Ch. 17. Nose Throat Mouth

Question 1

What the parts of the nasal cavity

Answer 1

Septum, Tubinates (conche) MEatus (where sinus drains)

Question 2

What’s the most common site for nose bleeds?

Answer 2

Kiesselbach plexus

Question 3

4 Paranasal sinus’s

Answer 3

Frontal
Maxillary
Ethmoid
Sphenoid

provide mucus, are sound radiators and lighten the skull. Can only access frontal and Maxilliary sinus

Question 4

3 salvary glands

Answer 4

Parotid, sublingual, submandibular

Question 5

Considerations for infants for mouth/throat/neck

Answer 5

Salivation - babies droll before learning to swallow
Deciduous teeth
Nose - doesn’t develop till 12-13

Question 6

Considerations for pregnant women

Answer 6

Nasal stuffiness
Epistaxis
Hyperemic gums (soften)

Question 7

Considerations for Older Adults

Answer 7

Loss of subcutaneous fat which makes nose more prominent
Diminished smell and taste
Atrophic tissues
Dental changes
Malocclusion - teeth loss causes remain teeth to drift (incisors protrude)
Malnutrition

Question 8

Cultural and Social Considerations

Answer 8

• Incidence of cleft lip and palate (asian and aboringinals)
• Leukoedema - large grey opaque patch on ducal muscles (africa/south asia)
• Oral hyperpigmentation
• Increased incidence of dental disease in Inuit
Changes from traditional diets
Lack of access to fluoridated water and dental health services
Correlation between socioeconomic variables and dental disease
32% of Canadians lack adequate dental insurance

Question 9

Health History for Nose

Answer 9

Nose
Discharge
Frequent colds (upper respiratory infections)
Sinus pain
Trauma
Epistaxis (nosebleeds)
Allergies
Altered sense of smell

Question 10

Health History for Mouth/Throat

Answer 10

Mouth and throat
Sores or lesions
Sore throat
Bleeding gums
Toothache
Hoarseness
Dysphagia
Altered taste
Smoking, alcohol consumption
Self-care behaviours

Question 11

Nose Inspection

Answer 11

Inspect and palpate
• External nose
> bleeding, perspiration, colour, polyps
• Nasal cavity
Holding the otoscope, symmetry
Nasal septum
Turbinates - colour swelling, exudate.  should look same colour as nasal mucose

Question 12

Sinus areas Check

Answer 12

Palpate

Frontal and maxillary sinuses

Question 13

Mouth Check

Answer 13

Lips
Teeth and gums
Tongue (test cranial nerve XII) 
Buccal mucosa
Palate and uvula

colour intactness, sores, different coloured areas, palate and uvula
“ahh” checks nerve X

Question 14

Palate Normal Findings

Hard, Soft

Answer 14

Hard palate- whitish colour, irregular transverse rugae

Soft palate- pink, smooth, moves upwards

Question 15

Grading Tonsils

Answer 15

1-4
Are tonsils visible
4 is emergency. 4 is toughing uvula

1 = visible
2=halfway between tonsil pillars and uvula
3=touching uvula
4=touching each other

0 – Tonsils are entirely within the tonsillar pillar or previously removed by surgery.
1+ – Tonsils occupy less than 25% of the lateral dimension of the oropharynx, as measured between the anterior tonsillar pillars (solid yellow arrow).
2+ – Tonsils occupy 26 to 50% of the lateral dimension of the oropharynx.
3+ – Tonsils occupy 51 to 75% of the lateral dimension of the oropharynx.
4+ – Tonsils occupy more than 75% of the lateral dimension of the oropharynx.