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Patient Care 2 > Intraoral Exam > Flashcards

Intraoral Exam Flashcards

1
Q

Most primary medical care providers still not
comfortable performing basic oral health
assessments. Why?

A

Many consider oral health outside their

realm of practice

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2
Q

Look for… (7)

A 
Cancer
•Signs of systemic ds.
•Tissue trauma
•Infections
•Pain
•Esthetic concerns
•Occlusal dysfunction
•Etc
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3
Q

90% of cancer is

A

squamous cell

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4
Q

oral cancer accounts for –% of all cancers

A

3%
•~36,000 cases / yr.
•>8,000 deaths / yr.

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5
Q

Overall, –% have a 5-yr survival rate

A

57

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6
Q

oral cancer men vs women

A

men 2x more than women

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7
Q

–% are found in Stages I or II

•–% survival

A

40

80-90

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8
Q

–% are found in Stages III or IV
•–% survival (3 yrs.)
•–% = recurrence in 2 yrs.

A

60
33
67

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9
Q

Lesion Description (8)

A
  • number
  • size
  • shape
  • color
  • profile
  • base
  • border
  • texture
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10
Q

Risk factors: Oral Cancer (9)

A
  • Tobacco (#1 overall)
  • Alcohol (#2 overall)
  • Viruses: HIV+, HPV
  • Sun exposure
  • Inadequate nutrition
  • Genetic predisposition
  • Chronic inflammation
  • Radiation exposure
  • Carcinogen exposure
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11
Q

prevention of oral cancer (4)

A

~75% could be prevented by eliminating tobacco
and alcohol use
• 35% reduction after 5 years w/o tobacco
• Lip balm w/ sunscreen
• HPV vaccine (avoid HPV exposure)
• Diet rich in fresh fruit and vegetables

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12
Q

High-risk areas for oral cancer (4)

A

floor of mouth
lateral border of tongue
ventral surface of tongue
oropharynx

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13
Q

Signs and symptoms: oral cancer (6)

A
  • nonhealing ulcer
  • bleeding
  • lymphadenopathy
  • hardness
  • paresthesia
  • drooling
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14
Q

Routine Oral Cancer Exam:

Question pt. about risk factors such as (4)

A

Tobacco, alcohol, sunlight, HPV

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15
Q

Routine Oral Cancer Exam:

examine face for (3)

A

discolorations
swellings
asymmetry

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16
Q

Routine Oral Cancer Exam:

palate (3)

A

lymph nodes
lips
labial and buccal mucosa (vestibule, mucobuccal folds, frenums, buccal mucosa)

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17
Q

Routine Oral Cancer Exam:

examine (4)

A
  • Examine and bimanually palpate floor of mouth
  • Examine / palpate tongue (dorsal, ventral, lateral borders, base)
  • Examine hard and soft palate (palpate hard)
  • Examine tonsils and oropharynx
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18
Q

Basic Techniques (2)

A

inspection, eyes

palpation, fingers

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19
Q

Bony hard =

A

torus

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20
Q

Induration =

A

firm but not as hard as

bone (solid rubber ball)

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21
Q

Compressible =

A

pressure alters its shape

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22
Q

Doughy =

A

returns slowly to original shape

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23
Q

Spongy =

A

returns quickly to original shape

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24
Q

Pitting =

A

soft and leaves indentation -edema

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25
Q

Collapsing =

A

contents expressed –usually fluid

like-abscess

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26
Q

Blanching =

A

color change

ex. anesthetic, tissue turns white

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27
Q

Discrete

A

separate, not running together or blending

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28
Q

CONFLUENT

A

Running together, merging, blended.

Originally separate but now formed into one.

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29
Q

Papillary

A

having small bump-like elevations or projections

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30
Q

VERRUCOSE (AKA VERRUCOUS) LESION

A

covered with or full of wart-like growths; cauliflower-like surface.

31
Q

Sessile

A

attached to the surface on a broad base.

•Immobile, fixed, firmly attached

32
Q

Pedunculated lesion

A

elevated lesions having a narrow stem

which acts as a base. Elongated stalk

33
Q

Pedunculated squamous papilloma usually

occur on the (3)

A

soft palate, tonsil, or epiglottis.

•These lesions are sometimes fatal

34
Q

Erythema:

A

red area of variable size and shape

35
Q

erythema is usually in

A

patches

36
Q

PETECHIA(E)

A

round red pinpoint areas of hemorrhage

37
Q

PETECHIA(E) is usually caused by (3)

A

trauma
vital infection
bleeding problems

38
Q

skipped
Saw an increased number of petechiae(e) reports
re: Cutaneous manifestations with COVID.

A

Erosions, ulcerations, petechia, and blood crusts on the

inner surface of lips

39
Q

Macule. (4)

A

Small (<1 cm) circumscribed area of color change
•Brown, black, blue, red
•Not elevated or depressed
•Ex: freckle (=ephelis)

40
Q

Eschar

A

a sloughing (shedding) of epithelium caused by disease, trauma, or chemical burn•i.e., aspirin burn

41
Q

Torus

A

bony elevation or prominence

42
Q

Patch (3)

A
  • Large (>1 cm) circumscribed area of color or texture change (or both)
  • Not elevated or depressed
  • Ex: port wine stain-caused by an abnormal formation of tiny blood vessels in the skin
43
Q

Ulcer (4)

A
  • A denuded area extending below the basal layer
  • Gradual tissue disintegration
  • Usually, painful
  • Ex: aphthous or herpes simplex
44
Q

Crust

A

an outer layer, covering, or scab, from a
coagulation of blood, serum, pus, or any
combination

45
Q

Plaque (3)

A
  • A solid, flat, raised area >1cm.
  • Often keratinized (white)
  • Ex: Snuff dipper’s lesion
46
Q

Papule (4)

A
  • A superficial, elevated, solid lesion <1 cm.
  • Any color
  • Solid base or pedunculated
  • Ex: parulis (“gum boil”)
47
Q

Vesicle (3)

A
  • Small (<1 cm) fluid filled, elevated lesion with a thin surface covering = Small blister
  • Lymph or serum
  • Ex: Herpes simplex (before it bursts)
48
Q

Pustule (3)

A
  • Small (<1 cm.) vesicular-type lesion containing purulent material rather than clear fluid
  • Creamy white or yellow
  • Ex: dental abscess
49
Q

Nodule (3)

A
  • An elevated, deep solid lesion .5 –2.0 cm
  • Overlying mucosa not fixed
  • Ex: fibroma
50
Q

Bulla (4)

A
  • A large vesicle >1 cm = large blister
  • Contains serum
  • Usually at the mucosal –submucosal junction
  • Ex: Pemphigus, 2nd degree burn
51
Q

Sample Intraoral Sequence (8)

A
  • Lips
  • Buccal mucosa
  • Buccal vestibules
  • Tongue
  • Oropharynx
  • Palate
  • Floor of mouth
  • Lymph nodes
52
Q

Lips (4)

A
  • Outside = extraoral
  • evert (inside)
  • palpate
  • lumps, bumps, etc
53
Q

Linea Alba (4)

A
  • white line
  • parallel to occlusal plane
  • Asymptomatic
  • Caused by trauma (ex. chewing cheek)
54
Q

Leukoedema (6)

A
  • More common in African-Americans
  • “milky” white surface or blue-grey
  • Symmetrical
  • Doesn’t rub off
  • Disappears / decreases when stretched
  • normal
55
Q

LICHEN PLANUS (4)

A

•Common inflammatory disease involving the
skin and mucous membranes
•Interlacing white striae (Wickham) with
erythema of the surrounding mucosa.
•usually appearing bilaterally
•Painful erythematous erosions and ulcers may
also occur.

56
Q

LICHEN PLANUS

Interlacing white striae(Wickham) usually appears —

A

bilaterally

57
Q

Fordyce granules (5)

A
  • Sulfur-colored
  • Very common
  • Asymptomatic
  • 1-3mm papules in the oral cavity
  • Or lip vermillion
58
Q

Hard Palate: Anterior palate

•Look for: (4)

A
  • Rugae (normal) = Horizontal ridges
  • Torus palatinus (normal) = Bony lump
  • Ulcerations
  • Lesions
59
Q

Torus Palatinus (2)

A
  • Bony lump(s)

* Asymptomatic

60
Q

Torus Palatinus prevalence

A

20-30% of people

females: males= 2:1

61
Q

treatment of Torus Palatinus

A

no treatment of necessary -unless need dentures, partials, or interferes with speech, chewing, homeware, etc

62
Q

Torus Mandibularis (3)

A
  • Bony lump(s)
  • Asymptomatic
  • More common w/ bruxism?
63
Q

Torus Mandibularis prevalence

A

8-16% of people

•Males = females

64
Q

Torus Mandibularis Treatment

A

No Tx necessary

•Unless need dentures, partials, or interferes with speech, chewing, homecare etc.

65
Q

Soft Palate (3)

A
  • Depress tongue
  • Say “Ah”
  • Look for: Ulcers, Patches, Etc.
66
Q

NICOTINE STOMATITIS (4)

A 
•Lesion of the hard palate.
•Lesion is white, rough, asymptomatic, and leathery 
appearing
•Contains numerous red dots or macules
•Caused by extreme heat in the mouth
67
Q

BENIGN MIGRATORY GLOSSITIS (3)

A

•THE LESIONS OFTEN HEAL IN ONE AREA AND THEN
MOVE (MIGRATE) TO A DIFFERENT PART OF THE TONGUE
•ERYTHEMATOUS, WELL DEMARCATED ARES OF
PAPILLARY ATROPHY
•USUALLY ASYMPTOMATIC BUT CAN CAUSE
DISCOMFORT, PAIN OR BURNING SENSATION IN
SOME CASES, OFTEN RELATED TO EATING SPICY OR
ACIDIC FOODS

68
Q

BENIGN MIGRATORY GLOSSITIS is also called

A

geographic tongue

69
Q

Leukoplakia

A

White or grayish thick keratotic patch-like lesion on the mucosa which cannot be rubbed off

70
Q

Hairy Leukoplakia is caused by

A

Epstein-Barr virus and is usually associated HIV infection or other immunosuppressive conditions

71
Q

Hairy Leukoplakia typically occurs on the

A

lateral border of the tongue

72
Q

Hairy Leukoplakia is either

A

unilateral or bilateral

73
Q

Hairy Leukoplakia looks like

A

white rough patches

Patient Care 2 (15 decks)

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