Clinical examination
To test the sense of smell, first check that the nasal passages are clear by observing with a nasal speculum. Then, each nostril is tested in turn with a series of bottles containing familiar smells, e.g. oil of cloves, peppermint, coffee, etc. It is normal not to be able to name smells, but one smell can be distinguished from another.
Noxious smells, e.g. ammonia, should not be used because:
- they are upsetting to the patient
- noxious stimuli are detected by the sensory fibres of the fifth - trigeminal - nerve and not the olfactory nerve
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