Chapter 16: Nose, mouth and throat

Question 1

When does salivation start?

Answer 1

At 3 months

Question 2

How many deciduous teeth to children have and when does it erupt around?

Answer 2

20 deciduous teeth that erupt between 6 months and 24 months

Question 3

Why do you check an infants palate?

Answer 3

To make sure theres no cleft palate and its intact

Question 4

What are common developmental competencies in children regarding moth and throat?

Answer 4

Epstein pearls, Sucking reflex, Sucking tubercle (a normal finding in infants, a small pad in the middle of the upper lip from friction of breastfeeding or bottle-feeding.), Higher incidence of GAS pharyngitis

Question 5

Developmental competence in pregnant women

Answer 5

• Gum hypertrophy (surface looks smooth, and stippling disappears)
• Pregnancy gingivitis
• Nasal stuffiness (increased vascularity)
• Epistaxis
• Heightened sense of smell

Question 6

Developmental competence in older adults

Answer 6

Loss of subcutaneous fat,
Mouth and lips give a “purse string” look, Teeth may look slightly yellow because worn enamel , Vertical cracks on the incisors, gum margins recede, Teeth loosen, Tongue looks smoother b/c papillary atrophy, Buccal mucosa is thinned and may look shinier

Question 7

Cleft lip is common in what groups of people? Least common in which?

Answer 7

Asians, intermediate whites, and least prevalent in blacks

Question 8

Bifid Uvula

Answer 8

show uvula split either completely or partially

Question 9

Torus palatinus

Answer 9

benign bony ridge running in the middle of the hard palate

Question 10

Leukodema

Answer 10

benign, milky bluish-white opaque appearance of buccal mucosa

Question 11

What are you inspecting in the nasal mucosa?

Answer 11

Symmetry, midline
No lesions or swelling
Palpate for deviation or pain

Question 12

What are you inspecting in the nasal septum?

Answer 12

Close one and have them breath in and out, then same for second

Question 13

What sinuses do you palpate?

Answer 13

Frontal and maxillary

Question 14

What cranial nerve moves the tongue?

Answer 14

XII

Question 15

What duct are you looking for when you inspect the buccal mucosa?

Answer 15

Stensons duct

Question 16

When you inspect the hard palate, soft palate and uvula what nerves are you checking for?

Answer 16

Say ahh hard and soft palate should rise

**Checking for cranial nerve 9 and 10

Question 17

How do you grade tonsils?

Answer 17

0-4 (0 is no tonsils and 4 being if they were touching)

0: no longer there
1: slightly visible
2: comes out but doesn’t touch the uvula
3: touches the uvula
4: tonsils are touching

Question 18

What are the 4 sinuses

Answer 18

Frontal, Maxillary, Ethmoid, Sphenoid

Question 19

What are paranasal sinuses

Answer 19

are air filled pockets within the cranium

Question 20

Choanal atresia

Answer 20

Congenital bony septum btw nasal cavity and the pharynx

Question 21

Epistaxis

Answer 21

Most common site of a nosebleed (Kiesselbach plexus)

Question 22

Perforated septum

Answer 22

A hole in the septum usually in the cartilaginous part
Can be due to snorting cocaine
Can be seen directly or as a spot of light

Question 23

Deviated septum

Answer 23

Looks like a hump or shelf in a nasal cavity

Question 24

Acute rhinitis

Answer 24

1st sign: Clear watery discharge, rhinorrhea, which later becomes purulent
-Turbinates are dark, red and swollen

Question 25

Allergic Rhinitis

Answer 25

Itching of nose, lacrimation, nasal congestion and sneezing

-Turbinates are pale, sometimes purple

Question 26

Sinusitis: what is it and what are the signs

Answer 26

Infected frontal sinus, inflamed,

-Signs: mucopurulent drainage, nasal obstruction, facial pain, pressure, loss of smell

Question 27

Nasal Polyps

Answer 27

• Small smooth, pale gray, avascular mobile and non tender

- Overgrowths of mucosa, due to chronic allergic rhinitis

Question 28

Cleft lip

Answer 28

Maxillofacial clefts are most common, congenital deformity, associated with phenytoin, maternal smoking, alcohol use, benzodiazepines, corticosteroids

Question 29

HSV 1

Answer 29

Cold sore group of clear vesicles with a surrounding indurated erythematous base, evolves into pustules which rupture, weep and crust, healing in 4-10 days

Question 30

Angular cheilitis (stomatitis)

Answer 30

Erythema, scaling, and shallow and painful fissures at the corners of the mouth with excess salivation and candida infection
**Seen with people who have poorly fitting dentures

Question 31

Carcinoma

Answer 31

Initial lesion is round and indurates, becomes crusted and ulcerated with an elevated border (outer and middle thirds of the lip)

Question 32

Baby bottle tooth decay

Answer 32

Destruction of numerous deciduous teeth may occur in infants and toddlers who take a bottle of milk, juice or sweetened drink to bed and prolonged bottle feeding past 1 (when liquid pools at upper front teeth and acids and bacteria break down tooth enamel)

Question 33

Malocclusion

Answer 33

Upper or lower dental arches are not in alignment, problem with mandible or maxilla or incompatibility between teeth and jaw

Question 34

Dental Carries

Answer 34

Progressive destruction of tooth, cavities

Question 35

Gingival hyperplasia: what is it and what drug can it be due to

Answer 35

Painless enlargement of the gums, sometimes overreaching the teeth
**Due to phenytoin (dilantin)

Question 36

Gingivitis

Answer 36

• Gum margins are red and swollen and blood easily

- Inflammation due to poor dental hygiene or vitamin C deficiency

Question 37

Aphthous ulcers

Answer 37

due to stress, fatigue or food allergy. “Canker Sores”

Question 38

Koplik spots

Answer 38

small blue-white spots with irregular red halo scattered over mucosa opposite the molars
“measles”

Question 39

Leukoplasia

Answer 39

• Chalky white, thick, raised patch with well-defined borders
• Lesion firmly attached and does not scrape off, lateral edges of tongue
• Caused by chronic irritation and occurs w/ heavy smoking and alcohol use
• Lesions are precancerous

Question 40

Candidiasis infection

Answer 40

White, cheesy, curd-like patch on the buccal mucosa and tongue, scrapes off leaving a raw red surface that bleeds easily.

• “Thrush” in newborns
• Opportunistic infection

Question 41

Ankyloglossia

Answer 41

Short lingual frenulum (midline fold of tissue that connects the tongue to the floor of the mouth), here fixing the tongue tip to the floor of the mouth and gums “tongue tie”

Question 42

Smooth, glossy tongue (atrophic glossitis; B12)

Answer 42

• Surface is slick and shiny, mucosa thins and looks red from decreased papillae
• Occurs with vitamin B12 deficiency (pernicious anemia), folic acid deficiency, iron deficiency

Question 43

Black hairy tongue

Answer 43

• Not hair, elongation of filiform papillae and painless overgrowth of mycelial threads of fungus on the tongue
• Color varies from black and brown to yellow, usually seen after antibiotics or heavy smoking

Question 44

Carcinoma

Answer 44

Ulcer with rolled edges, occurs at base of tongue, smoking and heavy alcohol use are associated; incidence of HPV related or oral pharyngeal cancers also increased

Question 45

Cleft palate

Answer 45

A congenital defect, failure of fusion of the maxillary processes

Question 46

Oral Kaposi’s sarcoma

Answer 46

Bruise Like, dark red or violet, confluent macule, usually on hard palate or gingival margin

Question 47

Acute tonsillitis

Answer 47

Bright red throat; swollen tonsils; white or yellow exudate on tonsils and pharynx; swollen uvula; and enlarged, tender, anterior cervical and tonsillar nodes , sore throat, painful swallowing, fever

Question 48

Peritonsillar abscess

Answer 48

Untreated acute pharyngitis may cause suppurative complications, peritonsillar abscess or suppurative thrombophlebitis
(Neck swelling can be a sign of it)