Nose, mouth and throat

Question 1

How would we inspect the external nose?

Answer 1

inspect for any deformity, asymmetry,
inflammation or skin lesions

Question 2

how would we inspect the nasal cavity?

Answer 2

ask the person to tilt their head back shine a penlight into the nose, inspect nasal mucosa noting normal red color and smooth moist surface
- note any swelling, discharge, bleeding or foreign bodies

Question 3

how would we inspect the nasal septum?

Answer 3

using the penlight with the person’s head back, look at the nasal septum for no deviations, no bleeding if there is note, and go into questions

Question 4

how would we inspect the nasal turbinates ?

Answer 4

using the penlight with the person’s head back, look at nasal turbinates, should be a nice red color as the nasal mucosa. Look for any swelling, polyps, benign growths

Question 5

How would we palpate the sinus areas?

Answer 5

using our thumbs, press the frontal sinuses upward under the eyebrows and over the maxillary sinuses under cheekbones

Question 6

How would we inspect the mouth?

Answer 6

using a tongue blade start with anterior structures and move posteriorly retracting structures

Question 7

what do we look for when inspecting the mouth?

Answer 7

-inspect lips for color, moisture, lesions
(retract lips and note the inner
surface)

Question 8

inspection of teeth

Answer 8

*note any diseased, absent,loose or abnormal teeth
*compare # of teeth with # expected with persons age

Question 9

inspection of gums

Answer 9

• gums are well intact
• check for swelling, retraction , spongy, bleeding gums

Question 10

inspection of the tongue

Answer 10

• check tongue for color, surface characteristics, and moisture
• ask person to touch the tongue at the roof of mouth (the ventral surface should look smooth, glisten, and should show veins)
• have a gauze pad and hold tongue swinging it left and right - look for any white patches or lesions

Question 11

inspection of the palate

Answer 11

• anterior palate should be white with rugae
• posterior palate should be pink and smooth

Question 12

inspection of uvula

Answer 12

• uvula should be midline
• ask the patient to say ahh and the uvula should rise midline

Question 13

inspection of throat

Answer 13

tonsils should be oval and rough-surfaced with indentations and color is pink and there should be no exudate on them

Question 14

tonsil grading

Answer 14

1+ visible
2+ halfway between tonsilar pillars and uvula
3+ touching uvula
4+ touching each other

Question 15

inspection of the back of the throat

Answer 15

-depress the tongue with a tongue blade, look at the posterior wall for any lesions, exudate, and color
- test hypoglossal nerve ( nerve XII ) - ask the person to stick out tongue, which should protrude midline. note any tremor, loss of movement or deviation
- note any halitosis ( breath odor )

Question 16

what to expect in the aging adult?

Answer 16

• teeth may look slightly yellowed
• the surface of incisors may have some vertical cracks from a lifetime of exposure to temp.
• teeth may look longer due to gums margins receding
• tongue looks smoother as a result of papillary atrophy
• aging buccal mucosa is thinned and may look shiner

Question 17

epistaxis

Answer 17

nose bleed

Question 18

sinusitis

Answer 18

inflammation of sinuses may see mucopurulent drainage, facial pain, or pressure - a patient may also have a fever, chills, and malaise

Question 19

seasonal allergic rhinitis

Answer 19

the abnormal immune response caused by dust mites, animal dander, mold, and pollen. may have lacrimation, nasal congestion, sneezing and swollen turbinates

Question 20

furuncle

Answer 20

boil inside the nose

Question 21

nasal polyp

Answer 21

overgrowth of the mucosa

Question 22

herpes simplex 1

Answer 22

cold sores are groups of clear vesicles with a red base, evolve into pustules, with rupture, weep and crust they heal 4-10 days

Question 23

angular cheilitis

Answer 23

red, scaling, and shallow painful fissures at the corners of the mouth ( usually occurs with yeast infection )

Question 24

carcinoma

Answer 24

outer and middle 3rds of lip round and indurated becomes elevated and crusted

Question 25

baby bottle tooth decay

Answer 25

occur when infants and toddlers take drinks to bed - there are liquid pools on upper teeth.