Extra Oral Examination Flashcards
Why do we do an extra/intra oral exam?
Early identification To detect cancers Thyroid disorders Eating disorders Nutritional deficiencies STD’s Systemic conditions
Sequence of extra oral examination
Overall appraisal of patient Face Skin Eyes Nodes Glands Temporomandibular joint Lips (herpetic lesions?)
What should you ask your patient during the exam?
Pain or discomfort during palpation/swallowing
Persistent difficulty swallowing w/no pain
Recent lumps/bumps w/ no pain
Persistent earache or hoarseness
Methods for examination
Visual exam Palpation Instrumentation Percussion Electrical test Auscultation
4 types of palpation
Digital
Bidigital
Bimanual
Bilateral
What are signs
Objective and observable by hygienist/dentist
What are symptoms
Subjective, felt or experienced by patient
What does the physical exam technique consist of?
Visual inspection of the skin of the head and neck
Palpation of the lymph nodes, salivary gland’s, thyroid, and TMJ
What is palpation
Using fingertips to move or compress structures against tissues
To detect abnormalities such as swelling, tumors, or in large lymph nodes, the structure must be compressed:
Against a firm Structure such as bone or between examiners fingers
Why must you also request information from the patient about your findings
They may have information about the duration and may know the cause
Four sub groups of the head and neck exam
Overall appraisal of head neck face and skin
Lymph nodes
Salivary gland‘s
TMJ
What happens during the overall appraisal of the head and neck
Greet and see patient. While chatting do visual assessment of face and neck
Divide face and neck into imaginary zones noting signs of a symmetry, unequal peoples, skin color changes or lesions
Notable findings during the overall appraisal of the head and neck
Lesions or color changes of the skin Uneven pattern of hair loss Swelling of face/neck Masses on the neck Wounds, bruises, scars Asymmetry of face or neck
What is the lymphatic system
A network of lymph nodes connected by lymphatic vessels
Plays a role in defense against infection
What are lymph nodes
Being shipped structures that filter and trap bacteria, fungi, viruses and wastes
Always passes through at least one lymph node where it is filtered and destroyed
How many lymph nodes are in the body and the neck
400-700 in the body
170-200 in the neck
Lymphadenopathy
Nodes swell in area of infection
Usually in large to a half inch to 1 inch across
Can in large over 1 inch with a bacterial infection
Painless with cancer
Lymphatic system can transport cancer cells throughout the body
Keys to effective examination procedure
Consistent sequence every time
Correct palpation technique
Careful documentation
Characteristics of infected lymph nodes
Firm and tender Enlarged and warm Bilateral swelling Freely movable from underlying structures Swollen, feels like a grape
Characteristics of malignant lymph nodes
Firm and not tender
Matted, stuck to each other
Fixed, stuck to underlying tissue
Unilateral, only on one side
Salivary gland
Produce saliva and release it into the mouth through ducts
3 main pairs of salivary gland
Parotid
Submandibular
Sublingual
Parotid gland
Located on the surface of the masseter muscle between the ear and jaw
