Chapter 17: Nose, Mouth, Throat

Question 1

Which sinuses can we palpate?

Answer 1

Frontal and maxillary

Question 2

Teeth/Gums

Answer 2

Children = 20 deciduous teeth
Adults = 32 permanent teeth
Pregnant women = hyperemic gums…prone to bleeding

Question 3

Mouth Changes for the Aging Adult

Answer 3

Inner mouth thins out, which makes it more susceptible to ulcers/breakdown;
Tooth loss
Loss of sense of taste and smell…think about how this affects quality of life/eating

Question 4

Subjective Data for the Nose

Answer 4

Ask the patient about history of or recurring:
Discharge (color, thickness, smell)
Frequent colds
Sinus pain
Trauma
Epistaxis (nose bleeds)
Allergies
Altered smell

Question 5

Subjective Data for Mouth and Throat

Answer 5

Ask the patient about history of or recurring:
Sores/lesions
Bleeding gums
Toothache
Dysphagia (difficulty swallowing)
Altered taste
Smoking, alcohol use
Dental care, dentures

Question 6

Common mouth and UR symptoms (that bring people in)

Answer 6

Facial pressure and pain
Snoring/sleep apnea
Cough…sputum (color, thickness, smell)
Sore throat
Dysphagia (difficulty swallowing)

Question 7

Inspection and Palpation of the Nose

Answer 7

External: symmetry, midline, swelling/bruising
Internal: mucous membranes, septum, patency of nares (occlude 1 nare and have the patient breathe in and out…repeat both sides)

Question 8

Inspection of Sinuses

Answer 8

Redness/swelling

Question 9

Palpation of Sinuses

Answer 9

Frontal and maxillary

Question 10

Sinusitis

Answer 10

Sinus infection; mucopurulent drainage (mix of puss and mucus), facial pain, fever/chills/malaise

Question 11

Maxillary Sinusitis

Answer 11

Dull, throbbing pain in cheek and teeth; pain with palpation

Question 12

Frontal Sinusitis

Answer 12

Pain above the supraorbital ridge

Question 13

Inspection of the Mouth

Answer 13

Look at:
Lips
Inner mouth
Tongue
Uvula
Teeth and gums

Question 14

How do we assess CN IX (glossopharyngeal)?

Answer 14

Have the patient stick out their tongue and move it around

Question 15

How do we assess CN XII (hypoglossal)?

Answer 15

Have the patient say consonant heavy words: light, tight, dynamite

Question 16

How do we assess CN X (vagus)?

Answer 16

Have the patient say, “ahhh.” The uvula and soft palate should rise

Question 17

Inspection of the Throat

Answer 17

(Swelling, redness, growths, etc.)
Posterior oral pharynx
Tonsils (1+ or 2+)
Soft palate
Tonsillar pillars

Question 18

Thrush

Answer 18

Fungal infection in the mouth/on the tongue

Question 19

Acute Tonsillitis and Pharyngitis

Answer 19

Redness, swelling, tonsil stones (white, calcified)