Clinical Methods -- Oral Physical Exam Flashcards
Body parts included in the extraoral examination (6)
- Temporo-mandibular joints (TMJ) and facial symmetry
- Neck
- Lymph nodes
- Thyroid
- Lips
7 physical parts included in the intraoral examination
- Lips
- Cheeks (buccal mucosa)
- Floor of mouth
- Tongue
- Palate
- Teeth and periodontium
5 general rules in dentistry
- Inspection/observation
- Palpation
- Hear (auscultation)
- Percussion
- Smell (olfcation)
7 things to observe when inspecting the TMJs
Evaluation of the degree and movement and sounds:
- Open
- Close
- Lateral movements
- Protrusion
- Measurement in mm
- Crepitus (grating sound)
- Click
What is occurring in this photo?
- Palpation with fingers on the B/L TMJs
- Auscultation (if necessary)
4 normal movements and range of motion of the TMJs and facial symmetry
- Rotation - translation
- Opening to 3 fingers in length
- Closing
- Laterality
Abnormalities (symptoms) seen in TMJs and facial symmetry
- Painful clicking vs. asymptomatic clicking
- Crepitus
- Asymmetry/condylar fracture
4 levels of the cervical lymph nodes
- Superficial
- Deep
- Anterior digastric
- Posterior digastric
2 ways to examine the cervical lymph nodes
- Visual inspection
- Palpation of digastric region
3 parts of the digastric region
- Submandibular
- Submental
- Cervical
4 landmarks of the digastric region
- SCM (sternocleido muscle)
- Inferior border of mandible
- Digital
- Bimanual
Label the parts of this anatomical diagram
Steps for palpation of the neck
- Patient’s head turned to opposite side
- Follow the SCM
- Tilt the chin down
- Displace tissue along inferior border of mandible
Normal lymph nodes and thyroid
- Palpable or non-palpable
- Movable, non-enlarged, non-painful
Abnormalities that can be found when examining the lymph nodes and thyroid
- ENlarged lymph nodes or thyroid –> refer for further investigation
Normal appearance of lips
Reddish-pink color
Vermillion border
Abnormalities that can be found when examining the lips
Actinic cheilitis (precursor to squamous cell carcinoma)
Herpes labialis
5 normal findings of the buccal mucosa (inner cheek)
- Linea alba
- Forcyde granules
- Desquamation due to parafunctional habit
- Stenson’s duct orifice
- Saliva (clear, watery)
3 abnormal findings upon examination of the oral mucosa
- Chemical burn
- Ulceration
- Oral lichen planus
Normal findings of the labial mucosa (inner surface of lips) upon examination
Minor salivary gland, color
Abnormal findings of the labial mucosa upon examination
- Mucositis
- Mucocele
- Ulcer-aphthous ulcer
2 examination steps for the palate
- Visual inspection
- Palpation
Normal findings upong examining the palate
- Hard/soft palate
- Torus (bump in middle)
5 abnormalities of the palate upon examination
- Chemical burn
- Nevus
- Herpes
- Micotinic stomatitis
- Plemorphic adenoma
Steps to inspect the oropharynx
- Depress the tongue with a tongue depressor or mirror
- Ask the patient to say “ahh”
3 spaces in the mouth
Parts of the oropharynx
What is this
Bifid uvula
What is this
Pharyngeal tonsils
What is this
Lymphoepithelial cysts
Normal findings at the floor of the mouth
Wharton’s duct
Saliva flow
Abnormal findings of the floor of the mouth
- Varicosities
- Sialolith/obstruction
- Ranula
How to palpate the floor of the mouth
- Lingual aspect of the alveolar ridge (digital)
- Floor of the mouth (bimanual)
- Right index in the floor of the mouth
- Fingers of left hand under the chin
- NOTE: GENTLE COMPRESSION
How to inspect and palpate the tongue
Use the latero-posterior method:
- Ask the patient to stick out the tongue
- Hold the tongue by wrapping the tip with 2x2 gauze
- Assess for induration or tenderness
Normal findings on the tongue upon examination
All types of papillae
Lingual tonsils
Abnormal findings of the tongue (6)
- Papilloma/condyloma
- Ankyloglossia
- Hair tongue
- Fissured tongue
- Benign migratory glossitis
- OSCCa (oral squamous cell carcinoma)
What to inspect for the salivary glands
Openings of the ducts:
- Stenson’s duct
- Warthon’s duct
How to palpate the salivary glands
- Stimulate (milk) the production of saliva
- Observe the color and texture of the saliva
How to palpate the buccla mucosa
Palpate the cheeks and lips with this method:
- Index in mouth/thumb on cheek (skin)
Abnormalities of the teeth and periodontium
- Caries
- Tooth fracture
- Pulpal polyp
- Calculus
- Biofilm/plaque
6 types of abnormalities of occlusion
- Classe I
- Classe II
- Classe III
- Diastema
- Anterior open bite
- Cross bite
Demonstrate Classe I occlusion
Differentiate between classes I, II, and III of occlusion
The degree by which the anterior maxillary teeth angle forward
