Week 3 Nose and Mouth PDF

NOSE, MOUTH, AND THROAT Chapter 17 STRUCTURE AND FUNCTION - NOSE  External nose  Nasal cavity  Septum  Turbinates  Meatus Copyright © 2019 Elsevier, Inc. STRUCTURE AND FUNCTION – PARANASAL SINUSES  Frontal  Maxillary  Ethmoid  Sphenoid Copyright © 2019...

NOSE, MOUTH, AND THROAT Chapter 17 STRUCTURE AND FUNCTION - NOSE  External nose  Nasal cavity  Septum  Turbinates  Meatus Copyright © 2019 Elsevier, Inc. STRUCTURE AND FUNCTION – PARANASAL SINUSES  Frontal  Maxillary  Ethmoid  Sphenoid Copyright © 2019 Elsevier, Inc. STRUCTURE AND FUNCTION – MOUTH Oral cavity Hard and soft palates Uvula Tongue Copyright © 2019 Elsevier, Inc. STRUCTURE AND FUNCTION – SALIVARY GLANDS  Parotid  Submandibular  Sublingual  Teeth and gums Copyright © 2019 Elsevier, Inc. DEVELOPMENTAL CONSIDERATIONS  Pregnant women  Older adults  Nasal stuffiness  Diminished smell and taste  Epistaxis  Atrophic tissues  Hyperemic gums  Dental changes  Malocclusion  Malnutrition Copyright © 2019 Elsevier, Inc. DEVELOPMENTAL CONSIDERATIONS  Pregnant women  Pregnancy-related gingivitis  Older adults  “Purse string” appearance of mouth  Yellow teeth Copyright © 2019 Elsevier, Inc. CULTURAL AND SOCIAL CONSIDERATIONS  Leukoedema  Oral hyperpigmentation  Correlation between socioeconomic variables and dental disease  32% of Canadians lack adequate dental insurance Copyright © 2019 Elsevier, Inc. SUBJECTIVE DATA: HEALTH HISTORY – NOSE  Discharge  Frequent colds (upper respiratory infections)  Sinus pain  Trauma  Epistaxis (nosebleeds)  Allergies  Altered sense of smell Copyright © 2019 Elsevier, Inc. SUBJECTIVE DATA: HEALTH HISTORY – MOUTH AND THROAT Sores or lesions  Sore throat  Bleeding gums  Toothache  Hoarseness  Dysphagia  Altered taste  Smoking, alcohol consumption  Self-care behaviours Copyright © 2019 Elsevier, Inc. ADDITIONAL HEALTH HISTORY QUESTIONS Infants and children For the older adult  Mouth disease  Mouth dryness  Throat disease  Teeth  Tooth development  Mouth care  Self-care behaviours  Taste and smell Copyright © 2019 Elsevier, Inc.  PROMOTING HEALTH: SMOKELESS TOBACCO (SLT)  AND CANCER RISK Chewing tobacco and snuff (dry or moist) used in Canada  Using SLT can lead to oral, esophageal, or pancreatic cancer  Early signs of oral cancer include:  Ulcers or sores that do not heal  White or red patches  Prolonged sore throat or feeling that something is in the throat  Difficulty chewing  Unexplained bleeding  Numbness or tingling  Restricted movement of the tongue or jaw  A small lump or thickening in the lip, tongue, floor or roof, cheeks, gums, tonsil Copyright © 2019 Elsevier, Inc. OBJECTIVE DATA: PHYSICAL EXAM  Preparation  Positioning  Equipment  Otoscope with short, wide-tipped nasal speculum attachment  Penlight  Two tongue blades  Cotton gauze pad (10 × 10 cm)  Gloves  Occasionally: long-stem light attachment for otoscope Copyright © 2019 Elsevier, Inc. PHYSICAL EXAM – NOSE  Inspect and palpate  External nose  Nasal cavity  Holding the otoscope  Nasal septum  Turbinates Copyright © 2019 Elsevier, Inc. PHYSICAL EXAM – SINUS AREAS  Palpate  Frontal and maxillary sinuses Copyright © 2019 Elsevier, Inc. PHYSICAL EXAM – MOUTH  Inspect  Lips  Teeth and gums  Tongue (test cranial nerve XII)  Buccal mucosa  Palate and uvula Copyright © 2019 Elsevier, Inc. PHYSICAL EXAM – THROAT  Inspect  Tonsils—grading from 1+ to 4+  Use of tongue blade  Posterior pharyngeal wall Copyright © 2019 Elsevier, Inc. ABNORMAL FINDINGS (1 OF 3) Nose Lips  Choanal atresia  Cleft lip  Epistaxis  Herpes simplex I  Foreign body  Angular cheilitis  Perforated septum (stomatitis, perlèche)  Furuncle  Carcinoma  Acute rhinitis  Retention “cyst”  Allergic rhinitis (mucocele)  Sinusitis  Nasal polyps Copyright © 2019 Elsevier, Inc. ABNORMAL FINDINGS (2 OF 3) Teeth and Gum Buccal mucosa  “Baby bottle” tooth  Aphthous ulcers- canker decay sores  Malocclusion-under/over  Koplik’s spots -measles bite  Leukoplakia - tongue  Dental caries  Candidiasis or monilial  Epulis-gingival lesions infection  Gingival hyperplasia  Herpes simplex I  Gingivitis  “Meth mouth” Copyright © 2019 Elsevier, Inc. ABNORMAL FINDINGS (3 OF 3) Tongue Oropharynx  Anklyoglossia- tongue tie  Cleft palate  Fissured or scrotal tongue  Bifid uvula  Geographical tongue (migratory glossitis)  Oral Kaposi’s sarcoma  Smooth, glossy tongue  Acute tonsillitis and (atrophic glossitis) pharyngitis  Black hairy tongue  Enlarged tongue (macroglossia)  Carcinoma Copyright © 2019 Elsevier, Inc. CHAPTER 17 QUESTIONS Nose, Mouth, and Throat Copyright © 2019 Elsevier, Inc. 1. WHICH OF THE FOLLOWING QUESTIONS IS LIKELY TO ELICIT THE MOST INFORMATION? A. How often do you brush your teeth? B. Has your sense of taste changed? C. What is your daily dental care routine? D. Do you have any problems with your dentures? Copyright © 2019 Elsevier, Inc. 2. WHICH OF THE FOLLOWING IS AN EXPECTED FINDING IN DARK-SKINNED PEOPLE? A. Circumoral pallor B. Dappled brown patches on the buccal mucosa C. Bluish lips D. A chalky white raised patch on the mucosa of the tongue Copyright © 2019 Elsevier, Inc. ANSWERS TO CHAPTER 17 QUESTIONS  1. Correct answer: C This open-ended question invites the patient to tell the examiner about any and all aspects of self-care—and dental problems. The patient’s response will likely prompt follow-up questions from the examiner. Although the three closed-ended questions in Options A, B, and D will probably receive short answers, they too may elicit a descriptive answer, depending on the patient.  2. Correct answer: C Dark-skinned people normally may have bluish lips. Circumoral pallor occurs with shock and anemia in light-skinned people. Dappled brown patches and a chalky white raised patch are abnormal findings.  Note to instructors: This is a discussion question. Ask students how mouth examination findings vary among dark- skinned people. Copyright © 2019 Elsevier, Inc.