Chapter 17 - Nose, Mouth, and Throat Flashcards
What is the columella of the nose?
part that divides the two nares and is continuous with the septum
What is the ala of the nose?
lateral outside wing
What are vibrissae?
nasal hairs
What do nasal hairs filter?
coarse matter from inhaled air
What does the ciliated mucous blanket filter?
dust and bacteria
Why does nasal mucosa appear redder than oral mucosa?
rich blood supply used to warm inhaled air
What divides the nasal cavity?
the septum
What is the Kiesselbach’s plexus?
vascular network in the septum
Where is the most common site of nosebleeds?
Kiesselbach’s plexus
What are turbinates?
paralleled body projections in the nasal cavity
What is the role of turbinates?
Increase surface area so more blood vessels and mucous membranes are available
How many turbinates are there?
3
What is the meatus?
a cleft under each turbinate that is named for the turbinate above
What drains into the middle meatus?
sinuses
What drains into the inferior meatus?
tears from nasolacrimal duct
Which cranial never is the olfactory nerve?
I
Where does CN I transmit impulses?
temporal lobe
What are the paranasal sinuses?
air-filled pockets in the cranium
What is the role of the paranasal sinuses?
lighten the weight of the skull, resonate sound, provide mucus
How many frontal sinus are there?
2
Where are the frontal sinus located?
frontal bone above and medial to the orbits
Where are the maxillary sinuses?
in the maxilla (cheekbones)
Where are the ethmoid sinuses?
between the orbits
Where are the sphenoid sinuses?
deep within the skull in the sphenoid bone
Where is the hard palate?
anterior
What is the hard palate made of?
bone
What colour is the hard palate?
whitish
Where is the soft palate?
posterior
What colour is the soft palate?
pink
What is the frenulum?
a midline fold of tissue connecting the tongue to the floor of the mouth
Which salivary gland is the largest?
parotid
Where is the parotid gland?
in the cheeks, in front of the ear
What is the parotid glands duct called?
Stensen’s duct
Where is Stensen’s duct?
across from the second molar
How big is the submandibular gland?
the size of a walnut
Where is the submandibular gland?
beneath the mandible at the angle of the jaw
Which salivary gland is the smallest?
sublingual
Where is the sublingual gland?
the floor of the mouth
How many permanent teeth do adults have?
32
What kind of tissue are the gums?
fibrous tissue covered in mucous membrane
What separates the oropharynx from the mouth?
anterior tonsillar pillars
When does tonsillar tissue begin to decrease in size and function?
after puberty
The nasopharynx is continuous with the ____________
oropharynx
Where is the nasopharynx?
above the oropharynx and behind the nasal cavity
When does salivation start in infants?
3 months of age
How many temporary deciduous teeth do children have?
20
When do teeth begin to errupt?
6-24 months
All 20 teeth should appear by ____ years of age
2.5
When are deciduous teeth lost?
between age 6 and 12
Which teeth are the first to be lost?
central incisors
Epistaxis
nosebleeds
Why are nose bleeds and nasal stuffiness more common during pregnancy?
due to increased vascularity in the upper respiratory tract
Atrophy in the oral cavity results in an ______% reduction in taste functioning
80%
What is candidiasis (thrush)?
oral yeast infection
What is malocclusion?
teeth drift that causes upper or lower incisors to drift
What are the adverse effects of malocclusion?
-bone reabsorption, then further tooth loss
-muscle imbalance, spasms, tenderness, chronic headaches
-increases TMJ stress that leads to osteoarthritis and pain
What kind of medications decrease saliva production?
anticholinergic
Which ethnic population has a higher incidence of cleft lip?
indigenous
What is torus palatinus?
a bony ridge running down the middle of the hard palate
Torus palatinus is more commin in people of which descent?
indigenous and asian
What is Leukoedema?
greyish-white benign lesion occuring in the buccal mucosa
Which group is leukoedema common in?
people of African descent
Edentulism
toothlessness
Rhinorrhea
nasal discharge
Odynophagia
pain while swallowing
What does testing nostril patency reveal?
obstruction
What should you normally view with an otoscope in the nasal cavity?
red colour, smooth moist surface
Why is documentation of deviated septum important?
in case of need for nasal suctioning or a ng (nasogastric) tube
What should the buccal mucosa look like?
pink, smooth, moist
What are Fordyce’s granules?
small, isolated white or yellow papules that are painless and significant
Where can Fordyce’s granules be found?
cheeks, tongue, lips
What does the “ahhhh” test check?
CN X the vagus nerve
Halitosis
breath odour
What can cause halitosis?
food consumption, alcohol consumption, heavy smoking, dental infection, systemic disease
Tonsil Grade 1+
visible
Tonsil Grade 2+
halfway between tonsillar pillars and uvula
Tonsil Grade 3+
touching the uvula
Tonsil Grade 4+
touching each other
What grade of tonsils in seen in healthy people?
1+ or 2+
How do you depress the tongue?
-push down halfway back, pushing on the tip will hump the back
-press slightly off-centre to avoid eliciting the gag reflex
Which cranial nerves control the gag reflex?
CN IX (glossopharyngeal) and X (vagus)
How do you test CN XII (hypoglossal nerve)
ask patient to stick out tongue and observe if it protrudes in the midline
What are Epstein Pearls?
a normal finding in newborns and infants - small, whitish, pearly papules on hard palate and gums
What are bednar apathae?
traumatic areas or ulcers on the posterior hard palate resulting from abraisions during sucking
Are tonsils visible in newborns?
no
What is choanal atresia?
bony or membranous septum between nasal cavity and pharynx of newborn
What is a perforated septum?
a hole in the septum, can be caused by cocaine use, trauma
What is a furuncle?
small boil on skin that is red, swollen, and painful
What is sinusitis?
facial pain after upper respiratory infection characterized by red, swollen nasal mucosa and purulent discharge
What are nasal polyps?
smooth, pale grey nodules, overgrowths of mucosa, most commonly caused by chronic allergic rhinitis
What is angular cheilitis?
erythema, scaling, and shallow painful fissures at the corner of the mouth occur with excess salivation and candida infection
What is baby bottle tooth decay?
destruction of deciduous teeth in older infants who take milk or juice to bed
What is Malocclusion?
teeth aren’t aligned properly between the upper and lower rows (bite)
What are dental caries?
progressive tooth destruction, eventually forms cavity
What is epulis?
growth on the gingiva or alveolar mucosa
What is gingival hyperplasia?
painless enlargement of the gums, sometimes overreaching the teeth
When does gingival hyperplasia often occur?
puberty, pregnancy, leukemia, long term phenytoin use
What is gingivitis?
earliest stage of gum disease due to plaque and bacteria build up on the teeth
What is meth mouth?
Extreme tooth decay due to meth abuse, often with black stained or rotting teeth
What are aphthous ulcers?
aka chancre sores, they are vesicles first, last 1-2 weeks
What causes aphthous ulcers?
unknown - associated with stress, fatigue, and food allergy
What are Koplik’s spots?
small white spots, a pathogenic feature of measles in pre-eruptive stages
What is leukoplakia?
chalky white, thick raised patch with well-defined borers
Where does leukoplakia occur?
occurs on the lateral edges of the tongue
What causes leukoplakia?
heavy smoking and alcohol use
Why are leukoplakia concerning?
they are precancerous and associated with squamous carcinoma
What is thrush (candidiasis)?
a fungal infection that develops in the mouth and leads to white lesions on tongue and inner cheeks
What is ankyloglossia?
aka tongue-tie that fixes the tongue to the floor of the mouth and affects speech
What is a fissured tongue?
harmless condition involving furrows/grooves on tongue surface
What is geographic tongue? (migratory glossitis)
patterns of normal coating interspersed with bright red, shiny, circular bald areas
What causes geographic tongue?
unknown
What is glossitis?
inflamed tongue caused by low iron (anemia)
With black hairy tongue what makes the “hair”?
elongation of filiform papillae and overgrowth of mycelial threads of fungal infection
What causes black “hairy” tongue?
after antibiotic use that inhibit normal bacteria and allow fungus to grow
What is macroglossia?
larger than typical size tongues
What is bifid uvula?
a forked uvula
What is oral kaposi’s sarcoma?
bruise-like, dark red, confluent macule on the hard palate often associated with AIDs
