Extraoral Exam

Question 1

what does atypical mean

Answer 1

not present in all individuals but still within normal limits

Question 2

what does pathologic mean

Answer 2

associated with infection, trauma, neoplastic growth, errors in development

Question 3

what is hemiplegia

Answer 3

paralysis one side usually from stroke

Question 4

what is paraplegia

Answer 4

paralysis both sides

Question 5

what is hemiparesis

Answer 5

weakness on one side

Question 6

what is paraparesis

Answer 6

weakness on both sides

Question 7

what is ataxic gait

Answer 7

presence of abnormal uncoordinated movements
-unsteady, staggering gait
-walking is uncoordinated and not ordered

Question 8

what are parkisonian gaits and examples

Answer 8

motor disturbances-resting tremors
-tremor
-rigidity
-postural instability
-hypokinesia

Question 9

what are the guidelines of interacting with wheelchair riders

Answer 9

-avoid presumptions
-greet normal
-speak directly
-learn locations of ramps
-offer help

Question 10

how do you do a wheelchair transfer

Answer 10

-position wheelchair as close as possible
-lock wheels
-fold footrest out of the way

Question 11

what is marfans syndrome and incidence

Answer 11

genetic disorder that affects the bodys connective tissue, effects about 1-5,000

Question 12

what are symptoms of marfans syndrome

Answer 12

-tall
-thin
-arachnodactily
- wingspan> height
- chest concavity
-heart murmur
-spine abnormalities

Question 13

what to do if you notice head lice

Answer 13

dismiss patient and vacuum chair

Question 14

what does HEENT stand for

Answer 14

head, eyes, ears, nose, throat

Question 15

what is prognathic

Answer 15

protruding mandible

Question 16

what is retrognathic

Answer 16

retrusive mandible

Question 17

what are the cancer precautions

Answer 17

-if on chemo they are immunocompromised
-head and neck radiation therapy: xerostomia, mucosal irritation, cervical caries

Question 18

what is the most common skin disorder, where is it located, and what is the incidence rate

Answer 18

basal cell, middle 2/3 of face, more than 3 million cases in the US per year

Question 19

describe squamous cell carcinoma

Answer 19

-irregular borders
-crusty surface
-persistent thick rough scaly patches

Question 20

what percentage of cancers does squamous cell carcinoma make up

Answer 20

90%

Question 21

describe a melanoma

Answer 21

-multiple colors
-irregular borders
-flat or slightly raised borders and somewhat asymmetrical in form
-highly infiltrative

Question 22

what are nodular melanomas

Answer 22

aggressive lesions that have only a vertical growth

Question 23

what is ptosis and what can it indicate

Answer 23

eyelid lag, sometimes sign of past stroke

Question 24

what is occular hypertelorism

Answer 24

excess spacing between eyes

Question 25

what is exophthalmos

Answer 25

abnormal protrusion of the eye

Question 26

what is exophthalmos a sign of

Answer 26

hyperhtyroidism

Question 27

what are the lymph node groups

Answer 27

-cervical -axillary -inguinal -internal (pelvis, abdominal, thoracic

Question 28

what are the cervical lymph nodes

Answer 28

-submental -submandibular -tonsilar/jugulodigastric -preauricular -postauricular -occipital -anterior cervical chain -supraclavicular -posterior cervical chain

Question 29

where are submental lymph nodes located

Answer 29

below chin

Question 30

where are submandibular lymph nodes

Answer 30

3-6 nodes below the mandible

Question 31

describe the size of tonsillar lymph nodes

Answer 31

some of the largest lymph nodes in the cervical chain due to lots of lymphatic drainage. decreases in size with age in cancer free patients

Question 32

where is the anterior cervical chain nodes

Answer 32

on top and beneath the SCM, from the angle of the mandible to the top of the clavicle

Question 33

where are the supraclavicular lymph nodes

Answer 33

in the hollow above the clavicle just lateral to where it joins the sternum

Question 34

where is the posterior cervical chain located

Answer 34

extends in a line posterior to the SCM but in front of the trapezius

Question 35

describe how infected lymph nodes appear

Answer 35

firm tender, enlarged and warm, overlying skin may be inflamed

Question 36

how do malignant lymph nodes feel

Answer 36

firm, non-tender, matted, fixed and increase in size over time

Question 37

what area is the most common lymphadenopathy

Answer 37

cervical

Question 38

what are some clues to routine swelling in lymph nodes from recent infection

Answer 38

-tender -mobile -current or recent viral infection -bilateral (not always) -predictable locations -long lasting without change

Question 39

what are mumphs

Answer 39

infection of the parotid gland

Question 40

what are symptoms of mumphs

Answer 40

swelling in the cheek and sore lymph nodes

Question 41

where is the thyroid located and can you palpate it

Answer 41

inferior to the larynx and just superior to the clavicles, cannot palpate

Question 42

how do you do a thyroid exam

Answer 42

- place fingers on either side of adam's apple -then slide to just below it -ask patient to swallow -feel gland rise up then drop back -feel for any aymmetry or lumps

Question 43

what percentage of the US have TMJ issues

Answer 43

20%

Question 44

what percentage of TMJ sufferers are women

Answer 44

85.4%

Question 45

what are TMD symptoms

Answer 45

-joint pain -headaches -tinnitus -insomnia -neck ache -teeth sensitive to hot and cold

Question 46

what are the causes of TMD

Answer 46

-bruxism -clenching -stress -malocclusion -arthritis -trauma -stimulants

Question 47

what are the 3 diagnostic classes of TMD

Answer 47

-muscles -soft tissue of the joint - hard tissues of the joint

Question 48

what does referred pain in temporalis mean

Answer 48

anterior teeth pain

Question 49

what does referred pain in masseter mean

Answer 49

posterior teeth pain

Question 50

what are the components of a TMD exam

Answer 50

-excessive tooth mobility -widened PDL -migration in the absence of period ds -buccal mucosa ridging -lateral tongue scalloping -inspect symmetry and alignment of face jaws and dental arches

Question 51

what are splints for TMD used for

Answer 51

-redistribute occlusal forces -relax the masticatory muscles and stabilize the joint - protect dentition and dental work

Question 52

what are treatment options for TMD

Answer 52

-NSAIDs -anti-anxiety -muscle relaxers -botox -physical therapy -surgery -joint rest, limit joint movement, keep teeth ajar -soft food diet - medications to relieve pain and relax muscles -hot or cold compress -TMJ physical therapy -wearing a night guard

Question 53

what abnormal things do you look for in head and neck exam

Answer 53

-nosebleeds -congestion -trouble swallowing - lumps in neck, hoarseness, scratchy throat that doesnt get better -pain in neck, jaw, or ears

Question 54

what is angular cheilitis and where is it found

Answer 54

on corners of mouth, usually candida

Question 55

what is one of the first signs of bruxism

Answer 55

teeth become sensitive to hot and cold