Exam 3 - Nose, Mouth, & Throat Flashcards
Function of the nose
Warms and moistens, filters inhaled air
Contained in nasal cavity
Vibrissae (nose hairs)
Nasal mucosa which is red b/c of rich blood supply
Divides nasal cavity medially
Septum
What is contained in the septum
Kiesselbach plexus (nose bleeds)
Function of turbinates
Increase surface area to better warm, humidify, and filter inhaled air
Cleft under each turbinate
Superior, middle, or inferior meatus
What are olfactory receptors?
Hair cells
Receptors for smell
What do olfactory receptors merge into?
Olfactory nerve (CN I)
Where is the vestibule located?
Just inside each nare
Divides the two nares and is continuous inside with the nasal septum
Columella
Lateral outside wing of nose on each side
Ala
Function of paranasal sinuses
Lighten the weight of the skull
Resonators for sound production
Provide mucous
Name the paranasal sinuses
Frontal
Maxillary
Ethmoid
Sphenoid
Where are the frontal sinuses located?
Frontal bone, above and medial to orbits
Where are the maxillary sinuses located?
In the maxilla (cheek bone), along side of nasal cavity
Where is the ethmoid sinus located?
Between orbits
Where is the sphenoid sinus located?
Deep in skull, in sphenoid bone
Which paranasal sinuses are palpable?
Frontal
Maxillary
Which paranasal sinuses are present at birth
Maxillary
Ethmoid
Function of tongue
Enhances functions in mastication, swallowing, teeth cleansing, speech formation
Larger papillae in inverted V shape at posterior base of tongue
Gallate papilla
Midline fold of tissue that connects tongue to floor of mouth
Frenulum
Name the pairs of salivary glands
Parotid gland
Submandibular gland
Sublingual gland
Largest salivary gland
Parotid gland
Smallest salivary gland
Sublingual gland
Salivary gland located beneath mandible at angle of jaw
Submandibular gland
Salivary gland that lies beneath floor of mouth, under tongue
Sublingual gland
Salivary gland located within the cheeks, in front of ear
Parotid gland
Duct for parotid gland and where does it open?
Stensen gland
Opens on buccal mucosa, opposite the second molar
Duct for submandibular gland and where is it located?
Wharton duct
Opens at floor of mouth, on either side of frenulum
Where are the sublingual gland openings?
Many small openings along sublingual fold, under tongue
Separated from mouth by anterior tonsillar pillar (fold of tissue on each side)
Oropharynx
What do tonsils look like?
Masses of lymphoid tissue
Granular with deep crypts
Behind tonsils, some small blood vessels may be visible
Posterior pharyngeal wall
What is a bifid uvula?
Uvula split partially or completely
Bony ridge in midline of hard palate
Torus palatines
Benign, milky, bluish-white opaque appearance of buccal mucosa. Commonly occurs in African Americans
Leukoedema
Who are dental caries more common in?
Rural residents Minorities Older adults Pregnant women Homeless Low income Institutionalized
What is poor oral health associated with?
Diabetes Coronary artery disease Peripheral vascular disease Metabolic syndrome (Possibly due to chronic inflammation)
What is perio caused by?
Chronic inflammation
What is perio linked to and why?
Type 2 diabetes
Chronic elevated blood glucose levels result in gingival inflammation, which leads to gingivitis and perio
What causes oral cancer
Smoking
Alcohol
HPV
Name for runny nose?
Rhiorrhea
What causes rhinorrhea?
Colds
Allergies
Sinus infection
Trauma
What causes sinus pain?
Up to 90% of pts with viral URI have viral sinusitis, which resolves without antibiotics
Why is it important to know about trauma to nose?
Could cause deviated septum, which could cause nares to be obstructed
What causes epistaxis?
Occurs with trauma, vigorous nose blowing, foreign body
What should someone do if they have a nose bleed?
Side with head tilted forward
Pinch soft part of nose above nostrils for 10-15 min
Allergies caused by pollen
Seasonal
Allergies caused by dust
Perennial
What could diminish smell?
Cigarette smoking
Chronic allergies
Aging
How to test the patency of nostrils
Push each nostril shut and ask pt to sniff
Absence of sniff = obstruction (due to cold, nasal polyps, or rhinitis)
What is rhinitis?
Nasal mucosa swollen and bright red with URI
What does nose discharge look like and when is it common
Common with rhinitis and sinusitis
Varies from watery and copious to thick, purulent, and green-yellow
What does nose mucosa look like with allergies?
Mucosa swollen, boggy, pale, and gray
What does a deviated septum look like?
Looks like a hump or shelf in one nasal cavity
If can see a spot of light shining in other naris
Perforation
Where does epistaxis come from?
Anterior septum
What are polyps?
Benign growths that accompany chronic allergy
What do polys look like?
Smooth, pale gray, avascular, mobile, nontender
What is a furuncle?
Small boil in nose, appears red and swollen
Which turbinates will be visible with speculum and what will they look like?
Middle and inferior
Same light red color as nasal mucosa
When would a pt have tender sinus areas while palpating?
With chronic allergies or an acute infection
How can you determine if pt has sinusitis
Have them bend over to check for focal pain
What is sinusitis?
Treatment?
Inflamed infected sinus areas, following URI
Usually viral and do not need antibiotics
In light-skinned people, what does circumoral pallor mean?
Shock
Anemia
In light-skinned people, what does cyanosis on lips mean?
Hypoxemia and chilling
In light-skinned people, what do cherry red lips mean?
Carbon monoxide poisoning
In light skinned people, what does acidosis on lips mean?
Aspirin poisoning or ketoacidosis
Cracking at the corners of the mouth
Chelitis
What could an enlarged tongue indicate?
Hypothyoidism
What could a small tongue indicate?
Accompanies malnutrition
What causes deep fissures in tongue?
Occurs with dry mouth due to dehydration or fever
What causes decreased saliva?
Occurs with anticholinergic and other meds
What causes increased saliva/drooling?
Occur with gingivostomatitis and Parkinson disease
High risk areas for oral squamous cell cancer
Lateral and ventral tongue and floor of mouth
When should a pt have a lesion or ulcer further investigated
If it lasts over 2 weeks
What is an indurated area?
May be a mass or lymphadenopathy and must be investigated
What is leukoplakia?
What causes it?
Chalky white and does not scrape off.
Precancerous from chronic irritation of smoking or alcohol use
If pt has dappled down patches on buccal mucosa
Present with Addison disease (chronic adrenal insufficiency)
If pt’s stensen duct is red
Mumps
If pt has Koplik spots
Early warning sign of measles
What are Fordyce granules
Sebaceous cysts
Small isolated white or yellow papules on cheek, tongue, and lips
What is an aphthous ulcer? What does it look like? What is it associated with?
Canker sore
Vesicle that turns into “punched out” ulcer with white base, surrounded by red halo
Associated with stress, fatigue, food allergy
What is candidiasis?
White, cheesy, curd like patch on buccal mucosa and tongue
Does scrape off, red under
If pt has yellow hard palate
Jaundice
Most common early lesion in people with AIDS
Oral kaposi sarcoma
What indicates nerve damage to CN X
If uvula has any deviation to one side or absent movement
If uvula deviates to side or movement is absent, what nerve is possibly damaged? What conditions could this mean?
Damage to CN X
Poliomyelitis
Diphtheria
By looking at tonsils, how can you tell if pt has an acute infection?
Tonsils bright red and swollen
May have exudate or large white spots
If pt has white membrane covering tonsils, what could it be?
May accompany infectious mononucleosis
Leukemia
Diphtheria
How can you tell if pt has viral pharyngitis when looking at tonsils?
Erythematous tonsils
No hypertrophy
No exudates
How can you tell if a pt has streptococcal pharyngitis by looking at their tonsils?
Erythematous Enlarged tonsils Exudate Absence of cough Swollen, tender anterior cervical nodes
If pt’s tongue deviates to one side, what can that mean?
CN XII damage
If pt’s tongue has a tremor, what could it mean?
Hyperthyroidism
If pt has course tremor in tongue, what could it mean?
Cerebral palsy or alcoholism
Smooth, glossy tongue
Atrophic glossitis
If pt has Atrophic glossitis, what could it mean?
Vitamin B12 deficiency
Iron deficiency anemia
If someone has sweet breath
Diabetic ketoacidosis
If someone has acetone breath
Children with malnutrition or dehydration
If pt’s breath smells like ammonia
Uremia
If pt’s breath smells musty
Liver disease
If pt’s breath is foul, fetid
Dental or respiratory infections
If pt’s breath is mouselike
Diphtheria
