm alcohol test uses a freshly opened isopropyl alcohol packet held 30 cm 12 in. from the patient s nose. There is a commercially available scratch-and-sniff card containing three odors available for gross testing of olfaction. A superior test is the University of Pennsylvania Smell Identification Test UPSIT . This consists of a 40-item forced choice scratch-and-sniff paradigm. For example one of the items reads This odor smells most like a chocolate b banana c onion or d fruit punch. The test is highly reliable is sensitive to age and sex differences and provides an accurate quantitative determination of the olfactory deficit. The UPSIT which is a forced-choice test can also be used to identify malingerers who typically report fewer correct responses than would be expected by chance. The average score for total anosmics is slightly higher than that expected on the basis of chance because of the inclusion of some odorants that act by trigeminal stimulation. .

• Y học thường thức
• Disorders of Smell
• Taste
• Hearing
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• Taste disorders
• Smell and taste disorders
• Non neurodegenerative disorders
• Neurodegenerative chemosensory disorders
• Chemosensory disorders
• Medicolegal aspects
• Physiology of olfaction
• Anatomy and physiology of gustation
• Measurement of gustation
• Measurement of olfaction
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care