Extraoral Exam Flashcards
Exam 1 Prep
Extraoral Head and Neck Examination
What is is?
A physical examination technique consisting of:
A ___ ____ ____ of the skin of the head and neck
_____ of the lymph nodes, salivary glands, thyroid, and TMJ
Thorough and accurate _____ of findings.
systematic visual inspection
Palpation
documentation
When do I preform a extra oral screening
Annually or more often if needed
EXTRAORAL: Keys to Effective Examination
- Thorough Examination
- Consistent Sequence to include all structures
- Good Palpation technique
- Careful Documentation of all findings
***Never palpate prior to __ ____
visual examination
Document findings utilizing ____/_____
lesion/descriptors
Correct Palpation Technique
Circular palpation. Light to firm pressure
***What are Compression Techniques
To detect abnormalities such as swelling, tumors, enlarged lymph nodes, structure must be compressed :
- Against a firm structure
- or between the examiners fingers
Compression between fingers of one hand
Bi-digital palpation
Compression between fingers of both hands
Bi manual palpation
Compression against underlying structure /compression over underlying structure
Digital palpation
Descriptors of Head and Neck Findings Detected by Palpation
Surface: Smooth or rough/flat/raised knob/lump/swelling
Shape: Irregular/round/oval
Consistency:Firm/Hard/Spongy
Mobility: Mobile or Fixed
Tennderness: Amount of tenderness if any experienced by the patient whe the structure is palpated
Four Subgroups of Head and Neck Exam
- Overall appraisal of head, neck, face, skin
- Lymph nodes of head and neck
- Salivary and thyroid glands
- TMJ
Overall Appraisal of Head, Neck, Face, Ears, Skin
Position patient in upright position, supporting his or her own head
___ ___ and ____ for performing procedure to patient, answer any questions and secure consent
Remove eyeglasses, hat, visor, scarf, headphones, etc.
Patient napkin is placed ___ _____ of head and neck exam.
Unobtrusively inspect skin and symmetry of face and neck
Explain procedure and rationale
upon completion
Normal Findings
- Face and neck appear ___
- Skin is ___ and ___ in color
- Even ____ of hair on scalp
symmetrical
intact and uniform
distribution
Is documentation required for findings within normal limits for Extra oral
No
Notable Findings
- Lesions or color changes of the skin
- Uneven patterns of hair loss
- Masses in the neck
- Wounds, bruises, scars
- Swelling of face or neck
- Asymmetry of face or neck
How to document notable findings
Location
Discriptors( shape, borders,color,size)
Duration
follow up questions
***Request the following information for follow up on findings
- Has it always looked like this or has it changed over time? Include size, shape, texture, color.
-Does it hurt or how do you know that it is there? If yes, when does it hurt? What makes it hurt?
Lymphatic System
A network of lymph nodes connected by lymphatic vessels
-plays a role in defense against infection
Bean Shaped structures that filter and trap bacteria, fungi, viruses, and waste
Lymph nodes
400- ___ lymph nodes in the body
700
170- ___ lymph nodes in neck
200
Normal healthy lymph nodes can or can not be felt
can not
Enlarged lymph nodes
Lymphadenopathy
Infected lymph nodes will have 6 qualities
- Swollen, feels a bit like a grape
- firm
- tender
- enlarged
- bilateral swellin
- freely moveable
Malignant Lymph Nodes
- Enlarged
- Firm
- Non-tender-***Painless
- Matted-stuck to each other-bundle of grapes
- FIXED to underlying tissue
- Unilateral (enlarged on only one side of head or neck)
Correct Palpation Technique:
Use the fingertips to ________________, using a circular motion.
ALWAYS ____ PRIOR to _____
compress the structure against the underlying tissues
Always look prior to palpating
something to remember before palpating postauricular nodes
move ear and visual
Occipital
- Always look prior to palpating
- Visually inspect head, scalp, and ears from behind patient
- Have patient lift hair so neck is visible
- Begin at midline of neck and palpate along hairline
- **Use CIRCULAR MOTION TO COMPRESS tissues against the underlying bone
located on the surface of the masseter muscle between the ear and jaw
Parotid glands
sit below the jaw toward the back of the mouth
Submandibular glands
located under the tongue, beneath the mucous membrane of the floor of the mouth
Sublingual glands
An enlarged thyroid gland
goiter
Sits below the larynx (voice box)
Sits over the trachea and just above the clavicles
Thyroid
Salivary glands: NOTABLE FINDINGS
- Palpable gland (healthy gland cannot be felt)
- swollen or enlarged
- Firm, hard consistency
- Tender to palpation
THYROID GLAND NOTEABLE FINDINGS
- Palpable gland (healthy gland cannot be felt)
- Deviates from midline of neck
- Asymmetrical lobes
- Enlarged lobes nodules present hard, firm consitency
- fixed to underylying sturcutres
Crepitus means
clicking
TMJ NOTable findings
- Abnormal sounds
- Asymmetrical movements
- Tenderness or pain
- Limited opening adequte range of motion. patients fingers
