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Patient Care II > Extraoral Exams > Flashcards

Extraoral Exams Flashcards

1
Q

What are some examples of atypical structures in the mouth?

A

tori
3rd molar prevelance

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2
Q

What term is associated with
infection, trauma, neoplastic
growth, errors in development?

A

pathologic

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3
Q

What term is not present in all
individuals but still within normal
limits ( a variation of normal)?

A

Atypical

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4
Q

What is hemiplegia?

A

paralysis one side (usually from stroke)

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5
Q

What is paraplegia?

A

paralysis both sides

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6
Q

What is hemiparesis?

A

weakness one side

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7
Q

What is paraparesis?

A

weakness on both sides

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8
Q

What type of gait is ataxic?

A

presence of abnormal,
uncoordinated movements

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9
Q

What type of gait is parkinsonian?

A

motor disturbances-resting tremors
- Tremor
- Rigidity
- Postural instability
- Hypokinesia

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10
Q

What type of gait is known from small, shuffling steps?

A

parkinson’s gait

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11
Q

What should you do when interacting with wheelchair riders?

A
  • avoid presumptions about a person’s physical ability
  • greet them the same as anyone else
  • speak directly to the person using the wheelchair
  • learn the locations of accessible areas
  • offer to help when appropriate
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12
Q

How should you perform a wheelchair transfer?

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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13
Q

What are the two different statures and habitus?

A

stature - short, tall
habitus - thin, obese

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14
Q

What genetic disorder affects the body’s connective tissue?

A

marfan’s syndrome

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15
Q

How many people does marfan’s syndrome affect?

A

1 - 5,000

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16
Q

What are the symptoms of marfan’s syndrome?

A

tall
thin
arachnodactily
wingspan > height
chest concavity
heart murmur

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17
Q

What is an abnormal side curvature of the spine called?

A

scoliosis (can happen in marfan’s syndrome)

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18
Q

What is an abnormal curvature of the spine leading to a rounded back?

A

kyphosis (can happen in marfan’s syndrome)

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19
Q

How should you deal with a patient with head lice?

A
  • dismiss patient
  • vacuum chair
  • fresh headrest cover for every patient
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20
Q

What are the six important facial landmarks?

A
  1. Outer canthus
  2. Inner canthus
  3. Ala
  4. Philtrum
  5. Tragus
  6. Nasion
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21
Q

What are 1-6 called?

A
  1. Outer canthus
  2. Inner canthus
  3. Ala
  4. Philtrum
  5. Tragus
  6. Nasion
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22
Q

What does HEENT stand for in a head and neck exam?

A

Head
Eyes
Ears
Nose
Throat

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23
Q

What is important for head and facial form symmetry?

A

HEENT (head, eyes, ears, nose, throat)

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24
Q

What is a prognathic profile?

A

mandible jets outward (underbite)
- often has a pointy chin

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25
Q

What is a retrognathic profile?

A

mandible is shorter/pulled in more (overbite)
- “no chin”

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26
Q

What are three things you should ask about during a head and neck exam?

A

nosebleeds
congestion
trouble swallowing

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27
Q

During a head and neck exam you should look for (very generally)?

A

LOOK FOR LUMPS IN NECK, HOARSENESS, SCRATCHY THROAT THAT DOESEN’T GET BETTER. PAIN IN NECK, JAW OR EARS

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28
Q

What are some complications with oral cancer?

A

adverse bleeding
side effects of drugs
infection

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29
Q

What are some cancer precautions?

A
  • chemotherapy (immunocompromised)
  • head and neck radiation therapy (xerostomi, mucosal irritation, cervical caries)
  • med consult
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30
Q

What are the locations of skin lesions to watch for?

A

hands, arms, neck, face, ears

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31
Q

What are things to watch out for when considering skin lesions?

A
  • chronic, non healing lesions
  • change in pre-existing lesion
  • sun exposure
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32
Q

What is the most common type of skin cancer?

A

basal cell carcinoma

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33
Q

What are the characteristics of basal call carcinoma?

A
  • middle 2/3 of face
  • won’t heal
  • usually, benign
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34
Q

How many people have basal cell carcinoma every year in the US?

A

more than 3 million cases

35
Q

What are the characteristics of squamous cell carcinoma?

A
  • irregular borders
  • “crusty”surface
  • persistent thick rough scaly patches
36
Q

What percent of oral cancers are squamous cell carcinomas?

A

90%

37
Q

What are the characteristics of melanoma?

A
  • multiple colors
  • irregular borders
  • flat or slightly raised borders
  • somewhat asymmetrical
  • highly infiltrative
38
Q

What are the issues with nodular melanomas?

A

aggressive lesions that have vertical growth

39
Q

What are the parts of the eye?

A

pupil (black)
sclera (white)
iris (colored)

40
Q

What is ptosis?

A

lid lag (can be a sign of past stroke)

41
Q

What is ocular hypertelorism?

A

excess spacing between eyes

42
Q

What is exophthalmos?

A

abnormal protrusion of the eye (could be a sign of hyperthyroidism)

43
Q

What can yellow sclera of the eye be a sign of?

A

hepatotoxicity

44
Q

What are the groups of lymph nodes?

A

cervical
axillary
inguinal
internal (can’t palpate)

45
Q

What are the nine cervical lymph nodes that should be palpated?

A

1 = submental
2 = submandibular
3 = tonsillar/
jugulodigastric
4 = preauricular
5 = postauricular
6 = occipital
7 = ant. cervical chain
8 = supraclavicular
9 = post. cervical chain

46
Q

1

A

submental

47
Q

2

A

submandibular

48
Q

3

A

tonsillar/jugulodigastric

49
Q

4

A

preauricular

50
Q

5

A

postauricular

51
Q

6

A

occipital

52
Q

7

A

anterior cervical chain

53
Q

8

A

supraclavicular

54
Q

9

A

posterior cervical chain

55
Q

What are the characteristics of an infected lymph node?

A

firm, tender, enlarged, and warm (can appear reddened)

56
Q

What are the characteristics of a lymph node with maligancies?

A

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

57
Q

What is the sequence of palpation of the lymph nodes?

A
  • ahead and behind ear
  • slide down under the mandible
  • slide down to SCM (turn head opposite way)
  • slide down to above collarbone
58
Q

What is a more thorough sequence of palpatating lymph nodes?

A
  • ahead of the ear
  • behind ear
  • anterior border of SCM
  • posterior border of SCM
  • anterior and posterior SCM simultaneously
  • floor of mouth
59
Q

What do healthy lymph nodes feel like

A

soft like a grape
moveable

60
Q

You should describe any lymphadenopathy (abnormal lymph node) by…

A

location
size
tenderness
consistency
mobility

61
Q

Where is the most common lymphadenopathy?

A

cervical (head and neck)

62
Q

What are clues that suggest routine swelling from a recent infection?

A

tender
mobile
current or recent viral infection
bilateral (sometimes)
predictable locations
long duration without change

63
Q

What are mumps?

A

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

64
Q

Where is the thyroid located?

A

inferior to the larynx and just superior to the clavicles

65
Q

Can you palpate the thyroid?

A

usually no

66
Q

How should you do a thyroid exam?

A
  • place fingers on either side of Adam’s apple
  • slide down to just below it
  • ask patient to swallow
  • feel gland rise up and then drop back
  • feel for any asymmetry or lumps
67
Q

What are the three lip landmarks?

A
  • philtrum
  • vermillion border
  • commisures (angles/corners)
68
Q

What is angular cheilitis?

A
  • corners of the mouth crack and irritate
  • usually caused by candida
69
Q

What percent of people in the US are affected by TMD?

A

20%

70
Q

What percent of those with TMD are women?

A

85.4%

71
Q

What are the symptoms of TMD?

A

joint pain
headaches
tinnitus
insomnia
neck ache
teeth become sensitive to temp (bruxism)

72
Q

What are the causes of TMD?

A

bruxism
clenching
stress
malocclusion
arthritis
trauma
stimulants

73
Q

What are the three broad diagnostic classes of TMD?

A
  • muscles
  • soft tissue of the joint
  • hard tissues of the joint
74
Q

Where is the referred pain of TMD?

A

temporalis - anterior teeth
masseter - posterior teeth

75
Q

What are the pterygoid muscles?

A

lateral pterygoid
medial pterygoid

76
Q

What are some screening TMJ questions to ask?

A
  • Do you have difficulty, pain or both when opening your mouth wide (yawning, etc)?
  • Does your jaw get “stuck,” “locked,” or “go out”?
  • Do you have difficulty, pain or both when chewing, talking or using your jaws?
  • Are you aware of noises in the jaw joints?
  • Do you have pain in or around the ears, temples, or cheeks?
  • Does your bite feel uncomfortable or unusual?
  • Do you have frequent headaches?
  • Have you had a recent injury to your head, neck, or jaw?
  • Have you previously been treated for a jaw joint problem? If so, when?
77
Q

How to palpate TMJ?

A
  • palpate the bony prominence just anterior to the ear
  • have patient open and close
  • look for altered opening/closing paths, abnormal sounds, tenderness, and limitations in opening
78
Q

What to look for when doing an exam on TMJ?

A
  1. measure range of motion
  2. palpate for crepitus (grinding) and clicking while open/close
  3. palpate for tenderness in the masseter and temporalis muscles
79
Q

What are signs during 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, and dental arches
80
Q

What is the main treatment of TMD?

A
  • night guards/ bruxism splits
    … used to redistribute occlusal forces, relax the masticatory muscles, protect dentition and dental work
81
Q

What are some medication treatments for TMD?

A

anti-inflammatory
anti-anxiety
msucle relaxers
botox

82
Q

What is the more “rare” treatments for TMD?

A

surgery

83
Q

What are some regular everyday treatments for TMD?

A
  • Joint rest and reducing jaw movement; keeping teeth slightly ajar.
  • Soft-food diet
  • Medications to relieve pain and/or relax muscles
  • Hot or cold compresses
  • TMJ physical therapy
  • Wearing of a night guard/splint
84
Q

What things are important during an extraoral exam?

A

gait
accessibility
stature/habitus
headlice
head/facial form (jaw)
cancer
skin lesions
eyes
lymph nodes
thyroid
lips
TMJ

Patient Care II (10 decks)

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