Mouth, Throat and Neck Exam

Question 1

Introduction

Answer 1

Clean hands
Introduction
Check name and DOB/age
Explanation and gain consent

Question 2

Position

Answer 2

Patient sitting
Glass of water nearby
Neck exposed to clavicles
Remove any jewelry

Question 3

Inspection

Answer 3

Lips - colour, angular stomatitis, lesions
Inside mouth - dentition, check tongue dryness, wasting, fasciculations, parotid duct opening, tonsils, uvula, oropharynx (say “ah”) underside of tongue
Bite
Neck - scars, swellings, lumps, movement with tongue protrusion and swallowing

Question 4

Palpation

Answer 4

Tracheal position (from front)
Lymph nodes (from behind, in Z pattern)
Gloves on - floor of mouth, inside cheeks, salivary glands, substance of tongue (feeling for cystic swellings, rough areas, stones in parotid duct)

Question 5

Auscultation

Answer 5

Carotid artery - stenosis

Thyroid if enlarged - bruit in Graves’

Question 6

‘Z’ nodes

Answer 6

I - submental, submandibular
II - upper deep cervical
III - mid deep cervical
IV - lower deep cervical 
V - posterior triangle
VI - pretracheal nodes