Extra/Intra Oral Examination revision notes quiz

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Questions and Answers

What should be done when examining the lips during an intraoral examination?

  • Examine inside and outside while using fingers to stretch the lips. (correct)
  • Use a mirror only for external examination.
  • Ask the patient to keep their lips closed throughout the examination.
  • Only examine the inside without using fingers.

What is an abnormal finding when inspecting the buccal mucosa?

  • Presence of minor trauma.
  • Normal pigmentation.
  • Smooth and moist texture.
  • White/lacy patches. (correct)

Which appearance of the tongue indicates a need for further examination?

  • Geographic appearance.
  • Fissured surface.
  • Coated tongue.
  • All of the above. (correct)

What should be used to facilitate a full examination of the floor of the mouth?

<p>Gauze may be necessary to grasp the tongue. (D)</p> Signup and view all the answers

What is the primary purpose of an extra oral examination?

<p>To identify any undisclosed or undiagnosed conditions (D)</p> Signup and view all the answers

During the examination of the soft palate, what action should the patient take?

<p>Say 'ahh' while the dentist examines. (A)</p> Signup and view all the answers

Which of the following indicates an abnormal finding during the palpation of lymph nodes?

<p>Fixed and swollen, tender to touch (D)</p> Signup and view all the answers

When inspecting the vestibules and fauces, what finding would be concerning?

<p>Presence of an abnormal frenulum. (D)</p> Signup and view all the answers

What type of swelling is normally considered during oral examinations?

<p>Tori. (B)</p> Signup and view all the answers

What position should the patient's head be in during the extra oral examination?

<p>Slightly forward with chin tipped downwards (D)</p> Signup and view all the answers

During the examination of the temporomandibular joint (TMJ), which symptom should the examiner look for?

<p>Clicking or limited opening (C)</p> Signup and view all the answers

Which condition requires urgent referral during an oral examination?

<p>Any sore that does not heal or continues to grow. (C)</p> Signup and view all the answers

What technique is recommended for palpating difficult areas during the examination?

<p>Using the pads of fingertips in an on/off motion (C)</p> Signup and view all the answers

Which of the following symptoms may indicate lymphadenopathy?

<p>Swelling and tenderness in lymph glands (A)</p> Signup and view all the answers

What is bruxism commonly associated with?

<p>Temporomandibular joint (TMJ) disorders (D)</p> Signup and view all the answers

What should be documented if an abnormality is detected during an examination?

<p>Size, location, consistency, and history of the abnormality (A)</p> Signup and view all the answers

What might be indicated if a sore, ulcer, or blister does not heal?

<p>Squamous cell carcinoma (B)</p> Signup and view all the answers

Which symptom is commonly associated with apthous ulcers?

<p>Painful sore in the mouth (A)</p> Signup and view all the answers

What should be avoided in patients with active cold sores?

<p>Cold sore treatment (D)</p> Signup and view all the answers

Which condition is characterized by red, inflamed, and sore lips that may crack?

<p>Angular cheilitis (D)</p> Signup and view all the answers

Which question is important for understanding potential causes of oral ulcers?

<p>Do you remember biting your lip or tongue? (C)</p> Signup and view all the answers

What is a common characteristic of both angular cheilitis and herpes labialis?

<p>They both primarily affect the lips. (C)</p> Signup and view all the answers

What type of examination might show color changes and breaks in the mucosa?

<p>Oral examination (B)</p> Signup and view all the answers

Intraoral lesions can commonly be found in which areas?

<p>On mucous membranes (B)</p> Signup and view all the answers

What is a common method to prevent angular cheilitis?

<p>Regular hydration of the lips (A)</p> Signup and view all the answers

Which condition is characterized by painful and variable size sores in the mouth?

<p>Apthous ulcers (A)</p> Signup and view all the answers

What is the first step to take when conducting an intraoral and extraoral examination?

<p>Explain the procedure to the patient and gain consent (A)</p> Signup and view all the answers

Which symptom might indicate the need for an additional examination of the lymph nodes?

<p>Recent infection causing tenderness in the area (C)</p> Signup and view all the answers

During the extraoral examination of the face, which of the following signs should be recorded?

<p>Signs of infection and presence of cuts (C)</p> Signup and view all the answers

When palpating the lymph nodes, what is a normal characteristic to expect?

<p>Small and mobile with no tenderness (C)</p> Signup and view all the answers

What behavior might a patient exhibit that could suggest a condition leading to TMD?

<p>Clenching or grinding of teeth (B)</p> Signup and view all the answers

Which question should NOT be asked if a patient presents with an oral abnormality?

<p>How would you describe your usual daily routine? (B)</p> Signup and view all the answers

When assessing the TMJ, what is an indication of a potential issue?

<p>Clicks or deviations during jaw movement (A)</p> Signup and view all the answers

Which characteristic should be documented during the visual examination of the lymph nodes?

<p>The size, duration, and any tenderness felt (D)</p> Signup and view all the answers

What does TMD stand for?

<p>Temporomandibular dysfunction (C)</p> Signup and view all the answers

Which of the following is NOT a symptom associated with TMD?

<p>Color change in eyes (D)</p> Signup and view all the answers

Why is it important to check for facial asymmetries during a TMD examination?

<p>They may suggest underlying health issues (A)</p> Signup and view all the answers

What is the best way to assess if a patient's condition is normal or abnormal for them?

<p>Ask the patient directly about their normal (A)</p> Signup and view all the answers

In a TMD examination, what should you visually inspect for in the eyes?

<p>Color changes, dryness, or irritation (C)</p> Signup and view all the answers

What might deviations in facial symmetry during examination indicate?

<p>Possible trauma or nerve issues (D)</p> Signup and view all the answers

Which of the following could cause TMD symptoms?

<p>Stress, infections, or medical conditions (C)</p> Signup and view all the answers

What should be done if an abnormality is detected during a TMD examination?

<p>Make a note and discuss it with the patient (D)</p> Signup and view all the answers

What is the recommended action when examining a tongue for abnormalities?

<p>Use gauze to pull the tongue out (B)</p> Signup and view all the answers

What condition is characterized by smooth, red depapillation of the tongue?

<p>Glossitis (D)</p> Signup and view all the answers

Which symptom indicates a potentially serious oral condition that requires urgent referral?

<p>Red, white, or dark patch that does not heal (C)</p> Signup and view all the answers

What can be a potential side effect of a lingual salivary stone?

<p>Blocking of saliva flow (C)</p> Signup and view all the answers

Which type of lesion is associated with a burning sensation and numbness in the mouth?

<p>Glossitis (D)</p> Signup and view all the answers

What is the appearance of a normal tongue, in contrast to a pathological one?

<p>Smooth and red (C)</p> Signup and view all the answers

Limited lip movement can be caused by which condition?

<p>Abnormal labial frenulum (C)</p> Signup and view all the answers

What type of oral condition could cause halitosis (bad breath)?

<p>Tonsillar calcification (D)</p> Signup and view all the answers

What type of lesion often indicates a serious underlying condition when persistent?

<p>Sore that does not heal (D)</p> Signup and view all the answers

Which of the following is NOT typically associated with a harmless oral condition?

<p>Painful white patches (D)</p> Signup and view all the answers

Flashcards

Facial Asymmetry

Facial asymmetry is a condition where one side of the face is visibly different from the other. This can be due to a variety of factors, such as swelling, injury, or underlying medical conditions.

Palpation of Lymph Nodes

During an extraoral examination, lymph nodes are palpated using the pads of fingers in an on/off motion. This means gently pressing the fingers against the node and then releasing, allowing the node to return to its normal position.

Normal Lymph Node Characteristics

Lymph nodes are small, bean-shaped organs that are part of the lymphatic system. When they are healthy, they are small, not tender to the touch, and move freely.

Temporomandibular Joint (TMJ) Assessment

The temporomandibular joint (TMJ) is located in front of the ear. It helps us open and close our mouths. An examiner will palpate the TMJ on both sides to look for tenderness or pain, and will also ask the patient to open and close their mouth slowly to observe any limitations or clicking sounds.

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Bruxism

Bruxism is the involuntary grinding or clenching of teeth, usually during sleep. It can be a common cause of temporomandibular disorders (TMD), leading to pain, stiffness on opening, headaches, neck aches, and tooth pain.

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Jaw Deviation

Deviation is when the jaw moves to one side when opening the mouth. This can occur due to a variety of factors, including muscle imbalances, joint problems, or a misaligned bite.

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Temporomandibular Disorders (TMD)

TMD is a disorder that affects the temporomandibular joint (TMJ) and the muscles that control jaw movement. It can cause a variety of symptoms, including pain, stiffness, clicking, and limited jaw opening.

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Extraoral Examination

The extraoral examination is an essential part of a comprehensive oral examination. It involves visual assessment of the face and head, palpation of the lymph nodes, and assessment of the temporomandibular joint.

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Glossitis

A condition found on the tongue that causes a smooth, red, inflamed surface.

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White/lacy patches on buccal mucosa

A condition that causes white, lacy patches on the buccal mucosa.

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Tori

Abnormal bumps found on the hard or soft palate.

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Fordyce spots

An abnormal fleshy growth found on the lips or buccal mucosa.

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Ranula

A fluid-filled cyst that occurs on the floor of the mouth.

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Geographic tongue

A condition that causes a geographic pattern on the tongue.

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Fissured tongue

A condition that causes deep grooves or fissures on the tongue.

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Black hairy tongue

A condition characterized by a black, hairy appearance on the tongue.

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Lymphadenopathy

Swelling or disease of the lymph glands.

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Purpose of extraoral examination

The purpose of an extraoral examination is to identify any undisclosed or undiagnosed conditions.

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Temporomandibular joint (TMJ)

The temporomandibular joint (TMJ) is located in front of the ear and helps us open and close our mouths.

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Examining the Temporomandibular Joint

Examination of the temporomandibular joint (TMJ) involves palpating both sides and asking the patient to open and close their mouth to check for tenderness, pain, deviation, clicking, or limited opening.

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Temporomandibular Joint Dysfunction (TMD)

A type of joint disorder that affects the jaw joint and the muscles that control jaw movement.

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Eyes Examination

The process of examining the eyes for any abnormalities, such as color changes, pupil dilation, or irritation.

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Mandibular Tori

A benign bony growth on the floor of the mouth.

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Lingual Ranula

A harmless collection of saliva fluid, often appearing as a cyst on the floor of the mouth.

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Tonsillar Calcification

A small, hard lump on the tonsils that may cause bad breath, a sore throat, or taste disturbances.

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Herpangina

A condition characterized by a painful ulcer located in the space between the oral cavity and pharynx.

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Lingual Salivary Stone

A small stone that can block saliva flow in the salivary gland.

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Abnormal Labial Frenulum

A condition characterized by limited lip movement.

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Mouth Cancer

A red, white, or dark patch in the mouth that may be a sign of cancer.

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Angular Cheilitis

Lips that are inflamed, red and sore, with cracking at the corners of the mouth, often associated with fungal infection. This condition is usually caused by dryness or a vitamin deficiency.

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Squamous cell carcinoma

A condition that causes a sore, an ulcer, a blister, or a red/white patch that does not heal or go away. This can indicate a squamous cell carcinoma, a cancerous tumor in the skin. Urgent referral is required.

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Apthous ulcers

A condition that causes sores and pain on the tongue, often with varying sizes and possible causes such as anemia or vitamin deficiency.

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Dry/Chapped Lips

Dryness of the lips, often accompanied by cracking and peeling. This can have many causes, including dehydration, cold weather, or certain medications.

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Study Notes

Extra/Intra Oral Examination Questions

  • Always review patient medical history.
  • Key questions to ask if abnormality is detected:
    • How long has the abnormality been present?
    • How are you feeling generally?
    • Are you experiencing any pain?
    • How often do you get mouth ulcers?
    • Do you remember recent lip or tongue biting?
    • Do you remember any burning sensation?
    • Are you aware of teeth clenching or grinding?

Extra Oral Examination – Step-by-Step

  • Introduce yourself and the nurse to the patient. Explain the reason for the appointment and gain consent from the patient.
  • Face: Visually examine the face and top of the head looking for:
    • Symmetry
    • Swelling
    • Signs of infection
    • Bruises
    • Cuts
    • Colors
  • Record location, size, color, duration and pain associated with any abnormality.
  • Lymph Nodes:
    • Stand behind the patient.
    • Ensure the patient is relaxed with the head slightly forward and chin tipped.
    • Palpate lymph nodes (using pads of fingers in an on/off motion) to check for tenderness or swelling.
    • Compare both sides.
    • Note any normal results as small (pea-sized), not tender, and mobile.
  • Record all findings noting location, size, duration and pain assessment.

Intra Oral Examination – Step-by-Step

  • Lips: Examine the outside and inside of lips with the fingers for any abnormalities. Look for any:
    • Trauma
    • Cold sores
    • Ulcers
    • Mucocele
    • Fordyce spots
    • Swelling
  • Buccal Mucosa: Use thumb and fingers to feel the buccal mucosa for:
    • Smoothness, moisture and pinkness
    • Trauma
    • White/lacy patches,
    • Ulcerations
    • Cheek biting
    • Burns
    • Granulomas
  • Vestibules and Fauces: Use a mirror to push down on the back of the tongue and check the fauces while patient says "ahh". Look for:
    • Ulcerations
    • Abnormal frenulum
    • Tonsillar calcification
    • Swelling

Other Intra Oral Considerations

  • Hard and Soft Palate: Evaluate for:
    • Dentures/appliance removal for examination (if present)
    • Thrush
    • Ulceration
    • Stomatitis
    • Tori (benign bony growths)
  • Tongue: Check for:
    • Colour
    • Breaks
    • Lumps/vessels
    • Textures
    • Geographic tongue
  • Additional points for evaluation and documentation for irregularities are present
    • Size
    • Location
    • Duration
    • Pain assessment
    • Any other abnormalities

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