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Patient Care 2 > Intraoral Exam Part 2 > Flashcards

Intraoral Exam Part 2 Flashcards

1
Q

hairy tongue

A 
trapped debris including 
bacteria
fungus
coffee 
tobacco
antibiotics and other drugs can cause
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2
Q

Floor of the mouth: visual (4)

A
  • Tongue to palate
  • Lumps, bumps, swellings
  • Mandibular tori
  • Submandibular duct
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3
Q

Submandibular duct is also called

A

Wharton’s duct

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4
Q

Wharton’s duct

A

Drains saliva from the submandibular and sublingual glands

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5
Q

Wharton’s duct accounts for –% of saliva

A

60

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6
Q

what is found of the ventral surface of the tongue?

A

lingual varicosities

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7
Q

lingual varicosities are normal with

A

age

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8
Q

Floor of the mouth palpation (4)

A
  • Have pt lift tongue up
  • One finger under one side of tongue
  • Have pt close down ½ way
  • One finger of other hand goes under chin
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9
Q

Floor of the mouth palpation (3)

A
  • Gently press two fingers together
  • “Walk” fingers to posterior
  • “Walk” external finger farther
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10
Q

Xerostomia is a side effect of

A

numerous over-the-counter and prescription medications

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11
Q

Xerostomia can be a symptom or a sign of a

A

systemic disorder or disease

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12
Q

Xerostomia can be a response to —, or a manifestation of —

A

physical climate

an emotional response

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13
Q

who is at a greater risk of Xerostomia?

A

Elderly patients are at greater risk for developing a dry mouth
condition, the problem is not limited to any specific age group

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14
Q

xerostomia significantly increases the risk of (4)

A

caries,
erosion,
dentinal hypersensitivity,
and candidiasis

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15
Q

most cases of xerostomia are

A

chronic

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16
Q

Xerostomia: Med History includes (5)

A
  • Diabetes
  • Hormone changes (Menopause, Pregnancy)
  • Depression, anxiety-medications
  • Radiation for head & neck cancer
  • Autoimmune ds.(Sjogren’s syndrome)
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17
Q

Xerostomia: subjective eval. questions (6)

A
  • Do you have difficulty swallowing?
  • Does your mouth feel dry when eating?
  • Do you sip liquids to help swallowing?
  • Do you have any oral burning or soreness?
  • Do you often have bad breath?
  • Do you eat crushed ice or drink fluids to keep your mouth moist?
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18
Q

Xerostomia: clinical assessment (3)

A
  • Reddened, pebbled surface of tongue
  • Dry and cracked corners of the mouth
  • Red, glossy, parched mucosal tissues
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19
Q

xerostomia test (2)

A
  • Mirror “stick” test: place mirror against the buccal mucosa and tongue
  • Saliva pooling: check for saliva collection in the floor of the mouth.
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20
Q

Evaluate flow & consistency for xerostomia (3)

A
  • tissues well moistened?
  • Sore mucosa
  • Burning sensation in the mouth
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21
Q

Xerostomia symptoms (6)

A
  • Candidiasis
  • Angular chelitis
  • Burning tongue
  • Root & Cervical caries
  • Stomatitis
  • Dysphagia
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22
Q

Stomatitis-

A

inflammation of the mucous membranes of the mouth

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23
Q

what does candidiasis look like? (3)

A
  • White plaque
  • Creamy white lesions
  • Looks like hyperkeratosis, but rubs off
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24
Q

where does candidiasis affect? (2)

A

buccal mucosa

lateral boarders of the tongue

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25
Q

Candidiasis (“Thrush”)

•Can spread to (3)

A
  • Tongue
  • Hard and soft palate
  • Tonsillar region
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26
Q

Candidiasis risk factors (12)

A
  • Immunocompromised
  • Pregnancy
  • Poor oral hygiene
  • Smoking
  • Stress
  • Depression
  • Birth control pills
  • Long term AB
  • Diabetes
  • Dentures that don’t fit
  • Xerostomia
  • Iron, B12 deficiency
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27
Q

most common Candidiasis

A

Acute Pseudomembranous Candidiasis

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28
Q

Acute Pseudomembranous Candidiasis affects the (3)

A

tongue
buccal mucosa
floor

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29
Q

Acute Pseudomembranous Candidiasis looks like (2)

A

creamy white patches

easily wiped off leaving an erythematous base

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30
Q

Acute Pseudomembranous Candidiasis: pain with

A

spicy, acidic foods

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31
Q

Acute Pseudomembranous Candidiasis: difficulty

A

swelling (dysphagia)

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32
Q

Acute Pseudomembranous Candidiasis physically looks like (3)

A
  • White plaque
  • Looks like hyperkeratosis, but rubs off
  • Inside the corners, buccal mucosa, lateral tongue
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33
Q

Atrophic Candidiasis (3)

A
  • Under dentures- usually ill-fitting or dentures are never taken out of mouth.
  • Red on palate or tongue
  • Burn w/ spicy foods & alcohol
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34
Q

Candidiasis treatment (6)

A
  • Oral hygiene
  • Yogurt, acidophilus
  • Avoid alcohol, simple sugars
  • Medications-antifungal
  • Nystatin
  • rinse and tablets
  • Ketaconozole
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35
Q

Ketaconozole –can cause

A

severe liver damage

36
Q

PRIMARY HERPES GINGIVOSTOMATITIS IS SEEN MAINLY IN — AND IS CAUSED BY — IN MOST CASES

A

CHILDREN

HS1

37
Q

HERPES SIMPLEX SEVERE PRIMARY INFECTIONS HAVE ORAL LESIONS ACCOMPANIED BY (4)

A

HIGH FEVER, MALAISE, CERVICAL LYMPHADENOPATHY AND DEHYDRATION

38
Q

HERPES SIMPLEX: LESS COMMONLY, PRIMARY INFECTION OCCURS IN THE —; IN SUCH CASES INFECTIONS MAY BE FROM EITHER (2)

A

YOUNG ADULT

HSV1 OR HSV2

39
Q

HERPES GINGIVOSTOMATITIS (2)

A

VESICLES DEVELOP IN THE ORAL CAVITY, INCLUDING THE PHARYNX, PALATE, BUCCAL MUCOSA, LIPS, AND/OR TONGUE.

THE VESICLES RAPIDLY BREAK DOWN INTO SMALL ULCERS AND ARE COVERED WITH AN EXUDATE

40
Q

HERPES GINGIVOSTOMATITIS LESIONS MAY EXTEND TO INVOLVE THE (2)

A

LIPS AND BUCCAL MUCOSA

41
Q

HERPES GINGIVOSTOMATITIS: THE LESIONS GENERALLLY RESOLVE WITHOUT THERAPY IN

A

TWO WEEKS

42
Q

HSV-

A

DOES NOT SURVIVE LONG IN THE EXTERNAL ENVIROMENT & ALMOST ALL PRIMARY INFECTIONS OCCUR FROM CONTACT WITH AN INFECTED PERSON WHO IS RELEASING THE VIRUS.

43
Q

Herpes Simplex-fever blisters, cold sores:

affects

A

50% of the population

44
Q

Herpes Simplex-fever blisters, cold sores:

age

A

starts <10, from adults

45
Q

Herpes Simplex-fever blisters, cold sores: is …

A

contagious (kissing,etc)

46
Q

Herpes Simplex-fever blisters, cold sores:

type 1

A

mouth, lips, face

47
Q

Herpes Simplex-fever blisters, cold sores:

type 2

A

genital

48
Q

Herpes Simplex-fever blisters, cold sores:

where are they found

A

outer lips and attached gingiva

49
Q

Herpes Simplex symptoms (4)

A
  • Prodromal signs-tingling, itching, pain, burning. Arise 6-24 hours before lesions develop.
  • multiple fluid-filled blisters
  • merge and collapse
  • yellowish crust
50
Q

healing time for Herpes Simplex

A

2 weeks

51
Q

Herpes Simples is a — that is dormant in — cells

A

virus

nerve cells

52
Q

Herpes Simples recurs with

A

immune weakness (stress, fever, illness, injury, sunburn)

53
Q

HERPETIC WHITLOW (3)

A

INFECTIONS OF THE THUMBS OR FINGERS.
•GROUPED, FLUID OR PUS FILLED.
•USUALLY, ITCH AND /OR PAINFUL

54
Q

In the past. Primary herpetic gingivostomatitis was treated
symptomatically; however, if the infection is diagnosed early,
— medications can have a significant influence

A

antiviral

55
Q

Acyclovir suspension-

A

initiated during the first 3 symptomatic days
in a rinse-and-swallow techniques 5x/day for 5 days. Significant
acceleration in clinical resolution is seen.

56
Q

treatment is complete when

A

development of new lesions ceases

57
Q

Recurrent herpes labialis is best treated in the — phase.

A

prodrome

58
Q

what decreases the number of vesicles?

A

Acyclovir ointment /cream

But clinically minimal reduction in healing time and pain.

59
Q

treatment can include (3)

A

Systemic acyclovir, valacyclovir, and famciclovir

60
Q

For patients, whose recurrences appear to be associated with dental procedures, a regimen of

A

2 g of valacyclovir taken 2x on the day of procedure and 1 g taken 2x the following day

61
Q

In immunocompromised patients, the viral load tends to be high, and replication is

A

not suppressed completely by antiviral therapy

62
Q

Aphthous Ulcers (“Canker Sores”) (6)

A 
•60% of U.S. pop.
•starts around 10-20 yrs. old
•frequency varies
•prodromal tingling or burning sensation-usually 1-2 days before the ulcer appears
•3 days pain, 7 days healed
•If mild disease-treatment is topical 
corticosteroids.
63
Q

Aphthous Lesions:

Although no single triggering agent is responsible, the mucosal destruction appears to represent a

A

T-cell mediated immunologic reaction

64
Q

Aphthous Lesions:
Tends to occur along family lines. When both parents have a history of aphthous ulcers, there is a –% chance that their children will develop the lesions.

A

90

65
Q

Aphthous Lesions:

3 clinical variations

A

Minor, Major, Herpetiform

66
Q

MINOR APHTHOUS ULCERATIONS:

Patients experience fewest — and — duration

A

recurrences

shortest

67
Q

MINOR APHTHOUS ULCERATIONS:
Ulcers arise almost exclusively on — — and may be preceded by an erythematous macule in association with prodromal symptoms of burning, itching, or stinging.

A

nonkeratinized mucosa

68
Q

MINOR APHTHOUS ULCERATIONS:

The ulcerations measure between —m in diameter, oval, and heal without scatting in —

A

3-10m

7-14 days

69
Q

MINOR APHTHOUS ULCERATIONS:

Usually, — lesions and the pain is often out of proportion for the size of the ulceration.

A

1-5

70
Q

MINOR APHTHOUS ULCERATIONS:

what is affect most frequently?

A

Buccal and labial mucosa are affected most frequently followed by the ventral surface of the tongue

71
Q

MINOR APHTHOUS ULCERATIONS:

recurrence rate

A

highly variable,

ranging from one ulceration every few years to two episodes per month.

72
Q

which has the longest duration per episode?

A

MAJOR APHTHOUS ULCERATIONS

73
Q

MAJOR APHTHOUS ULCERATIONS:

size

A

Ulcerations are deeper and can take 2-6 weeks to heal

74
Q

MAJOR APHTHOUS ULCERATIONS

may cause

A

scarring

75
Q

MAJOR APHTHOUS ULCERATIONS

lesions

A

vary from 1-10

76
Q

MAJOR APHTHOUS ULCERATIONS

onset

A

after puberty

77
Q

Greatest number of lesions and most frequent recurrence:

A

HERPETIFORM APHTHOUS ULCERATIONS

78
Q

HERPETIFORM APHTHOUS ULCERATIONS

size

A

small 1-3mm with as many as 100 ulcers present in a single recurrence.
• Because of their small size and large number, the lesions bear a superficial resemblance to a primary HSV infection

79
Q

HERPETIFORM APHTHOUS ULCERATIONS:

Common for individual lesions to coalesce into

A

larger irregular ulcerations

80
Q

HERPETIFORM APHTHOUS ULCERATIONS:

Heal within – days, but the recurrences tend to be closely spaced

A

7-10

81
Q

HERPETIFORM APHTHOUS ULCERATIONS:

Many patients are affected almost constantly for periods as long as

A

3 years

82
Q

HERPETIFORM APHTHOUS ULCERATIONS

what is involved?

A

any oral mucosa

83
Q

HERPETIFORM APHTHOUS ULCERATIONS
predominance
onset

A

female

adulthood

84
Q

Canker Sores (aphthous ulcers)
▪Minor:
▪Major:
▪Herpetiform:

A

Minor:
▪<1 cm and shallow

Major:
▪> 1 cm and deeper
▪May scar when heal

Herpetiform:
▪more numerous and vesicular

85
Q

aphthous ulcers treatment
•Symptomatic (2)
•Local anti-inflammatory: (1)
•Sealing agent (1)

A
  • Viscous benzocaine
  • Orajel, Anbesol
  • Kenalog in Orabase Paste 2-4x / day
  • Ameseal, etc.
86
Q

only FDA approved tx for canker sores (aphthous ulcers)

A

aphthasol

87
Q

aphthasol (3)

A
  • Paste = barrier
  • Apply 2-4x / day
  • Must start early (prodromal stage)

Patient Care 2 (15 decks)

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