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Patient Care II > Extraoral Examination > Flashcards

Extraoral Examination Flashcards

1
Q

What is normal?

A

found in most individuals

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2
Q

What is atypical?

A

not present in all individuals but still within normal limits ( a variation of normal)

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3
Q

What is pathologic?

A

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

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4
Q

What are the three exam classifications?

A

Normal, atypical, and pathologic

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5
Q

What is hemiplegia?

A

Paralysis one side, Usually from stroke

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6
Q

What is paraplegia?

A

paralysis both sides

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7
Q

What is hemiparesis?

A

Weakness one side

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8
Q

What is paraparesis?

A

Weakness on both sides

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9
Q

What is ataxic gait?

A

presence of abnormal, uncoordinated movements. Describes signs and symptoms without reference to specific diseases

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10
Q

What is a parkinsonian gait?

A

motor disturbances-resting tremors

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11
Q

What are the symptoms of a parkinsonian gait?

A

Tremor
Rigidity
Postural instability
Hypokinesia

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12
Q

What does an ataxic gait look like?

A

Unsteady, staggering gaitWalking is uncoordinated and not ordered

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13
Q

What does a parkinsonian gait look like?

A

Taking small, shuffling steps; moving more slowly than expected at their age; taking jerky steps; freezing of gait

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14
Q

What does freezing of gait look like?

A

loose the ability to pick up their feet, which makes them “stuck” in place. 5-85% of patients. Falls are common. Can be caused by anxiety, taking sharp corners, crowds (ie all things that occur in clinic).

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15
Q

What should you do when interacting with wheelchair riders?

A
  • Avoid presumptions about a person’s physical abilities.
  • Greet a wheelchair user the same as you would anyone.
  • Speak directly to the person who uses the wheelchair.
  • Learn the locations of accessible ramps, doors and parking.
  • Offer to help when appropriate.
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16
Q

What should you do for wheelchair transfer?

A

Leave in wheelchair if possible (private practice where there is more room)

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17
Q

If you must do a wheelchair transfer, then?

A

Position wheelchair as close as possible
Lock all wheels in place
Fold footrests out of way
Ask pt. what works best
Lift under armpits?
Hold onto belt in back?
Use your legs!

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18
Q

What is stature?

A

Short/tall

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19
Q

What is habitus?

A

Thin/obese

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20
Q

What is Marfan’s syndrome?

A

GENETIC DISORDER- affects the body’s connective tissue. Effects about 1-5,000

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21
Q

What are the signs of Marfan’s syndrome?

A

Tall, thin, arachnodactily, wingspan > height, chest concavity, heart murmur

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22
Q

What is scoliosis?

A

Side curvature

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23
Q

Can scoliosis occur in Marfan’s syndrome?

A

Yes

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24
Q

What is kyphosis?

A

Rounded back

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25
Can kyphosis occur in Marfan's?
Yes
26
How should you look for head lice?
Discreetly, white egg cases (not dandruff)
27
What should you do if you find a patient with head lice?
Dismiss patient and vacuum chair; fresh headrest cover for every patient
28
What is HEENT?
Head, eyes, ears, nose, throat
29
Where should you look for symmetry?
HEENT
30
What is a prognathic profile?
Mandible is forward
31
What is a retognathic profile?
Mandible is slid back
32
What should you look for in the head and neck exam?
LOOK FOR LUMPS IN NECK, HOARSENESS, SCRATCHY THROAT THAT DOESN’T GET BETTER.PAIN IN NECK, JAW OR EARS, nosebleeds, congesting, trouble swallowing
33
What should a dentist be aware of when patients are undergoing cancer treatment?
AWARE OF THE TYPE AND EXTENT OF THE CANCER AND PREPARE FOR COMPLICATIONS SUCH AS ADVERSE BLEEDING, SIDE EFFECTS OF DRUGS, AND INFECTION
34
What the precautions with chemotherapy?
Immunocompromised
35
What are the precautions with head and neck radiation therapy?
Xerostomia Mucosal irritation Cervical caries
36
What must you get before treating a cancer patient?
Med consult
37
Where should you look for skin lesions?
Hands, arms, neck, face and ears (could be a rash, mole, or patch)
38
What should you ask about with skin lesions?
Chronic, non-healing lesion; change in pre-existing lesion; sun exposure
39
What are basal cell characteristics?
most common; middle 2/3 of face; won't heal; usually benign
40
What are characteristics of squamous cell carcinoma?
irregular borders “crusty” surface Persistent thick rough scaly patches that may bleed Comprises 90% of all oral cancers
41
What are visual characteristics of melanoma?
multiple colors irregular borders Flat or slightly raised borders and somewhat asymmetrical in form
42
What are characteristics of melanoma?
Nodular melanomas are aggressive lesions that have only a vertical growth Highly infiltrative
43
What is ptosis?
Lid lag (can be sign of past stroke)
44
What is ocular hypertelorism?
Excess spacing between eyes
45
What should the pupils look like?
Should react equally to light
46
What is exophthalmos?
Abnormal protrusion of the eye (sign of hyperthyroidism)
47
What are lymph nodes?
Filters Part of lymphatic system
48
Where are lymph nodes?
Cervical (head / neck) Axillary (underarm) Inguinal (groin) Internal (pelvic, abdominal, thoracic): Can’t palpate
49
Where are the submental lymph nodes?
Just below the chin
50
Where are the submandibular lymph nodes?
3-6 nodes, beneath the body of the mandible
51
Where are the tonsillar/jugulodigastric lymph nodes?
Tends to be some of they largest lymph nodes in the cervical chain due to their significant lymphatic drainage. It does decrease in size with age in a cancer free patient
52
Where are the anterior cervical chain lymph nodes?
nodes that lie both on top and beneath the sternocleidomastoid muscles (SCM) on either side of the neck, from the angle of the mandible to the top of the clavicle
53
Where are the supraclavicular lymph nodes?
in the hollow above the clavicle, just lateral to where it joins the sternum
54
Where are the posterior cervical chain lymph nodes?
extends in a line posterior to the SCM but in front of the trapezius.
55
What do infected lymph nodes look like?
nodes tend to be –firm, tender, enlarged and warm. Inflammation can spread to the overlying skin, causing it to appear reddened
56
How do malignancies present in lymph nodes?
These nodes tend to be-firm, non-tender, matted (stuck to each other), fixed ( not freely mobile but attached to underlying tissue) and increase in size over time
57
What is the lymph node palpation sequence?
Ahead and behind ear; slide down to under angle of mandible; slide to SCM (turn head opposite way, anterior and posterior borders); slide down to above collar bone
58
What should a healthy lymph node feel like?
Soft like a grape and moveable
59
What does an unhealthy lymph node feel like?
Firm like a handball and fixed
60
What are characteristics of lymphadenopathy?
Abnormality in size, consistency, or number
61
How should you describe any abnormality found in lymphadenopathy?
Location Size (<1cm.>) Tenderness Consistency Mobility
62
Where is lymphadenopathy most common?
Cervical
63
What the clues to routine swelling from recent infection?
Tender Mobile Current or recent viral infection Bilateral-but not always Predictable locations Long duration without change
64
What is mumps?
Infection of the parotid gland (swelling in the cheek and sore lymph nodes)
65
Where is the thyroid?
Inferior to the larynx and just superior to the clavicles (most often not palpable)
66
How do you preform a thyroid exam?
Gently 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 asymmetry or lumps
67
What is angular cheilitis?
corners of mouth usually, candida
68
What are the symptoms of TMD?
Joint pain Headaches Tinnitus–ringing in the ears Insomnia Neck ache Teeth become sensitive to hot, and cold-this is one of the 1st signs of bruxism
69
What are the causes of TMD?
Bruxism Clenching Stress Malocclusion Arthritis Trauma Stimulants
70
What are the three classes of TMD?
Muscles Soft tissue of the joint Hard tissues of the joint
71
Where is the referred pain located in TMD?
Temporalis = generally ant teeth Masseter = generally post teeth
72
How do you palpate for TMJ?
Palpate bony prominence Just anterior to ear “Then have pt. open & close “Any discomfort?” Look for altered opening and closing pathways, abnormal sounds, tenderness, and limitations in opening
73
How do you preform a TMJ diagnostic exam?
Measure range of motion: opening; right and left lateral Palpate for crepitus (grinding) & clicking while opening and closing. Palpate for tenderness in the masseter and temporalis muscles
74
What should you look for in a TMD exam?
Excessive tooth mobility Widened PDL seen radiographically Migration in the absence of perio ds Buccal mucosal ridging Lateral tongue scalloping. Inspect symmetry and alignment of face, jaws, dental arches.
75
Treatment of TMD? (Night guards)
Night guards/Bruxism splints-used to: 1. Redistribute occlusal forces 2. Relax the masticatory muscles and stabilize the joint. 3. Protect dentition and dental work
76
Treatments of TMD? (Meds)
Meds: Anti-inflammatory (NSAIDs)-used for joint pain, inflammation, and stiffness. Tend to be inexpensive, easily accessible and well tolerated. Anti-anxiety-help relieve the stress that may aggravate TMD Muscle relaxers-relax muscles and decrease spasms. Botox-lasts 3-4 months-not FDA approved for TMD
77
Other treatments of TMD?
Physical Therapy: Helps ease pain and increase movement and normal jaw function. Surgery: Very rare

Patient Care II (3 decks)

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