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Physical Assessment > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Name the three factors in making a differential diagnosis of an oral lesion

A
  1. Lesion site
  2. Lesion morphological characterists
  3. Color of lesion
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2
Q

Name of morphological categories of oral lesions

A

Elevated
Depressed
Flat

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3
Q

Define elevated lesions

A

surface above the normal mucosa plane

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4
Q

Define coalescing

A

Clustered/Clumped/blend into one another

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5
Q

Define blisterform lesions

A

translucent

soft rebounding

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6
Q

Three types of blisterform lesions

A

vesicle
pustules
bulla

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7
Q

Define vesicles

A

> 5mm lesion

Clear fluid

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8
Q

Define pustule

A

greater or less than 5mm

yellowish color

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9
Q

Define bulla

A

lesion >5mm
may contain serum mucin or extavaasated blood
pink red or blue

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10
Q

Define nonblisterform lesion

A

firm and solid
contain NO fluid
opaque in appearance

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11
Q

Four types of nonblisterform lesions

A

papule
nodule
tumor
plaque

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12
Q

Define papule

size

A

Tissue

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13
Q

Define nodule

size

A

Tissue>5mm

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14
Q

Define tumor
term
size

A

tumescence (swelling)

>2cm

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15
Q

Define plaque
shape
size

A

slightly raised lesion with a broad flat toppasted or stuck on appearance
>5mm

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16
Q

Define Sessile nonblisterform lesion

A

papule nodule or tumor whose attachment to the normal mucosa is the greatest diameter of the lesion

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17
Q

Define Pedunculated nonblisterform lesion

A

papule nodule or tumor whose attachment to the normal mucosa is smaller than the greatest diameter of the lesion itself

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18
Q

Name of the four characteristics to describe depressed lesions

A

Outline-Oh
Margin-My
Depth-Double
Diameter- D’s

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19
Q

Define ulcer
definition
center
periphery

A

loss in the continuity of the oral epithelium
yellow
red

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20
Q

The normal viewing distance to determine the outline of lesions

A

30-40cm

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21
Q

Describe the depth of a superficial and deep depressed lesions

A

3mm

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22
Q

Define flat lesions

A

located on the same plane as normal oral mucosa

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23
Q

How are flat lesions detected

A

change in color

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24
Q

Define macule

A

a flat lesion of abnormal color

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25
Q

Why is the loss of a papillae on the tongue considered a flat lesion

A

Loss of papillae results in what looks like a depressed lesion however since it doesn’t involve the mucosal surface it is a flat lesion. Because it doesn’t involve an abnormality in color it is not considered a macule

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26
Q

Name the three most prominent colors of oral soft tissue lesions

A

Red
Pink
White

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27
Q

Name the four primary endogenous pigments of normal tissue

A

Oxyhemoglobin
Reduced hemoglobin
Melanin
Carotene

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28
Q

Define oxyhemoglobin
define
color

A

more oxygen

bright red

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29
Q

Define reduced hemoglobin
define
color

A

less oxygenated

bluish

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30
Q

Define melanin
define
color

A

formed by malanocytes, pigment particles transferred to malpighian cells of epithelium

brown

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31
Q

Define carotene
location
color

A

cornified superficial layer of the epithelium, sebaceous glands and blood plasma

yellow

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32
Q

Soft tissue lesions are rarely seen as single colors. The predominant color involves the greatest surface area first

A

Soft tissue lesions are rarely seen as single colors. The predominant color involves the greatest surface area first

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33
Q

Predominant color of the oral mucosa

A

pink

34
Q

Location of Red mucosa

A

vermillion border, alveolar mucosa, soft palate, pharynx

35
Q

Location of Melanin

A

buccal mucosa, attached gingiva, hard palate

36
Q

Pink lesions
characteristic
normally appear as

types-4 and describe

A

normally elevated
nonblisterform (papules,nodules, tumors)

  1. hyperplasia-increased quantity of normal connective or bone tissue
  2. neoplasia-abnormal growth of tissue or cellular infiltrate
  3. fluid accumulation-edema, Mucin- localized lesion (the more superficial the fluid accumulation the more translucent it will appear)
  4. cyst- fluid filled epithelial lined cavities that are well localized
37
Q

Red lesins

formed by-2 types

A

increased quantity of blood to an area via erythema

Intravascular changes and extravascular changes

38
Q

Define intravascular changes

A

result from dilation of blood vessels or proliferation of new vessels via hyperemia
use diascopic examination to determine (blanching=positive indication)

39
Q

Define extravascular changes

A

due to the escape of RBC’s into the surrounding tissue via extravasation leading to discoloration of skin known as purpura

40
Q

Three types of extravascular changes and their definitions

A
  1. petechiae-small red macule 1-5mm sharply outlined
  2. Ecchymosis-macule larger and slightly deeper than petechiae
  3. hematoma- lesion involving large area casing tumescence
41
Q

what is the most common condition resulting in abnormal redness

A

inflammation resulting from trauma or infection

42
Q

White lesions
result from
Four types and define

A

alteration of the epithelium and connective tissue

  1. hyperkeratinization- thickening of the outer surface of the epithelium via chronic irritation
  2. acanthosis- increased thickening via hyperplasia of prickle cell layer
  3. necrosis- death of cells in a localized area resulting in epithelial sloughing
  4. Fluid accumulation- intra or extracellular edema appearing pale white
43
Q

Red and White Lesions
commonly include
morphology

A

inflammation

large ulcers and depressed lesions

44
Q

Gray Lesions
caused by
morphology

A 
foreign matter (metals)
associated with macules
45
Q

Blue Lesions
caused by
Morphology

A

reduced hemoglobin

bullae

46
Q

Purple Lesions
morphology
caused by

A

bullae, nodules or hematomas

vascular lesion breakdown products

47
Q

Brown Lesions
caused by
morphology
characteristic

A

melanin and hemosiderin
macules
crusting and drying of ulcerated lesions (scabs)

48
Q

Black Lesions

caused by-4

A

foreign body deposition, altered blood pigments, necrosis/gangrene or melanin

49
Q

Yellow Lesions
caused by-6
morphology

A

1.carotene via puss, 2.lymphoid tissue, 3.serum exudate, 4.breakdown of blood pigments, 5.lipids, 6.neoplasms
ulcers of pustules

50
Q

Rough white lesion cause

A

mechanical friction (frictional keratosis)

51
Q

Corrugated white lesion cause

A

long term tobacco use

52
Q

Irregular, shaggy, sloughing or desquamating lesion cause-4

A

collapsed bullae, chemical burns, candidiasis, allergies

53
Q

TMD definition

A

problems involving the masticatory musculature, temporomandibular joint or both

54
Q

Synovial joint definition

A

synovial membrane that exudes synovial fluid to provide lubrication, and nutrients

55
Q

Complex joint definition

A

has an articular disk that separates the join into a superior and inferior compartment and has articular disk

56
Q

Articular disc definition

A

dense fibrous connective tissue that is saddle shaped containing a thick anterior band, thicker posterior band and a central zone that is non-innervated and avascular

57
Q

Fibers of lateral pterygoid muscles attach to

A

anterior portion of articular eminence, retrodiscal tissue (vascular and innervated) and posterior aspect of the articular disc behind the condylar head

58
Q 
Primary function of muscles
masseter-
medial pterygoid-
lateral pterygoid-
temporalis-
A

elevation of mandible
elevation of mandible
protrusion and lateral excursion of the mandible
elevation of mandible

59
Q

Masticatory muscles

A

masseter
medial pterygoid
lateral pterygoid
temporalis

60
Q

Define internal derangement

A

the location of the articular disc is displaced from its normal seated position on the condylar head

61
Q 
Define disc displacement WITH reduction
type
most common
painful?
click?
mouth opening
mandible deviation
A 
internal derangement 
anteromedial
very painful
reciprocal click during closing and opening
within normal limits
towards the affected side
62
Q 
Define disc displacement WITHOUT reduction
type
most common
painful?
click?
mouth opening
mandible deviation
A 
internal derangement
anteromedial 
very painful in acute phase
no joint noise
limited mouth opening called "closed lock"
towards the affected side
63
Q

Define Open Lock

A

hyper translation of the disc-condyle complex past the peak of the articular eminence with simultaneous contraction of the elevator muscles

64
Q

Define Retrodiscitis/Capsulitis

A

inflammation of the vascular bed of the retrodiscal tissue and inflammation of the capsular tissue/synovial membrane resulting in edema that can “throw off” the normal bite of the patient

65
Q

Define Osteoarthritis

3 characterists

A

inflammatory degenerative process of the articular surface of the condyle and articular eminence
1. roughened articular surface
2.pain
crepitus (crunchy) joint noise

66
Q

Define Myalgia

A

local muscle soreness via overuse

67
Q

Define odontalgia

A

referred false tooth pain

68
Q

Define Obstructive Sleep Apnea (OSA)

A

repetitive episodes of complete (apnea) or partial (hypopnea) upper airway obstruction via the soft palate or tongue

69
Q

Prevalence of hypertension

A

25%

70
Q

True or False:

“Data Suggests that a person with high blood pressure yields poorer results in dentistry”

A

False-the disease itself does not pose a risk to treatment rather the systemic cardiovascular, renal, near, and retinal cause increased risk during treatment.

71
Q

Medicines used to treat hypertension cause-5

A
  1. orthostatic hypotension
  2. labial blood pressure during general anesthesia
  3. gingival hyperplasia
  4. xerostomia
72
Q

what % of hypertension is known?

A

*5%- caused by catecholamine secreting tumors and kidney disease
95% considered essential hypertension

73
Q

at what age should the diagnosis of hypertension be based solely on systemic blood pressure?

A

age 50

74
Q

When should blood pressure be checked?

A

prior to giving a local anesthetic

75
Q

What is white coat hypertension

A

a raise in blood pressure due to fear of medical practitioners including dentists

76
Q

Define One MET

A

3.5ml of O2/Kg/min (ability of patient to perform physical work)

77
Q

1-4 MET

A

eating, dressing, walking around, washing dishes

78
Q

4-10 MET

A

climbing stairs, short run, game of golf

79
Q

> or = 10 MET

A

swimming, long distance running, singles tennis, football, Friday dental basketball=12

80
Q

Sedation does what to BP

A

lowers it

Physical Assessment (1 decks)

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