Inta/extra Oral Examination

Question 1

What should you be observing as a patient walks through the door?

Answer 1

Mobility. 
Mental state, e.g. depressed.
Anxiety levels. 
Breathlessness 
Pain
Nutritional state, e.g. can they fit in the chair. 

Hand shake important too: Trembling, warm/cold.

Question 2

When the patient sits in the chair what are you now assessing whilst communicating?

Answer 2

Facial symmetry, flushing, swelling.

Colour of skin: jaundice, pallor.

Eyes: Sclera/Colour, dilation of the pupils, exophthalmos.

Mouth-breathing.

Position of the mandible.

Question 3

Describe the steps taken to carry out an extra-oral examination.

Answer 3

Assess face for symmetry.

Standing behind the patient:

Place 2 fingers bilaterally onto the TMJ and ask the patient to open and close slowly. Asses for clicking/ask about pain.

Ask the patient to clench their jaw and feel the masseter and the temporalis muscles.

Palpate the parotid gland and then the submandibular in parallel .

Palpate under the chin, under the mandible, behind the ears/in front and down the neck for abnormalities with the lymph nodes.

Question 4

What should also be assessed on the face?

Answer 4

The face should also be assessed for lumps, moles and cysts.

Question 5

Name the 3 types of tumours found on the face.

Answer 5

Basal cell carcinoma: Raised borders.
Squamous cell carcinoma: Ulcerated.
Malignant melanoma: Pigmented lesion.

Question 6

In an intra-oral examination; whats sites should be assessed systematically?

Answer 6

Lips
Labial mucosa
Buccal mucosa 
Salivary gland papillae.
Hard palate 
Dorsal surface of the tongue.
Ventral side of the tongue/ floor of the mouth. 
Sides of the tongue. 
Oropharynx and the fauceal

Question 7

What salivary gland papillae should be assessed? How would you do this?

Answer 7

Wharton’s duct on the floor of the mouth.

Stensen’s duct next to the upper second molar.

Run finger along the duct extra and intra orally.

Question 8

What can be found on the buccal mucosa?

Answer 8

Linea alba: Found at the biting plane.

Question 9

How should the labial mucosa be palpated?

Answer 9

Bimanually.

Question 10

What is required to carry out an intra-oral examination?

Answer 10

Chair lying flat.
2 mirrors.
Gauze to hold the tongue.