Ch 15: Nose, sinuses, mouth, throat Flashcards
What is the function of the nose an upper respiratory system
Warm, filter and humidified air
What is the structure of the nose (sinuses) in relation to the osteomeatal complex
(What empties where)
The frontal, ethmoid, and maxillary sinuses empty into the nasal cavity
What artery supplies the blood to the nose
What is vital to do after nasal Surgery/ throat/ bronchoscopy/endoscopy in relation to bleeding
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
What is the cranial nerve that pertains to the nose And what does it test
CN 1 olfactory pertains to the nose
It tests sense of smell
What do the sinuses provide in relation to the voice
Use medical term
The sinuses provide
Timbre: Quality and sound of voice and sinuses also produces mucus
What areas are affected by chronic sinusitis in the nasal bones
The superior, middle, inferior turbinate are areas affected by chronic sinusitis
What are adenoids and where can They be found
Adenoids are lymphoid tissue
Found in:
- roof of nasopharynx
- lateral to estachian tube
What is absolutely vital to consider when a patient has an upper respiratory infection in relation to appettite
 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
When assessing the nose and sinuses what is important to note
(Colds and patent)
Mucosal swelling (Cold‘s) Any blocked nasal passages
How do you assess the sinuses
What are the three sinuses
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
What are the cranial nerves that assist in the mouth and throat And what do you test when you take them
CN9 (glossopharyngeal)
Sensory: taste
Motor: swallow
CNN 10 (Vagus) Sensory and motor: bilateral gag reflex
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
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
What is the structure that connects the tongue to the sublingual pallet
The lingua frenulum Connect the tongue to the sublingual pallet
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
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
What is the Vermilion border
What are the taste buds found in the interior portion of the tongue


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
How do you test to see uvula rising how do you document normal finding
What would be an abnormal finding
To test Uvula rising you have the patient say “ahhh”
Normal finding: uvula rises equally
Abnormal: uvula rises to one side

Give the three salivary ducts and how much saliva we produce a Day 
- Parotid: from second molar to inferior jaw (skeenes)
- Submandibular (whartons)
- Sublingual
We produce 2000 to 4000 mL of saliva every day
How many teeth should a 2 1/2-year-old have and what kind of teeth
How many teeth should an adult have
2 1/2 YOA: all 20 deciduous teeth “milk teeth”
Adult: 32 permanent teeth
What is a common condition found in relation to the gums of the teeth and what are a few causes
(NAME BIGGEST ONE )
In relation to the gums gingival hyperplasia: is excessive gum overgrowth
Causes include medications or hereditary MEDS: -phenytoin ( dilatin) *** -immunosuppressants -calcium channel blockers -Cephalosporins
What is the medical name for your throat and Where does your throat begin
Throat a.k.a. ortho pharynx begins at the border of the soft palate
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
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
Describe tonsillitis, what it would look like, what it causes
Give the rating scale of tonsil size
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
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)
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
What is the percentage of cavity increased incidence in children and what specific population
There’s a 43% Hispanic increase in cavity incidences among children
What is gustatory rhinitis
Gustatory rhinitis is a runny nose
What are normal lifespan considerations for older adults
Runny Smell Mouth water Buds Teeth Teeth align
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
Define gingivitis
What cultural groups is gingivitis most common in and why
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
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
Cleft lip happens in 1/800 Children
More noted in N/A and Asians
1/250 get minor clift
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)
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
What population has an increased risk of sleep apnea
Those were obese have an increased risk of sleep apnea
What are pregnant women most likely to have an increased risk of in relation to the nose
Nose
Sinus
Blood
Gums
- increased nasal congestion
- increased sinus infection
- increased epistaxis :nose bleeds
- Increased gum hyper trophy (gingival hyperplasia)

What is the term used to describe carcinomas and why do you carcinomas occur
Carcinomas are painful
Due to heavy tobacco and alcohol use
What is the function of saliva
3 things
- Provides lubrication
- protects oral Macosa
- rinses oral cavity
What is epistaxis
What can it be result of how its it treated
Where does Epistaxis originate from
Epistaxis is a nose bleed
Results from:
- trauma: apply pressure and ice
- HTN: Assess BP and control
Epistaxis originate from KIESSELBACH PLEXUS
What is Ludwig angina
Causes and what. it creates 
 Ludwig angina is an infection of the mouth floor causing Edema pushing the tongue up and back
Creating an airway obstruction
Who is a high alert aspiration patient, what position must they maintain
What are risk factors for aspiration
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
What can an abrupt loss of smell indicate And what kind of assessment is it
An abrupt loss of smell can indicate a brain tumor which is an urgent assessment
After what kind of surgery are you worried about a bleeding risk and aspiration and what do you check
After nose, throat, bronchoscopy, endoscopy you want to assess patient for nasal drip pad and continually swallowing as it can cause aspiration
What are normal findings when it comes to NG tube insertions
What situation would not allow for an NG tube insertion
Normal findings: no issues
A deviated septum would not allow for the passing of an NG tube
What are signs of a basilar skull fracture How to basilar skull fracture’s originate
Where exactly is he basilar skull fracture located
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
What do you want to teach a patient with heart valve disease
It’s vital to teach a patient with heart valve disease to take a prophylactic antibiotic before dental surgery
Give a few risk factors within subjective data for the nose, sinuses, mouth, throat
Personal Meds FAM Risk F Dental Psychosocial Environmental
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

What can use of cocaine cause within the nose
Nasal septum perf otherwise known as the process of nasal septum
What is vital to ask alcoholics and smokers every single time you see them
Ask alcoholics and smokers every single time you see them if they’re interested in stopping smoking or drinking
What are health goals in relation to the nose, sinuses, mouth , throat
Think RISK FACTORS
Get smokers to stop smoking
Get alcoholics to stop drinking
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
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
When assessing sleep disorders as a risk factor who do you get the information from
what information are you looking for
define it
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
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
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%
Give the definition of hereditary hemorrhagic telangiectasia
Chronic nosebleeds due to thin vessels in nose wall
What are a few strategies you can use to control hereditary hemorrhagic telangiectasia
+ 2 diet strategies
- Room humidification
- Nasal creams, Salines or gels for moisture
DIET
- Decrease in salicyates (spicy)
- avoid salicyate meds and toothpaste 
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
Thrush a.k.a. candidiasis
Thrush looks like white patches over tongue
Cause by:
- Antibiotics
- Corticosteroids
Teach patients to eat yogurt to replace coral Florida
What is the main cause of gingival hyperplasia
Phenytoin (dilantin) 
What do those who suffer from frequent allergies develop and what is it associated with
What does it look like
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
common symptoms related to the nose sinuses mouth and throat due to sinusitis
Facial pressure, pain, headaches
What can sleep apnea cause an increase risk for
MI, CVA, BP risk
Give a common symptoms for nose, sinus, mouth, throat
- Facial pressure, paying, headache
Snoring, sleep apnea, obstructive breathing
Nasal congestion, epistaxis
Halitosis, anosmia
 cough, pharyngitis
dysphasia, dental pain
What can nasal congestion plus a upper respiratory tract infection alter and cause
Nasal congestion and an upper respiratory tract infection can alter taste and smell causing anorexia
What is halitosis
What are causes of halitosis
Halitosis is foul breath caused by infection of mouth, cavities, tooth decay
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
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
What are common signs and symptoms with pharyngitis
Franchitis presents with the inflammation of the fairings with a sore throat
What is dysphasia and water causes
Dysphasia is difficulty swallowing can be caused by radiation or CV eight (stroke)
 during the comprehensive physical assessment what are you noting
External nose Internal nose Sinuses Mouth Throat Swallowing evaluation
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
Who does a swallowing evaluation, what patients are referred to the specialist and what may be required
Speech pathologists do swallowing evaluations if a patient has dysphasia
Thickening of liquid may be required
What can a mouth over closer cause
Angular colitis which is just a mouth tearing on the side (like joker)
Who is TBmore common in
TB most common in immigrants
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 
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
What are polyps in the nose and how do you fix them
Polyps or non-cancerous growths in the nasal passage fix with corticosteroids or surgery if they don’t shrink
Who is strep throat most common in (what ages) & how do you confirm infection
Stripped out most common in children 5 to 15 YOA
Confirm test using RSS: rapid strep swab
Call my love studies for nose, sinuses, mouth, throat include
WBC, culture sensitivity, RSS, allergy tests Even chest x-ray for persistent cough
What are nursing outcomes in relation to nose, sinus, mouth, throat
Oral mucous membranes pink and intact
Patient swallows without evidence of aspiration
Patient reports breathing more comfortable
What are nursing diagnosis related to nose, mouth, sinus, throat
Impaired dentition
Impaired oral mucous membranes

Impaired swallowing
Ineffective breathing
What are nursing interventions related to nose, sinus, mouth, throat
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
What are you always want to assess for in relation to respiratory status and airwaves striction
- teeth
- bleeding
- tongue for edema
- foreign body
What is C. Albicans
Candidiasis
Define Rosenmuller’s fossa
Bilateral projections of the nasopharynx just below the skull bone
What is another name for Wharton’s duct
What is another name for Stensen’s duct
Submandibular ducts
Parotid duct
Define a chalazion
How it compares to a stye
Hoe its treated
Its other name
A cyst in the eyelid resulting from inflammation of the meibomian gland
Bigger and painless than a stye
Treatment required 
Aka : meibomian gland
