Lecture 8 NMT Flashcards
Nose external parts
Bridge Tip Nares Vestibule Ala Columella
o Bridge – superior part (bone) o Tip – apex, free corner (cartilage) o Nares – openings (nostrils) o Vestibule – wider space inside nares o Ala – outside wings o Columella – divides ala
Nasal Cavity
Nasal septum Olfactory region Turbinates Meatuses Palate
o Nasal septum- divides nasal cavity
o Olfactory region- contains receptors for sense of smell (olfacation) (based on cranial nerve 1)
o Turbinates- bony projections, surface area (superior, middle, inferior) (highly vascular, epitasis = nose bleed) (increase surface area)
o Meatuses- small openings, allow drainage (tears)
o Bony/soft palate- separates oral & nasal cavities
Sinuses
Function
and the four sets
Functions: lighten skull, sound resonation, mucus production
• Only frontal and maxillary are accessible to examination
o Frontal- in frontal bone
o Maxillary- in maxilla
o Ethmoid- between orbits
o Sphenoid- deep within skull
Function of nose
- First part of respiratory system
- Warms, moistens, and filters air (turbinate’s)
- Sense of smell
- Sinuses - lighten skull, sound production and mucus production
Oral cavity
Hard/soft palate
uvula
tongue
teeth
- Formed by the lips, insides of cheeks, the palate, the mandible (only moveable bone in skull & maxilla
- Hard palate- anterior bony roof of mouth
- Soft palate- posterior mobile roof of mouth
- Uvula- free projection at back of throat
- Tongue- a muscle; functions in chewing, swallowing, taste, speech
- Teeth - chewing (mastication) (32 teeth in adults, 20 in children)
Salivary Glands
Parotid
Submandibular
Sublingual
• Parotid high in cheeks, drains near top of mouth
• Submandibular- below mandible, drains under tongue
• Sublingual - below tongue, many openings drain under tongue
o Up to a L of saliva a day
- First part of digestive system (also an airway)
- Formation of speech
- Sense of taste
Pharynx
Oropharynx
Nasopharynx
Laryngopharynx
Throat = Pharynx
• Oropharynx- behind the mouth
o Tonsils- large nodules of lymphoid tissue
Tonsillitis
• Nasopharynx- behind the nose
• Laryngopharynx – Behind the larynx (voice box)
o Epiglottis stop food from going into lungs
Subjective Data
- Discharge- consistency (Colour, is it watery, is it purulent (thick green) is it bloody) and amount
- Frequent colds- How often?
- Sinus pain- Pain scale? Where is the pressure, inflammation?
- Trauma- A blow to the nose? Problems breathing?
- Epistaxis- Nose bleeds? How often? How heavy?
- Allergies- What are you allergic to? Do you take medication? Hay fever? To what? Seasonal?
- Altered smell..?
Mouth and throat subjective
• Sores or lesions- in mouth, on tongue, gums
• Sore throat- how long? How often? Pain scale? Contributing factors?
o Strep throat?
o Tonsils removed?
• Bleeding gums- How heavy? How long? How often? Amount?
• Toothache- Sensitivities?
• Hoarseness- how long?
• Dysphagia- difficulty swallowing?
• Altered taste- change to taste?
• Smoking, alcohol consumption- amount?
o How many cigarettes do you smoke a day?
• Self-care behaviours…? Brushing your teeth? Flossing? Mouth wash? Dentures and denture care? How often do you go to the dentist?
Tonsil inspection:
• There should be no exudate (drainage)
• Tonsils are graded in size as follows:
o 1+: Visible
o 2+: ½ way between tonsillar pillars and uvula
o 3+: touching the uvula
o 4+: touching each other
Don’t use tongue blade on 3/4 can close up more
• Caution if pt is drooling, having difficulty swallowing & stridor (high pitch sound as airway is closing)
Abnormal Finding
• Tonsillitis- tonsil inflammation
• Pharyngitis- pharynx inflammation
o White patches = strep throat
Additional history for infants and children
- Mouth infection; sore throat
* Tooth eruption; care of teeth
Additional history for older adults
- Mouth dryness
- Tooth loss: dentures; care of teeth
- Taste, smell
