Midterm I: Head & Neck Anatomy Flashcards
what are the 4 steps to the ODTP process
- history gathering and assessment (CC, medical, dental, social, vital signs, etc.), CLINICAL EXAM OF HEAD AND NECK REGIONS: EOE- extraoral exam, and IOE (intraoral exam) includes oral cancer screening exam
- also lab tests/radiographs - Soft Tissue assessment (periodontal disease status)- diagnosis, etiology, prognosis
- hard tissue assessment (caries and occlusal disease status)-diagnosis, etiology, prognosis
- Treatment planning- ideal treatment plan and options/alternatives
what are the (skeletal) reference points for the extraoral exam?
forehead; frontal eminence, superciliary arches, glabella, nasion
- orbit
- zygomatic (malar) eminences
- maxilla: pririform aperture, alveolar process, zygomatic process
- ramus: condyle/neck, coronoid provess, mandibular notch, coronoid notch
- angle of mandible (gonial angle)
- alveolar process
- inferior border , antigonal notch
what is sclera, iris
sclera-the white part of the eye, iris= color part (brown eyes, blue eyes, that part only)
what is cilia in reference to the face
eye lashes
what are the upper and lower eyelids called
super and inferior palpebra
what is canthus
medial and lateral palpebral commissures (where eyelids meet, corners of eye on both sides)
what is the word for eyeball
bulbar
what is conjunctiva
bulbar (eyeball) and palpebral (eyelid) mucosa
-conjunctival sac is when you reflect eyelids, sac
what is the gland for tear fluid
lacrimal gland- in superior lateral area of orbit
whats another word for auricle
(external ear) also pinna
what is the depression in the line above the upper lip
philtrum
which lymph nodes should you check in a head and neck exam
- parotid (preauricular, buccal)
- mastoid (post auricular)
- submandibular/submental
- sternocleidomastoid muscle- anterior border, deep and superficial
- supraclavicular
what are the 8 major anatomical areas intraoral
- labia
- buccal mucosa
- gingiva
- vestibules
- Palates (roof of mouth)
- Pharynx (throat)
- Tongue (lingua)
- Sublingual (floor of mouth)
what are normal “abnormalities” of buccal mucosa
fordyce granules (yellow bumps - sebaceous glands) in posterior cheek region linea alba: white line on buccal mucosa, from occlusion (biting cheeks?)
what is the dip area behind last molar
retromolar pad (only mandibular) soft tissue
what is the line along the palate?
palatine raphe
what are the folds on the palate called?
palatal rugae
what is the ridge behind the last molars on the maxilla
maxillary tuberosity
what is the deepening behind the maxillary tuberosity?
hamular notch
what is the purpose of head and neck exam
- to examine visually and manually (feel) soft tissues of head and neck extra and intraoral
- to identify/characterize and document all areas of normality /pathology
- to make decisions about patient case based on the findings
what is the name of the exam we do for head and neck
head and neck exam (head and neck “soft tissue” exam)- which includes oral cancer exam or oral cancer screening exam
when should you do head and neck exam
while asking about health history
how has oral cancer survival changed and why? how common is metastasization? what is the survival if it is still localized?
from 50 to 57%, but due to an increase of hpv-16 caused oral cancer, which ahs a better survival rate. over 60% have already metastasized when detected
greater than 80% survival if localized. if cervical lymph nnodes are involved it drops
what are oral cancer risk factors
- age
- use of tobaco
- heavy alcohol use
- immunosuppression
- radiation therapy (second primary cancers)
- iron deficiency anemia (plummer vinson syndrome)
- diets low in fruits and veggies
- candida (fungus)
- hPV 16
- 27% of cases do not have risk factors
whats the basic armamentarium for head and neck exam
-advanced?
- light source
- mirror
- periodontal probe
- gauze
- air/water syringe
advanced: -radiographs -diascopy -dyes and optic illuminators -biopsy kit/cytology -stethescope (others for ent slide 47
what is diascopy
clear glass or anasthetic cartirage used to examine vascular lesions. compress lesion and look for blanching- loss of red/putple color
-intravascular lesions blanch (change color) extravascular lesions dont
what are macules/plaques
types of pigmented lesions
macules are small and flat, plaques are large and raised
what is the sequence of intraoral ex
- upper and lower lips and labial mucosa/gingiva
- right and left buccal mucosa and gingiva (parotid salivary flow)
- hard and soft palate areas and palatal gingiva
- oropharynx and tonsillar areas
- tongue; dorsal,lateral and ventral surfaces
- floor of mouth and lingual vestibule and gingiva (submandibular salivary flow
extraoral sequence
- visual inspection of hair/scalp and all H&N, skin
- inspection of external eyes, ears, nose and lips
- palpation of auricular, parotid, submandibular, submental, mid-line neck, lateral neck and supraclavicular areas
- salivary gland and lymph node eval
- evaluation of tmj
what always must be examined
lips labial and buccal mucosa palates and oral pharynx -tongue of floor of mouth -skin of face and neck -parotid regions and glands -regional lymph nodes of neck and face
whats are teh steps of head and neck exam
intraoral:
1.
visual exam and bidigital palpation of perioral region. vermillion part of lips, commisure of lips, palpate lips/labial mucosa. palpate labial gingiva
2.examine buccal mucosa. bidigital palpation. (milking parotid gland-dry, compress against ramus, observe for flow of saliva- if issue w patient saliva flow)
3. palpate and inspect hard palate visually
4. visually inspect soft palate and oropharynx
5. visually inspect then palpate tongue (grab, 1 side then the other)
6. palpate and visually inspect floor of mouth
extraoral:
7. visual inspection of face, ears, head and neck
8.palpate face and neck
(parotid-pre and post auricular areas, buccal and labial skin, temperomandibular joints, temples, submandibular and submental, anterior and posterior triangles of neck)
whats another term for pharyngeal tonsels and where is it
adenoids,its up above at the posterior of throat area, near concha, not visible i think
whats leukoplakia
premalignant white lesion-biopsy needed
how long should you wait to see if a lesion heals after a biopsy?
14 days
