Chapter 16: Nose, mouth and throat Flashcards
When does salivation start?
At 3 months
How many deciduous teeth to children have and when does it erupt around?
20 deciduous teeth that erupt between 6 months and 24 months
Why do you check an infants palate?
To make sure theres no cleft palate and its intact
What are common developmental competencies in children regarding moth and throat?
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
Developmental competence in pregnant women
- Gum hypertrophy (surface looks smooth, and stippling disappears)
- Pregnancy gingivitis
- Nasal stuffiness (increased vascularity)
- Epistaxis
- Heightened sense of smell
Developmental competence in older adults
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
Cleft lip is common in what groups of people? Least common in which?
Asians, intermediate whites, and least prevalent in blacks
Bifid Uvula
show uvula split either completely or partially
Torus palatinus
benign bony ridge running in the middle of the hard palate
Leukodema
benign, milky bluish-white opaque appearance of buccal mucosa
What are you inspecting in the nasal mucosa?
Symmetry, midline
No lesions or swelling
Palpate for deviation or pain
What are you inspecting in the nasal septum?
Close one and have them breath in and out, then same for second
What sinuses do you palpate?
Frontal and maxillary
What cranial nerve moves the tongue?
XII
What duct are you looking for when you inspect the buccal mucosa?
Stensons duct
When you inspect the hard palate, soft palate and uvula what nerves are you checking for?
Say ahh hard and soft palate should rise
**Checking for cranial nerve 9 and 10
How do you grade tonsils?
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
What are the 4 sinuses
Frontal, Maxillary, Ethmoid, Sphenoid
What are paranasal sinuses
are air filled pockets within the cranium
Choanal atresia
Congenital bony septum btw nasal cavity and the pharynx
Epistaxis
Most common site of a nosebleed (Kiesselbach plexus)
Perforated septum
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
Deviated septum
Looks like a hump or shelf in a nasal cavity
Acute rhinitis
1st sign: Clear watery discharge, rhinorrhea, which later becomes purulent
-Turbinates are dark, red and swollen
Allergic Rhinitis
Itching of nose, lacrimation, nasal congestion and sneezing
-Turbinates are pale, sometimes purple
Sinusitis: what is it and what are the signs
Infected frontal sinus, inflamed,
-Signs: mucopurulent drainage, nasal obstruction, facial pain, pressure, loss of smell
Nasal Polyps
- Small smooth, pale gray, avascular mobile and non tender
- Overgrowths of mucosa, due to chronic allergic rhinitis
Cleft lip
Maxillofacial clefts are most common, congenital deformity, associated with phenytoin, maternal smoking, alcohol use, benzodiazepines, corticosteroids
HSV 1
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
Angular cheilitis (stomatitis)
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
Carcinoma
Initial lesion is round and indurates, becomes crusted and ulcerated with an elevated border (outer and middle thirds of the lip)
Baby bottle tooth decay
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)
Malocclusion
Upper or lower dental arches are not in alignment, problem with mandible or maxilla or incompatibility between teeth and jaw
Dental Carries
Progressive destruction of tooth, cavities
Gingival hyperplasia: what is it and what drug can it be due to
Painless enlargement of the gums, sometimes overreaching the teeth
**Due to phenytoin (dilantin)
Gingivitis
- Gum margins are red and swollen and blood easily
- Inflammation due to poor dental hygiene or vitamin C deficiency
Aphthous ulcers
due to stress, fatigue or food allergy. “Canker Sores”
Koplik spots
small blue-white spots with irregular red halo scattered over mucosa opposite the molars
“measles”
Leukoplasia
- 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
Candidiasis infection
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
Ankyloglossia
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”
Smooth, glossy tongue (atrophic glossitis; B12)
- 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
Black hairy tongue
- 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
Carcinoma
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
Cleft palate
A congenital defect, failure of fusion of the maxillary processes
Oral Kaposi’s sarcoma
Bruise Like, dark red or violet, confluent macule, usually on hard palate or gingival margin
Acute tonsillitis
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
Peritonsillar abscess
Untreated acute pharyngitis may cause suppurative complications, peritonsillar abscess or suppurative thrombophlebitis
(Neck swelling can be a sign of it)
