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Take both together. Observe uvula & fauces saying ‘Aaah’. Look for saliva pooling, food, palate/uvula deviation.

 Voice sounds ‘wet’ in early bulbar weakness (Chapter 13)

 Listen to a cough

 Watch patient begin to drink, if safe – spluttering, pooling.

An isolated IXth – almost impossible to identify – causes impaired unilateral pharynx sensation.