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patient care > intraoral exam > Flashcards

intraoral exam Flashcards

1
Q

what are you looking for with intraoral exams

A

cancer
signs of systemic ds
tissue trauma
infections
pain
esthetic concerns
occlusal dysfunction

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1
Q

we continue to see an increase of oral cancer diagnoses in patients under the age of:
with no known risk factor.
what is included in this age group which is a significant increase in cancer of the tongue

A

40
HPV 16

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2
Q

current research implicates the what as the underlying cause of as many as 72% of oropharngeal squamous cell carcinomas with a predominate increase seen in YOUNGER:

A

HPV- human papillomavirus
younger white men

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3
Q

biopsy involving the removal of part or all of suspicious area of tissue and microscopic evaluation by a pathologist to determine its histological makeup is the ______ ______ for determining a definitive diagnosis

A

gold standard

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4
Q

what percent of misdiagnosis of oral lesions by dental practitioners when they based their diagnosis on clinic observations alone

A

43%

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5
Q

Oral cancer is 90%:

A

squamous cells

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6
Q

what percent is oral cancer of all cancers?

A

3%

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7
Q

overall, what percent have a 5-year survival rate

A

57%

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8
Q

oral cancer affects (men/women) 2x more

A

men

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9
Q

what percent of oral cancer are found in stages I or II?

what is the % survival rate?

A

40%
80-90% survival rate

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10
Q

what percent of oral cancers are found in stage III or IV?

what is the 3 year survival rate?
what is the % recurrence in 2 years?

A

60%
33% survival (3 yrs)
67% recurrence in 2 years

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11
Q

list lesion descriptions

A

number
size
shape
color
profile
base
border
texture

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12
Q

list the risks for oral cancer.
what are the top 2 overall risks?

A

top 2:
tobacco #1
alcohol #2
viruses: HPV and HIV
sun exposure
inadequate nutrition
genetic predisposition
chronic inflammation
radiation exposure
carcinogen exposure

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13
Q

75% of oral cancer can be prevented by

A

eliminating tobacco and alcohol use

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14
Q

what percent of reduction after 5 years w/o tobacco?

A

35%

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15
Q

list the prevention of oral cancers:

A

eliminating tobacco and alc use
lip balm with sunscreen
HPV vaccine (avoid exposure too)
diet rich in fresh fruit and vegetables

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16
Q

what are the 4 high risk areas for oral cancer?

A
  1. floor of mouth
  2. lateral border of tongue
  3. ventral surface of tongue
  4. oropharynx
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17
Q

individuals have large crypts in the tonsils that collect food debris, bacteria, and hardened material (tonsil stones). these patients often complain of:
also what is this

A

tonsillar crypt
complain of bad breath aka halitosis

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18
Q

what must you do after a tonsilllectomy

A

one may observe residual tonsil tissue or a regrowth of lymph tissue

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19
Q

what is a bifid uvula an indication for?
what can this cause

A

indication of submucous clef palate
can cause speech and swallowing difficulties

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20
Q

signs and symptoms with oral cancer:

A

nonhealing ulcer
bleeding
lymphadenopath
hardness
parasthesia
drooling

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21
Q

routine oral cancer exam:

A
  1. questions about risk factors (tobacco, alcohol, sunlight, HPV)
  2. examine face
    (discolorations, swellings, asymmetry)
  3. palpate lymph nodes
  4. palpate lips
  5. palpate labial and buccal mucosa
    (vestibule, mucobuccal folds, frenums, buccal mucosa)
  6. examine/palpate tongue
    (dorsal, ventral, lateral borders, base)
  7. hard and soft palate (palpate hard)
  8. examine tonsils and oropharynx
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22
Q

what risk factor questions do you ask with oral cancer exam

A

tobacco, alc, sunlight, HPV

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23
Q

when examining face, what are you looking for

A

discolorations, swellings, asymmetry

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24
Q

what do you palpate with the labial and buccal mucosa?

A

vestibule, mucobuccal folds, frenums, buccal mucosa

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25
Q

what do you examine on the tongue

A

dorsal, ventral, lateral borders, base

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26
Q

palpation terminology.

bony hard=

A

torus

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27
Q

palpation terminology.

induration=

A

firm but not as hard as bone (solid rubber ball)

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28
Q

palpation terminology.

commpressible=

A

pressure alters its shape

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29
Q

palpation terminology.

doughy

A

returns slowly to original shape

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30
Q

palpation terminology.

spongy=

A

returns quickly to original shape

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31
Q

palpation terminology.

pitting=

A

soft and leaves indentation aka edema

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32
Q

collapsing=

A

contents expressed
-usually fluid like abscess

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33
Q

palpation terminology.

blanching=

A

color change

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34
Q

separate, not running together or blending

A

discrete

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35
Q

running together, merging, blended.
originally separate but now formed into one

A

confluent

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36
Q

having small bump-like elevations or projections

A

papillary

37
Q

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

A

verrucose (aka verrucous) lesion

38
Q

attached to the surface on a broad base.
immobile, fixed, firmly attached.
lacks a stalk

A

sessile

39
Q

elevated lesions having a narrow stem which acts as a base.
elongated stalk

these are sometime fatal!

A

pedunculated lesion

40
Q

red area of variable size and shape

usually in patches

A

erythema

41
Q

round red pinpoint areas of hemorrhage

A

petechiae

42
Q

what is petechiae usually caused by

A

trauma, viral infection or bleeding problems

43
Q

small (<1cm) circumscribed area of color change
brown, black blue, red
not elevated or depressed
ex. freckle (ephelis)

A

macule

44
Q

sloughing (shedding) of epithelium caused by disease, trauma, or chemical burn
ex. aspirin burn

A

eschar

45
Q

bony elevation or prominence

A

torus

46
Q

Large (>1 cm) circumscribed area
of color or texture change (or both)

not elevated or depressed
ex. portwine stain-caused by abnormal formation of tiny blood vessels in the skin

A

vascular birthmark???

47
Q

denuded area extending below the basal layer

-gradual tissue disintegration
usually painful
ex. herpes simplex

A

ulcer

48
Q

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

A

crust
(outer covering)

49
Q

solid, flat area >1cm

often keratinized (white)
ex. snuff dipper’s lesion

A

plaque

50
Q

superficial elevated, SOLID lesion <1cm
any color
solid base or pedunculated

Ex. parulis (gum boil)

A

papule

51
Q

small <1cm FLUID FILLED elevated lesion with a thin surface covering
=small blister

lymph or serum

ex. herpes simplex (before it bursts)

A

vesicle
(“cold sore”)

52
Q

small <1cm vesicular-type lesion
-containing purulent material rather than clear fluid
cream white or yellow
ex. dental abcess

A

pustule

53
Q

elevated, deep SOLID LESION
.5-2.0 cm
-overlying mucosa not fixed

ex. fibroma

A

nodule

54
Q

classified as tumor because this lesion is
persistent and progressively increases in size

A

irritation fibroma

55
Q

large vessicle >1cm
=large blister

contains serum

usually at the mucosal -submucosal junction
ex. pemphigus, 2nd degree burn

A

bulla

56
Q

where are bulla’s usually

A

submucosal junction
at mucosal

57
Q

sample intraoral sequence

A

lips
buccal mucosa
buccal vestibules
tongue
oropharynx
palate
floor of mouth
lymph nodes

58
Q

lips.
outside=
evert=
how to check lips?

A

outside=extraoral
evert=inside
palpate and feel/look for bumps/lumps

59
Q

-white line
-parallel to occlusal plane
-asymptomatic
-atypical
-caused by trauma
-chewing cheek

A

linea alba

60
Q

“milky” white surface or blue-grey
-symmetrical
-atypical

A

leukoedema

61
Q

leukoedema (does/doesn’t) rub off

A

doesnt

62
Q

who is leukoedema most common in?

A

african americans

63
Q

how does leukoedema disappear/decrease

A

when stretched normal

64
Q

common inflammatory disease involving the skin and mucous membranes
-involving white straie (wichkam) with erythema of the surrounding mucosa
-appears bilateral
-painful erythematous erosions may also occur

A

lichen planus

65
Q

does lichen planus affect men or women more?

A

equally but more common in women

66
Q

how does lichen planus appear as

A

purplish, itchy, flat bumps
and bilateral

67
Q

-sulfur-colored
very common
-asymptomatic
atypical
(multicolored)

A

fordyce granules

68
Q

how large or fordyce granules and where

A

1-3mm papules in the oral cavity or lip vermillion

69
Q

most often affects the hard and soft palate, gingiva, and dorsal tongue with plaques or tumors of coloration ranging from non-pigmented to brownish-red or violaceou
-such as buccal vestibule
sarcoma flate or slightly elevated

A

kaposi’s sarcoma-flat or slightly elevated

70
Q

what to look for with hard palate:

A

anterior palate look for:
rugae (normal)= horizontal lines
torus palatinus (normal)= bony lump
ulcerations
lesions

71
Q

bony lump(s)
asymptomatic
atypical
20-30% of peeps
no treatment necessary unless what?

A

torus palatinus
unless need dentures, partials or interferes with speech, chewing, homecare etc

72
Q

what is the ratio of female to male with torus palatinus

A

2:1

73
Q

bony lumps
asymptomatic
atypical
8-16%
no treatment needed unless need dentures, partials or interferes with speech, chewing, homecare

A

torus mandibularis

74
Q

what is the ratio male to female with torus mandibularis?
what is this most common with?

A

male-female
more common with bruxism

75
Q

depress tongue and say AH when checking

A

soft palate

76
Q

what to look for with soft palate

A

ulcers
patches
etc

77
Q

lesion of the hard palate.
white, rough, asymptomatic and leathery appearing

A

nicotine stomatitis

78
Q

contains numerous red dots or macules
caused by extreme heat in the mouth

A

nicotine stomatitis

79
Q

where is the most common place for cancer to occur?

A

lateral border of tongue and base of tongue

80
Q

examine tongue using both

A

indirect and direct vision

81
Q

atypical findings on the dorsal surface of the tongue are

A

common fissuring, scalloping, enlarged papilla and benign migratory glossitis

82
Q

these lesions often heal in one area and then move (migrate) to a different part of the tongue

A

benign migratory glossitis

83
Q

also called geographic tongue

A

benign migratory glossitis

84
Q

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

A

benign migratory glossitis

85
Q

white or grayish thick keratotic patch-like lesion on the mucosa which CANT be rubbed off

A

leukoplakia

86
Q

leukoplakia (can/cant) be rubbed off

A

cant

87
Q

caused by the epstein-Barr virus and is usually associated with HIV infection or other immunosuppressive conditions

A

hairy leukoplakia

88
Q

typically occurs on the lateral border of the tongue
either unilateral or bilateral
white rough patches

A

hairy leukoplakia

89
Q

trapped debris, bacteria, fungus, coffee, tobacco, antibiotics and other drugs can cause

A

hairy tongue

90
Q

drains saliva from submandibular and sublingual glands. accounts for 60% OF SALIVA
(why patient’s have so much plaque on lower ant mandibulars)

A

wharton’s ducts also called submandibular duct

91
Q
A

patient care (5 decks)

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