Ch. 17 Nose, Mouth, & Throat Flashcards
1
Q
What is the first segment of the respiratory system?
A
Nose
The nose warms, moistens, and filters the inhaled air, and serves as a sensory organ for smell.
2
Q
What are the functions of the nasal cavity?
A
Filters out coarse materials, dust, and bacteria
The nasal cavity is lined with coarse nasal hairs and a ciliated mucous membrane.
3
Q
What is the role of olfactory receptors?
A
Responsible for sense of smell
Olfactory receptors lie at the roof of the nasal cavity and upper 1/3 of the septum.
4
Q
What are the paranasal sinuses?
A
Air-filled pockets within the cranium that lighten the weight of skull bones, help produce sound, and provide mucus
They drain into the nasal cavity.
5
Q
List the two pairs of sinuses accessible for examination.
A
- Frontal sinuses
- Maxillary sinuses
Other sets include ethmoid and sphenoid sinuses, which are smaller and deeper.
6
Q
What is the function of the hard palate?
A
Anterior part made up of bone
The hard palate forms the arching roof of the mouth.
7
Q
What are the three pairs of salivary glands?
A
- Parotid gland
- Submandibular gland
- Sublingual gland
The parotid gland is the largest and lies within the cheeks in front of the ear.
8
Q
What is the role of the uvula?
A
Free projection hanging down from the middle of the soft palate
It aids in speech and swallowing.
9
Q
What is the oropharynx?
A
Area behind the mouth that is separated from it by the anterior tonsillar pillar
It contains tonsils, which are masses of lymphoid tissue.
10
Q
What changes occur in the aging adult regarding the nose and mouth?
A
Gradual loss of subcutaneous fat, larger appearance of the nose, natural tooth loss, diminished sense of taste and smell
This may lead to malnutrition or dehydration.
11
Q
What does the term ‘acute sinusitis’ refer to?
A
Inflammation of the sinuses
The suffix ‘itis’ signifies inflammation.
12
Q
What subjective data should be collected regarding the nose?
A
- Discharge
- Frequent colds
- Sinus pain
- Trauma
- Epistaxis
- Allergies
- Altered smell
These factors help in assessing nasal health.
13
Q
Fill in the blank: The _______ is the area behind the mouth and nose.
A
Pharynx
14
Q
What should be inspected in the mouth during a clinical examination?
A
- Teeth
- Buccal mucosa
- Tongue
- Frenulum
- Hard palate
- Soft palate
- Posterior oropharynx
- Uvula
Each structure should be assessed for color, moisture, and lesions.
15
Q
What cranial nerve is tested when assessing the sense of smell?
A
Cranial Nerve I
This is not usually tested during routine exams.
16
Q
True or False: Tonsils are graded in size from 1+ to 4+.
A
True
Grading helps in assessing the size and condition of the tonsils.
17
Q
What is assessed to evaluate the gag reflex?
A
Touching the posterior oropharynx
This is done as part of testing Cranial Nerves IX and X.
18
Q
What are some common subjective data questions regarding the mouth and throat?
A
- Sores or lesions
- Sore throat
- Bleeding gums
- Toothache
- Hoarseness
- Dysphagia
- Altered taste
These questions help in diagnosing oral and throat conditions.
19
Q
What are the primary functions of the nasal cavity?
A
Warms, moistens, and filters the inhaled air
The nasal cavity also serves as a sensory organ for smell through Cranial nerve I.
20
Q
What lines the nasal cavity and its purpose?
A
Coarse nasal hairs and ciliated mucous membrane
Coarse nasal hairs filter out coarse materials, while the mucous blanket filters out dust and bacteria.
21
Q
What is the significance of the nasal mucosa’s appearance?
A
Very red due to rich blood supply
22
Q
What divides the nose medially?
A
The septum
23
Q
What are the lateral walls of the nasal cavity composed of?
A
Superior, middle, and inferior turbinates
These turbinates warm, humidify, and filter inhaled air.
24
Q
What is located below each turbinate?
A
A cleft called the meatus
25
What drains into the meatus?
Sinuses and nasolacrimal duct
26
Where are the olfactory receptors located?
At the roof of the nasal cavity and upper 1/3 of the septum
27
What is the function of multiple sinuses?
Lighten weight of skull bones, help produce sound, provide mucus
28
Which sinuses are accessible for examination?
Frontal and maxillary sinuses
29
Where are the frontal sinuses located?
In the frontal bone above and medial to orbits
30
Where are the maxillary sinuses located?
In maxilla (cheekbone) along side walls of nasal cavity
31
What are the names of the smaller and deeper sinuses?
Ethmoid and sphenoid sinuses
32
What is the characteristic of sinuses at birth?
Only maxillary and ethmoid sinuses are present
33
What does the term 'acute sinusitis' refer to?
Inflammation of the sinuses
## Footnote
The suffix 'itis' denotes inflammation.
34
What is the oral cavity?
A short passage bordered by lips, palate, cheeks, and tongue
35
What are the two parts of the palate?
Hard palate and soft palate
36
What is the uvula?
A free projection hanging down from the middle of the soft palate
37
What is the function of the tongue?
Mastication, swallowing, cleansing teeth, formation of speech, and taste
38
What is the frenulum?
A midline fold of tissue connecting the tongue to the floor of the mouth
39
How many pairs of salivary glands are there?
3 pairs
40
Where is the parotid gland located?
Within the cheeks in front of the ear
41
How many permanent teeth do adults have?
32 permanent teeth
42
What is a common physical change in the aging adult's appearance related to facial features?
Gradual loss of subcutaneous fat
## Footnote
This can make the nose appear larger.
43
What factors exacerbate natural tooth loss in aging adults?
Inadequate dental care, poor oral hygiene, and tobacco use
## Footnote
These factors contribute significantly to dental health issues.
44
What visual changes can occur in the teeth of aging adults?
Teeth may look slightly yellowed; Vertical cracks in teeth
## Footnote
These changes are often due to wear and aging.
45
What sensory changes may aging adults experience that affect their appetite?
Diminished sense of taste and smell
## Footnote
This can lead to a decrease in interest in food.
46
What are potential nutritional risks for aging adults due to decreased interest in food?
Malnutrition or dehydration
## Footnote
This can result in nutritional deficits such as protein, vitamins, and minerals.
47
What oral issue can arise in aging adults that affects chewing?
Trouble with chewing
## Footnote
This may be linked to dental issues and changes in the mouth.
48
What condition can result from nutritional deficits in aging adults?
Osteopenia/osteoporosis
## Footnote
These conditions are related to decreased bone density.
49
What change occurs to the tongue in aging adults?
Tongue looks smoother as a result of papillary atrophy
## Footnote
This atrophy can affect taste perception.
50
How does the aging buccal mucosa appear?
Thinned and may look shinier
## Footnote
This change can affect oral health.
51
What subjective data related to the nose might be reported in aging adults?
Discharge, Frequent colds, Sinus pain, Trauma, Epistaxis, Allergies, Altered smell
## Footnote
These symptoms can indicate various upper respiratory issues.
52
What is the first subjective data question regarding nasal discharge?
Any nasal discharge or runny nose? Continuous?
## Footnote
This question helps assess the presence and duration of nasal symptoms.
53
What types of characteristics should be assessed regarding nasal discharge?
Is discharge watery, purulent, mucoid, bloody?
## Footnote
Identifying the nature of the discharge can indicate different underlying conditions.
54
What is a key question to ask about the frequency of colds?
Any unusually frequent or severe colds (upper respiratory infections)? How often do these occur?
## Footnote
This assesses the patient's history of respiratory infections.
55
What should be inquired about sinus pain?
Any sinus pain or sinusitis? How is this treated?
## Footnote
Understanding treatment helps gauge severity and management of sinus issues.
56
What is an important question regarding postnasal drip?
Do you have chronic postnasal drip?
## Footnote
Chronic postnasal drip can indicate ongoing sinus or allergy issues.
57
What should be asked about trauma to the nose?
Ever had any trauma or a blow to the nose?
## Footnote
This question assesses past injuries that may affect nasal function.
58
What is a key aspect to assess regarding nasal breathing?
Do you breathe through your nose?
## Footnote
This helps evaluate nasal obstruction or other respiratory issues.
59
What should be asked about the use of nasal sprays?
Do they use nasal sprays such as Afrin?
## Footnote
Afrin can relieve congestion but may cause rebound congestion if overused.
60
What is a critical question regarding epistaxis?
Any nosebleeds? How often?
## Footnote
Frequency of nosebleeds can indicate underlying health issues.
61
What should be assessed regarding the severity of nosebleeds?
How much bleeding, a teaspoonful or does it pour out?
## Footnote
This helps determine the severity of the nosebleed.
62
What characteristics of blood should be noted during a nosebleed?
Color of the blood, red or brown? Clots?
## Footnote
The color and presence of clots can indicate the source and cause of bleeding.
63
What should be asked regarding the nostrils during a nosebleed?
From one nostril or both?
## Footnote
This can provide clues about the location of the bleeding source.
64
What aggravating factors should be assessed for nosebleeds?
Aggravated by nose-picking or scratching?
## Footnote
Understanding triggers can help in preventing future episodes.
65
How should patients be asked about treatment for nosebleeds?
How do you treat nosebleeds? Are they difficult to stop?
## Footnote
This assesses the effectiveness of current management strategies.
66
What should be inquired about allergies?
Any allergies or hay fever? To what are you allergic, for example, pollen, dust, or pets?
## Footnote
Identifying allergens is critical for management and treatment.
67
How should the determination of allergies be assessed?
How was this determined?
## Footnote
Understanding the method of diagnosis helps in evaluating the reliability of allergy claims.
68
What environmental factors should be considered regarding allergies?
What type of environment makes it worse? Can you avoid exposure?
## Footnote
This helps identify triggers and potential preventive measures.
69
What should be asked about the use of inhalers or nasal medications?
Do you use inhalers, nasal spray, or nose drops? How often? Which type?
## Footnote
Frequency and type of medication used can indicate the severity of symptoms.
70
What detail should be noted about the duration of nasal spray use?
How long have you used this?
## Footnote
Long-term use can lead to complications like rebound congestion.
71
What is an important question regarding changes in the sense of smell?
Experienced any change in sense of smell?
## Footnote
Changes in smell can indicate a variety of health conditions.
72
What are common subjective data points for the mouth and throat?
* Sores or lesions
* Sore throat
* Bleeding gums
* Toothache
* Hoarseness
* Dysphagia
* Altered taste
* Smoking, alcohol consumption
* Patient-centered care
* Dental care pattern
* Dentures or appliances
## Footnote
These data points are important for assessing oral health and potential issues in patients.
73
What questions should be asked regarding sores or lesions in the mouth?
* Have you noticed any sores or lesions in the mouth, tongue, or gums?
* How long have you had it?
* Ever had this lesion before?
* Is it single or multiple?
* Does it seem associated with stress, season change, or food?
* How have you treated the sore?
* Have you applied any local medication?
## Footnote
These questions help determine the nature and potential causes of oral lesions.
74
What questions should be asked about a sore throat?
* How frequently do you get them?
* Do you have a sore throat now?
* When did it start?
* Is it associated with cough, fever, fatigue, decreased appetite, headache, postnasal drip, or hoarseness?
* Is it worse when arising?
* What is the humidity level in the room where you sleep?
* Any dust or smoke inhaled at work?
* Do you usually get a throat culture for sore throats?
* Were any documented as streptococcal?
* How have you treated this sore throat: medication, gargling?
* How effective are these?
* Have your tonsils or adenoids been taken out?
## Footnote
These questions assess the frequency, duration, and severity of sore throats, as well as potential treatments.
75
What is patient-centered care in relation to dental health?
* How often do you use a toothbrush and floss?
* Last dental examination?
* Do dental problems affect which foods you eat?
* Do you have a dental appliance (e.g., braces, bridge, headgear)?
* Do you wear dentures? All of the time? How long have you had this set? How do they fit?
* Any sores or irritation on the palate or gums?
## Footnote
These questions focus on the patient's dental hygiene habits and how dental issues impact their daily life.
76
What additional history is important for aging adults regarding oral health?
* Any dryness in the mouth?
* Are you taking any medications (both prescribed and over-the-counter)?
* Have you had any loss of teeth?
* Can you chew all types of food?
* Are you able to care for your own teeth or dentures?
* Have you noticed a change in your sense of taste or smell?
## Footnote
Understanding these factors is essential for assessing the oral health needs of older adults.
77
What are the steps involved in the inspection and palpation of the nose?
* Inspect external nose
* Assess midline
* Assess patency of bilateral nares
* Occlude one nare at a time and have the patient inhale
## Footnote
These steps are crucial for evaluating nasal function and potential obstructions.
78
What cranial nerve is tested for the sense of smell?
Cranial Nerve I
## Footnote
This nerve is not usually tested during routine examinations, but can be assessed by having the patient identify familiar scents.
79
Fill in the blank: To test the sense of smell, have the patient close their eyes and place a familiar scent under their nose, such as _______.
[peppermint, alcohol, cinnamon]
## Footnote
These scents are commonly used to assess the olfactory function.
80
What is the first step in inspecting the nasal cavity?
Attach short wide-tipped speculum to otoscope head and insert apparatus into nasal vestibule
81
How should the head be positioned when viewing each nasal cavity?
With the person’s head erect and then with head tilted back
82
What normal characteristics should be noted in the nasal mucosa?
Normal red color and smooth moist surface
83
What should be noted during the inspection of the nasal cavity?
Swelling, discharge, bleeding, or foreign body
84
What should be observed about the nasal septum?
Deviation, perforation, or bleeding
85
What indicates allergic rhinitis in the nasal turbinates?
Paleness or bogginess
86
Which sinuses are only palpable during examination?
Frontal and maxillary sinuses
87
How are the frontal sinuses palpated?
By pressing up and under the eyebrows
88
What should be assessed when pressing over the sinuses?
Pain or tenderness
89
What equipment is needed for oral inspection?
Tongue depressor and pen light
90
What should be noted about the patient's teeth during inspection?
All 32 are present, white, and of good hygiene with no dental caries
91
What is the normal appearance of the buccal mucosa?
Pink and moist with no lesions
92
How should the tongue appear during inspection?
Pink, rough surface, and moist
93
What should be noted about the frenulum?
It is intact
94
What is the normal appearance of the hard palate?
Intact, pink, and moist with no lesions
95
What should be noted about the soft palate?
Pink and moist with no lesions
96
What is the normal appearance of the posterior oropharynx?
Pink and moist
97
What is the expected position of the uvula during inspection?
Midline
98
How should tonsils be assessed?
Present or not present; if present, grade them
99
What are the grading criteria for tonsils?
* 1+ Visible
* 2+ Halfway between tonsillar pillars and uvula
* 3+ Touching uvula
* 4+ Touching each other
100
What is a normal size for tonsils in healthy people?
1+ or 2+ tonsils
101
What is the first step in testing Cranial Nerve X?
Have the patient swallow on command
102
What should be observed when a person says 'ahhh'?
Soft palate and uvula rise then fall in midline
103
What is the procedure to test Cranial Nerve IX & X?
Gently touch the posterior oropharynx to elicit the gag reflex
104
What should be noted when testing Cranial Nerve XII?
Tongue should protrude in midline; note tremor, loss of movement, or deviation to side
