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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
Q

Can kyphosis occur in Marfan’s?

A

Yes

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26
Q

How should you look for head lice?

A

Discreetly, white egg cases (not dandruff)

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27
Q

What should you do if you find a patient with head lice?

A

Dismiss patient and vacuum chair; fresh headrest cover for every patient

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28
Q

What is HEENT?

A

Head, eyes, ears, nose, throat

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29
Q

Where should you look for symmetry?

A

HEENT

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30
Q

What is a prognathic profile?

A

Mandible is forward

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31
Q

What is a retognathic profile?

A

Mandible is slid back

32
Q

What should you look for in the head and neck exam?

A

LOOK FOR LUMPS IN NECK, HOARSENESS, SCRATCHY THROAT THAT DOESN’T GET BETTER.PAIN IN NECK, JAW OR EARS, nosebleeds, congesting, trouble swallowing

33
Q

What should a dentist be aware of when patients are undergoing cancer treatment?

A

AWARE OF THE TYPE AND EXTENT OF THE CANCER AND PREPARE FOR COMPLICATIONS SUCH AS ADVERSE BLEEDING, SIDE EFFECTS OF DRUGS, AND INFECTION

34
Q

What the precautions with chemotherapy?

A

Immunocompromised

35
Q

What are the precautions with head and neck radiation therapy?

A

Xerostomia
Mucosal irritation
Cervical caries

36
Q

What must you get before treating a cancer patient?

A

Med consult

37
Q

Where should you look for skin lesions?

A

Hands, arms, neck, face and ears (could be a rash, mole, or patch)

38
Q

What should you ask about with skin lesions?

A

Chronic, non-healing lesion; change in pre-existing lesion; sun exposure

39
Q

What are basal cell characteristics?

A

most common; middle 2/3 of face; won’t heal; usually benign

40
Q

What are characteristics of squamous cell carcinoma?

A

irregular borders
“crusty” surface
Persistent thick rough scaly patches that may bleed
Comprises 90% of all oral cancers

41
Q

What are visual characteristics of melanoma?

A

multiple colors
irregular borders
Flat or slightly raised borders and somewhat asymmetrical in form

42
Q

What are characteristics of melanoma?

A

Nodular melanomas are aggressive lesions that have only a vertical growth
Highly infiltrative

43
Q

What is ptosis?

A

Lid lag (can be sign of past stroke)

44
Q

What is ocular hypertelorism?

A

Excess spacing between eyes

45
Q

What should the pupils look like?

A

Should react equally to light

46
Q

What is exophthalmos?

A

Abnormal protrusion of the eye (sign of hyperthyroidism)

47
Q

What are lymph nodes?

A

Filters
Part of lymphatic system

48
Q

Where are lymph nodes?

A

Cervical (head / neck)
Axillary (underarm)
Inguinal (groin)
Internal (pelvic, abdominal, thoracic): Can’t palpate

49
Q

Where are the submental lymph nodes?

A

Just below the chin

50
Q

Where are the submandibular lymph nodes?

A

3-6 nodes, beneath the body of the mandible

51
Q

Where are the tonsillar/jugulodigastric lymph nodes?

A

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
Q

Where are the anterior cervical chain lymph nodes?

A

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
Q

Where are the supraclavicular lymph nodes?

A

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

54
Q

Where are the posterior cervical chain lymph nodes?

A

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

55
Q

What do infected lymph nodes look like?

A

nodes tend to be –firm, tender, enlarged and warm. Inflammation can spread to the overlying skin, causing it to appear reddened

56
Q

How do malignancies present in lymph nodes?

A

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
Q

What is the lymph node palpation sequence?

A

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
Q

What should a healthy lymph node feel like?

A

Soft like a grape and moveable

59
Q

What does an unhealthy lymph node feel like?

A

Firm like a handball and fixed

60
Q

What are characteristics of lymphadenopathy?

A

Abnormality in size, consistency, or number

61
Q

How should you describe any abnormality found in lymphadenopathy?

A

Location
Size (<1cm.>)
Tenderness
Consistency
Mobility

62
Q

Where is lymphadenopathy most common?

A

Cervical

63
Q

What the clues to routine swelling from recent infection?

A

Tender
Mobile
Current or recent viral infection
Bilateral-but not always
Predictable locations
Long duration without change

64
Q

What is mumps?

A

Infection of the parotid gland (swelling in the cheek and sore lymph nodes)

65
Q

Where is the thyroid?

A

Inferior to the larynx and just superior to the clavicles (most often not palpable)

66
Q

How do you preform a thyroid exam?

A

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
Q

What is angular cheilitis?

A

corners of mouth
usually, candida

68
Q

What are the symptoms of TMD?

A

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
Q

What are the causes of TMD?

A

Bruxism
Clenching
Stress
Malocclusion
Arthritis
Trauma
Stimulants

70
Q

What are the three classes of TMD?

A

Muscles
Soft tissue of the joint
Hard tissues of the joint

71
Q

Where is the referred pain located in TMD?

A

Temporalis = generally ant teeth
Masseter = generally post teeth

72
Q

How do you palpate for TMJ?

A

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
Q

How do you preform a TMJ diagnostic exam?

A

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
Q

What should you look for in a TMD exam?

A

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
Q

Treatment of TMD? (Night guards)

A

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
Q

Treatments of TMD? (Meds)

A

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
Q

Other treatments of TMD?

A

Physical Therapy:
Helps ease pain and increase movement and normal jaw function.
Surgery:
Very rare

Patient Care II (3 decks)

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