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Health Assessment > Ch 15: Nose, sinuses, mouth, throat > Flashcards

Ch 15: Nose, sinuses, mouth, throat Flashcards

1
Q

What is the function of the nose an upper respiratory system

A

Warm, filter and humidified air

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2
Q

What is the structure of the nose (sinuses) in relation to the osteomeatal complex
(What empties where)

A

The frontal, ethmoid, and maxillary sinuses empty into the nasal cavity

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3
Q

What artery supplies the blood to the nose

What is vital to do after nasal Surgery/ throat/ bronchoscopy/endoscopy in relation to bleeding

A

Branches of the internal and external carotid arteries supply blood to nose

After nasal surgery assess the patient’s nasal drip pad for any bleeding and assess of the patient is continuously swallowing
-Nasal drip pad and continuous swallowing indicate bleeding as a patient is swallowing blood

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4
Q

What is the cranial nerve that pertains to the nose And what does it test

A

CN 1 olfactory pertains to the nose

It tests sense of smell

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5
Q

What do the sinuses provide in relation to the voice

Use medical term

A

The sinuses provide

Timbre: Quality and sound of voice and sinuses also produces mucus

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6
Q

What areas are affected by chronic sinusitis in the nasal bones

A

The superior, middle, inferior turbinate are areas affected by chronic sinusitis

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7
Q

What are adenoids and where can They be found

A

Adenoids are lymphoid tissue

Found in:

  • roof of nasopharynx
  • lateral to estachian tube
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8
Q

What is absolutely vital to consider when a patient has an upper respiratory infection in relation to appettite

A

 upper respiratory infections obstructs the olfactory sensory receptors and that can impair sense of smell and taste

Within impaired sense of smell and taste due to the obstruction patient may develop anorexia

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9
Q

When assessing the nose and sinuses what is important to note
(Colds and patent)

A 
Mucosal swelling (Cold‘s)
Any blocked nasal passages
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10
Q

How do you assess the sinuses

What are the three sinuses

A

You assess the sinuses with direct percussion in the frontal, ethmoid, maxillary sinuses

The three sinuses are:

  • frontal: above brow
  • ethmoid: between eyes
  • maxillary: below eyes
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11
Q

What are the cranial nerves that assist in the mouth and throat And what do you test when you take them

A

CN9 (glossopharyngeal)
Sensory: taste
Motor: swallow

CNN 10 (Vagus)
Sensory and motor: bilateral gag reflex
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12
Q

What is the function of the mouth

In the mouth where can you find the hard roof, soft palette and what are each used for

A

Provide sense of taste, chewing, speech articulation

Hard roof found anterior
-Use for feeding and speech

Soft palate found posterior
-aids in speech and pronunciation
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13
Q

What is the structure that connects the tongue to the sublingual pallet

A

The lingua frenulum Connect the tongue to the sublingual pallet

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14
Q

What is the medical term for tastebuds and what happens if there is an injury or disturbance to your taste buds

What is the tongue considered of most

A

Taste buds a.k.a. “Vallate papille”

Is there’s injury or disturbances taste buds there is no sense of taste anymore

The tongue is one of the most vascular muscles

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15
Q

What is the Vermilion border

What are the taste buds found in the interior portion of the tongue




A

The Vermillion border is the junction between the lip and the skin (the little indentation)

Taste buds of sweet, buttery and salty can be found in the interior portion of the tongue

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16
Q

How do you test to see uvula rising how do you document normal finding

What would be an abnormal finding

A

To test Uvula rising you have the patient say “ahhh”

Normal finding: uvula rises equally

Abnormal: uvula rises to one side


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17
Q

Give the three salivary ducts and how much saliva we produce a Day 

A
  1. Parotid: from second molar to inferior jaw (skeenes)
  2. Submandibular (whartons)
  3. Sublingual

We produce 2000 to 4000 mL of saliva every day

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18
Q

How many teeth should a 2 1/2-year-old have and what kind of teeth

How many teeth should an adult have

A

2 1/2 YOA: all 20 deciduous teeth “milk teeth”

Adult: 32 permanent teeth

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19
Q

What is a common condition found in relation to the gums of the teeth and what are a few causes

(NAME BIGGEST ONE )

A

In relation to the gums gingival hyperplasia: is excessive gum overgrowth

Causes include medications or hereditary
MEDS: 
-phenytoin ( dilatin) ***
-immunosuppressants
-calcium channel blockers
-Cephalosporins
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20
Q

What is the medical name for your throat and Where does your throat begin

A

Throat a.k.a. ortho pharynx begins at the border of the soft palate

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21
Q

What else are the tonsils known as

Where are the adenoids located

Together what do the tonsils and adenoids provide

What is a common misconception about their removal

A

Tonsils otherwise known as anterior/posterior pillars

Adenoids located where nose connects to throat

Together the tonsils and add annoyed‘s provide immunological defense

Common misconception:Removal of tonsils or adenoids does not increase risk of infection

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22
Q

Describe tonsillitis, what it would look like, what it causes

Give the rating scale of tonsil size

A

Tonsillitis is the inflammation of the tonsils that would cause tender lymph nodes

Tonsils would be red, swollen, having tender lymph nodes

Tonsil size rating
•+1: covers 0–25% of airway 
•+2: covers 25–50% of airway
•+3: covers 50–75% of airway
•+4: covers 75–100% obstruction of midline
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23
Q

What is the condition xerostomia

Why does it occur

What is it related to

And when a persons teeth removed why is it done (to prevent what)

A

Xerostomia =dry mouth

occurs because of a decrease in saliva production

Related to:

  • emotional response
  • aging
  • damage/obstruction
  • radiation (CA of jaw/head)

Often with patients who are undergoing radiation for cancer of the jaw and head there is an option to remove the teeth to prevent tooth decay infection they would otherwise lead to ask you radial necrosis which is bone death of Jaw

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24
Q

What is the percentage of cavity increased incidence in children and what specific population

A

There’s a 43% Hispanic increase in cavity incidences among children

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25
Q

What is gustatory rhinitis

A

Gustatory rhinitis is a runny nose

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26
Q

What are normal lifespan considerations for older adults

Runny
Smell
Mouth water
Buds
Teeth
Teeth align
A 
Gustatory rrhinitis
 decrease in olfactory sensory fibers
-decrease sense of smell
Decrease saliva production (XERSTOMIA)
Decrease number of taste buds
Tooth loss
Malocclusion: over/under bites
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27
Q

Define gingivitis

What cultural groups is gingivitis most common in and why

A

Gingivitis: information/bleeding gums

Gingivitis most common in:

  • Hispanic adults***
  • alaskans/Native Americans/those in lower socioeconomic classes

Gingivitis occurs because of a lack of dental visits

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28
Q

What is the ratio of children who get cleft lip in the world and who is most common to get clef lip

What is the ratio of people who get minor cleft

A

Cleft lip happens in 1/800 Children

More noted in N/A and Asians

1/250 get minor clift

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29
Q

What is the fourth most common malignancy

Who is this malignancy most common in and why

Who is most likely to die from this malignancy

(Redneck)

A

ORAL and pharyngeal cancers  are the most common malignnities

Oral and pharyngeal cancers most common in Caucasians because of tobacco use

African Americans are more likely to die from oral and pharyngeal cancers because of tobacco use

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30
Q

What population has an increased risk of sleep apnea

A

Those were obese have an increased risk of sleep apnea

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31
Q

What are pregnant women most likely to have an increased risk of in relation to the nose

Nose
Sinus
Blood
Gums

A
  • increased nasal congestion
  • increased sinus infection
  • increased epistaxis :nose bleeds
  • Increased gum hyper trophy (gingival hyperplasia)
32
Q



What is the term used to describe carcinomas and why do you carcinomas occur

A

Carcinomas are painful

Due to heavy tobacco and alcohol use

33
Q

What is the function of saliva

3 things

A
  1. Provides lubrication
  2. protects oral Macosa
  3. rinses oral cavity
34
Q

What is epistaxis
What can it be result of how its it treated

Where does Epistaxis originate from

A

Epistaxis is a nose bleed

Results from:

  • trauma: apply pressure and ice
  • HTN: Assess BP and control

Epistaxis originate from KIESSELBACH PLEXUS

35
Q

What is Ludwig angina

Causes and what. it creates 

A

 Ludwig angina is an infection of the mouth floor causing Edema pushing the tongue up and back

Creating an airway obstruction

36
Q

Who is a high alert aspiration patient, what position must they maintain

What are risk factors for aspiration

A

High alert aspiration patients are tube
feeding patients Who must remain in high Fowlers

Risk factors for aspiration include:

  • blood
  • teeth swallowing
  • edema to tongue
37
Q

What can an abrupt loss of smell indicate And what kind of assessment is it

A

An abrupt loss of smell can indicate a brain tumor which is an urgent assessment

38
Q

After what kind of surgery are you worried about a bleeding risk and aspiration and what do you check

A

After nose, throat, bronchoscopy, endoscopy you want to assess patient for nasal drip pad and continually swallowing as it can cause aspiration

39
Q

What are normal findings when it comes to NG tube insertions

What situation would not allow for an NG tube insertion

A

Normal findings: no issues

A deviated septum would not allow for the passing of an NG tube

40
Q

What are signs of a basilar skull fracture How to basilar skull fracture’s originate

Where exactly is he basilar skull fracture located

A

Signs:

  • Battle sign: echymosis to mastoid
  • raccoon eyes: echymosis to Peri orbital area
  • clear drainage from ears and or nose

Location: fracture of middle cranial fossa of skull

41
Q

What do you want to teach a patient with heart valve disease

A

It’s vital to teach a patient with heart valve disease to take a prophylactic antibiotic before dental surgery

42
Q

Give a few risk factors within subjective data for the nose, sinuses, mouth, throat

Personal
Meds
FAM
Risk F
Dental
Psychosocial
Environmental
A

Personal

  • how often do they suffer from URI
  • any allergies, anaphylaxis, EpiPen

Medications/supplements

  • antibiotic use causes thrush CANDIDIASIS
  • any white patches
  • anticoagulant if epistaxis
  • phenytoin (dilantin) if gingival hyperplasia

Family history

Risk factors
-smoker, chew tobacco

dental health

  • frequent cleanings,
  • brush/floss 2X a day

Psychosocial history
-Alcoholism, piercings, cocaine

Environmental exposure
-Wearing mask with chemicals like paint, chlorine, toxic mold



43
Q

What can use of cocaine cause within the nose

A

Nasal septum perf otherwise known as the process of nasal septum

44
Q

What is vital to ask alcoholics and smokers every single time you see them

A

Ask alcoholics and smokers every single time you see them if they’re interested in stopping smoking or drinking

45
Q

What are health goals in relation to the nose, sinuses, mouth , throat

Think RISK FACTORS

A

Get smokers to stop smoking

Get alcoholics to stop drinking

46
Q

As a risk factor

For heavy tobacco use what do you need to assess for on the tongue

How do you document the number of your smoked and the packs of cigarettes a day

A

For tobacco users assess for leukoplakia which is discoloration on the side of the tongue

Leukoplakia is associated with oral cancer

You document for smokers
“ # of pack years ”

-packs per day X how many years
= Number of Pack years

47
Q

When assessing sleep disorders as a risk factor who do you get the information from

what information are you looking for

define it

A

For sleep disorders as a respector you get the information from the sleeping partner

Information you’re looking for is any sleep apnea: dont breathe for 20 seconds

48
Q

What cancer risk factors are you assessing for

Where does this cancer originate from

What are causes of this type of cancer

And what is the percentage these causes increase the occurrence of cancer

A

Cancer risk factors you’re setting for our oropharyngeal cancer‘s

Originate in squamous cell

Causes include:

  • alcoholism
  • heavy tobacco use
  • HPV

Related causes increase cancer of oropharyngeal by 60%

49
Q

Give the definition of hereditary hemorrhagic telangiectasia

A

Chronic nosebleeds due to thin vessels in nose wall

50
Q

What are a few strategies you can use to control hereditary hemorrhagic telangiectasia

+ 2 diet strategies

A
  1. Room humidification
  2. Nasal creams, Salines or gels for moisture

DIET

  1. Decrease in salicyates (spicy)
  2. avoid salicyate meds and toothpaste 
51
Q

What is thrush also known as

What does thrush look like

What causes thrush 2 things

What do you want to teach her patient about thrush

A

Thrush a.k.a. candidiasis

Thrush looks like white patches over tongue

Cause by:

  1. Antibiotics
  2. Corticosteroids

Teach patients to eat yogurt to replace coral Florida

52
Q

What is the main cause of gingival hyperplasia

A

Phenytoin (dilantin) 

53
Q

What do those who suffer from frequent allergies develop and what is it associated with

What does it look like

A

Those who suffer from frequent allergies may develop transference Ridge associated with allergic rhinorrhea (allergies)

Looks like a line or a bump over your nose

54
Q

common symptoms related to the nose sinuses mouth and throat due to sinusitis

A

Facial pressure, pain, headaches

55
Q

What can sleep apnea cause an increase risk for

A

MI, CVA, BP risk

56
Q

Give a common symptoms for nose, sinus, mouth, throat

A
  1. Facial pressure, paying, headache

Snoring, sleep apnea, obstructive breathing

Nasal congestion, epistaxis

Halitosis, anosmia

 cough, pharyngitis

dysphasia, dental pain

57
Q

What can nasal congestion plus a upper respiratory tract infection alter and cause

A

Nasal congestion and an upper respiratory tract infection can alter taste and smell causing anorexia

58
Q

What is halitosis

What are causes of halitosis

A

Halitosis is foul breath caused by infection of mouth, cavities, tooth decay

59
Q

What is anosmia

What is the lifespan consideration among older populations for anosmia

What can anosmia in older populations lead to

What is a safety risk with anosmia in older populations

A

Anosmia is the loss of smell

Older adults have anosmia attributed to age

Announce me an older populations can lead to a decrease in appetite that leads to anorexia

The safety issue with anosmia is that food may be expired or have an older and older populations are not able to smell or taste it so they get sick

60
Q

What are common signs and symptoms with pharyngitis

A

Franchitis presents with the inflammation of the fairings with a sore throat

61
Q

What is dysphasia and water causes

A

Dysphasia is difficulty swallowing can be caused by radiation or CV eight (stroke)

62
Q

 during the comprehensive physical assessment what are you noting

External nose
Internal nose
Sinuses
Mouth
Throat
Swallowing evaluation
A

External
-transference Ridge

Internal
-polyps deviations or patency

Sinuses
-Direct percussion on ultra sinuses for any pain or tenderness

Mouth
-any candidiasis

throat

  • infection
  • tonsil scale

Swallowing eval

63
Q

Who does a swallowing evaluation, what patients are referred to the specialist and what may be required

A

Speech pathologists do swallowing evaluations if a patient has dysphasia

Thickening of liquid may be required

64
Q

What can a mouth over closer cause

A

Angular colitis which is just a mouth tearing on the side (like joker)

65
Q

Who is TBmore common in

A

TB most common in immigrants

66
Q

When we’re assessing a tongue what are we assassing as far as it’s appearance

What are tongue fissures known as and what do they look like 

A

Treating her parents were assessing its shine, if there are any deficiencies in

  • riboflavin
  • folic acid
  • vitamin B

Tongue fissures are known as a scrotal tongue
-Looks like a cracked tongue

67
Q

What are polyps in the nose and how do you fix them

A

Polyps or non-cancerous growths in the nasal passage fix with corticosteroids or surgery if they don’t shrink

68
Q

Who is strep throat most common in (what ages) & how do you confirm infection

A

Stripped out most common in children 5 to 15 YOA

Confirm test using RSS: rapid strep swab

69
Q

Call my love studies for nose, sinuses, mouth, throat include

A

WBC, culture sensitivity, RSS, allergy tests Even chest x-ray for persistent cough

70
Q

What are nursing outcomes in relation to nose, sinus, mouth, throat

A

Oral mucous membranes pink and intact

Patient swallows without evidence of aspiration

Patient reports breathing more comfortable

71
Q

What are nursing diagnosis related to nose, mouth, sinus, throat

A

Impaired dentition

Impaired oral mucous membranes

Impaired swallowing

Ineffective breathing

72
Q

What are nursing interventions related to nose, sinus, mouth, throat

A

Provide oral hygiene every 8 hours and teach

Consult with speech pathologist to evaluate swallowing

Encourage flu increased to 2 L to liquor five secretions

73
Q

What are you always want to assess for in relation to respiratory status and airwaves striction

A
  • teeth
  • bleeding
  • tongue for edema
  • foreign body
74
Q

What is C. Albicans

A

Candidiasis

75
Q

Define Rosenmuller’s fossa

A

Bilateral projections of the nasopharynx just below the skull bone

76
Q

What is another name for Wharton’s duct

What is another name for Stensen’s duct

A

Submandibular ducts

Parotid duct

77
Q

Define a chalazion
How it compares to a stye
Hoe its treated
Its other name

A

A cyst in the eyelid resulting from inflammation of the meibomian gland
Bigger and painless than a stye
Treatment required 
Aka : meibomian gland

Health Assessment (20 decks)

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