Testing Olfaction...

[lapelirroja]

WTF?

I bought all my diagnostic equipment to prepare for our physical exam class and they just added an item for purchase....

"two small reclosable tubes containing odorous materials for testing olfaction"

I'm assuming this is for Cranial Nerve testing, etc. Where am I supposed to find these?? At the PC office where I did some MA work we had a smelly substance in a small white bag that almost knocked me over when I smelled it. I ran out of the room coughing and sputtering, it was brutal. Anyway, I forget what this is called, and by the sound of it, it isn't what we're required to buy anyways. Before I bug the Professor with what may be a simple question, does anyone know what I am talking about or where to find such a thing? I searched AllHeart and Redding Medical, etc. for smell kits and came up short...

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[TopSecret]

WTF?

I bought all my diagnostic equipment to prepare for our physical exam class and they just added an item for purchase....

"two small reclosable tubes containing odorous materials for testing olfaction"

I'm assuming this is for Cranial Nerve testing, etc. Where am I supposed to find these?? At the PC office where I did some MA work we had a smelly substance in a small white bag that almost knocked me over when I smelled it. I ran out of the room coughing and sputtering, it was brutal. Anyway, I forget what this is called, and by the sound of it, it isn't what we're required to buy anyways. Before I bug the Professor with what may be a simple question, does anyone know what I am talking about or where to find such a thing? I searched AllHeart and Redding Medical, etc. for smell kits and came up short...

Smelly erasers.

 

[Rendar5]

Smelly erasers.

you don't want to use what the doctor had in his office. Even if you had anosmia that might knock you for a loop, like alcohol. The best thing I've heard to use is coffee grounds.

Though seriously, I can't believe your school is making you get something to test CN I; I've never seen it tested in my life, including on my neurology rotation.

 

[Rogue Synapse]

The utility of testing CN I is diminishingly small. It has a very low specificity for detecting neurological lesions (which are exceedingly uncommon for CN I) because there are so many other, more common reasons for decreased sense of smell. Most of those reasons are in the nasopharynx and not the brain.

 

[TopSecret]

you don't want to use what the doctor had in his office. Even if you had anosmia that might knock you for a loop, like alcohol. The best thing I've heard to use is coffee grounds.

Though seriously, I can't believe your school is making you get something to test CN I; I've never seen it tested in my life, including on my neurology rotation.

Head trauma is a common cause of olfactory dysfunction. Parkinsonism is also associated with it.

 

[Tiger26]

Head trauma is a common cause of olfactory dysfunction. Parkinsonism is also associated with it.

non-contrast CT . . . . .

 

[ubcredfox]

At art supply shops you can buy little plastic re-closable tins for storing small amounts of paint. I used to carry around cloves as they are quite pungent. However, because the majority of the population eat out of microwavable boxes and have no understanding of vegetables, I switched to cinammon as it's much more easily recognizable. Try not to tell them what they are smelling before you hit their nostrils with the stuff.

Oh, and frontal lesions mistakenly diagnosed as dementia compressing the olfactory nerves will also give you anosmia.

Cheers.

 

[Ashers]

I saw a neurologist carry around an old film container filled with coffee beans (ya know -- what used to be used in cameras all the time)

 

[ZagDoc]

I saw a neurologist carry around an old film container filled with coffee beans (ya know -- what used to be used in cameras all the time)

Thats what a neurologist recommended to me as well. You have to choose your smells carefully, because some people may not "know" certain smells.

But almost everyone knows the smell of coffee grounds. I got a small little tube with a screw top with some ground coffee beans in it.

And yes, I've never used it outside my PE class.

 

[lapelirroja]

Some people over at the PA forum suggested getting scented oils, which I thought was a pretty good idea. I can get 1oz vials for 2.99ea, won't break the bank if I just need them to get through this year. I chose vanilla and cinnamon as smells my patients are likely to guess correctly.

I was confused at first, because I assumed with this being so standard (cranial n. exam, etc.) that specialized kits would exist somewhere...but since you all say CN I isn't really tested all that much in practice, it makes sense that these kits aren't readily available.

Thanks for all the responses, maybe this will help someone else...

ps, remembered what that nasty stuff was called, "Smelling salts." How eloquent. Freaking disgusting. Apparently people like filming themselves using smelling salts for LOLs.

 

[Ashers]

ps, remembered what that nasty stuff was called, "Smelling salts." How eloquent. Freaking disgusting. Apparently people like filming themselves using smelling salts for LOLs.

I found smelling salt things in my dad's patient rooms back in the late 80s, and being a dumb kid, I wanted to break the thing. Yeah, I learned not to do that.

 

[beefballs]

dont wear deoderant

 

[Rendar5]

Head trauma is a common cause of olfactory dysfunction. Parkinsonism is also associated with it.

And don't forget alzheimer's. anosmia is one of the earliest symptoms. But is a finding of CNI dysfunction ever going to affect management? Is it ever going to alter the differential? I know that it won't alter EM management or diagnosis of a TBI, so it's not useful to me in my field as far as I'm aware. But I'm not a neurologist nor was it one of my strongest subjects as a med student, so my question is genuine for Alzheimer's and Parkinson's (that one I didn't actually know, btw. Thx for the info)

 

[45408]

Yeah, even when we did chairman's rounds on neurology - and he tested physical exam findings I had never heard of - we never even discussed olfaction. The odds that you would actually use it in aiding your diagnosis....slim.

 

[metallo]

My school is really big on teaching physical exam skills. One thing we learned first year was never to use substances that are really potent or could cause someone to jump backwards after smelling them. Even though you think you're testing CN I, you risk actually stimulating pain fibers in CN V instead. My school gave us the two little containers... one had coffee grounds, but the other had vinegar, which would seem to violate the above rule.

 

[Pinkertinkle]

why would you test olfaction when you can just do a CT

 

[InternationlDoc]

PT is right.

Skip H&P and - as house would say - do a full body CT/MRI.

 

[lapelirroja]

I'm sure you guys are all right about what's true for clinical practice but I've got to go through the motions of what my school wants (requires) us to do for H&P class. On the first day of class we have an orientation to have all of our equipment checked to make sure it's up to par. If you do not have all the required items you are not allowed to participate and would get an unexcused absence... I just gotta get my -C and then we'll see what happens in the real world.

Thanks for all the suggestions, I bought small 1oz vials of vanilla and cinnamon scented oils. Maybe after the school year I can make a cool perfume or something?

PS re: deodorant, I like having friends so I think I'll keep wearing it.

 

[JAR]

http://www.fpnotebook.com/Neuro/Exam/CrnlNrv1.htm

"Coffee, cloves, peppermint"

 

[sprinkibrio]

I've heard of using coffee beans. BTW this is a total waste, who tests olfaction anyway?

 

[The Angriest Bird]

I just stopped using my daily deodorant. Then I realized that I'm actually testing CN V.

 

[Clemson Doc]

I have never seen CN I tested. It's always II-XII.

If you have to test olfaction at your school, though, I recommend farting. Walk in the room, turn around with your back to the patient, and fart in their direction. Then ask them if they can smell it. You won't have to carry anything in your pocket, nor will you have to spend your own money purchasing anything. Problem solved.