A velum deviates to the right during a sustained vowel. Which cranial nerve deficit is most likely on the left side?

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Prepare for the Praxis Dysphagia Test with flashcards and multiple-choice questions, designed to provide explanations and hints. Equip yourself with the knowledge needed for your examination!

Multiple Choice

A velum deviates to the right during a sustained vowel. Which cranial nerve deficit is most likely on the left side?

Explanation:
Unilateral weakness of the vagus nerve on one side reduces the elevator muscles of the soft palate on that side. During sustained phonation, the intact side pulls the palate toward itself, so the velum drifts toward the stronger, functioning side and the uvula points away from the lesion. Therefore, a velum that deviates to the right indicates weakness on the left, i.e., a left CN X deficit. The other options don’t fit because a right CN X lesion would pull the velum toward the left, and lesions of CN XII affect tongue movement rather than palate elevation, so they wouldn’t explain the observed velar deviation.

Unilateral weakness of the vagus nerve on one side reduces the elevator muscles of the soft palate on that side. During sustained phonation, the intact side pulls the palate toward itself, so the velum drifts toward the stronger, functioning side and the uvula points away from the lesion. Therefore, a velum that deviates to the right indicates weakness on the left, i.e., a left CN X deficit. The other options don’t fit because a right CN X lesion would pull the velum toward the left, and lesions of CN XII affect tongue movement rather than palate elevation, so they wouldn’t explain the observed velar deviation.

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