Nose, Mouth and Throat Assessment Flashcards
What are the functions of the nose?
Filters and warms the air we breath, also the smell organ
Name the different structures of the nose.
Bridge, tip, nares, vestibules, columella, ala
What are the course hairs lining the anterior portion of the nasal cavity called?
Vibrissae
What is the function of the ciliated mucous membranes?
- Hairs filter coarse matter
- Mucous traps dust and bacteria
- Richly supplied with capillary
Where are the turbinates located?
Superior, middle and inferior
Where are the olfactory receptors located?
The roof of the nasal cavity, and the upper third of the septum
Describe the structure of the paranasal sinuses.
- Ciliated
- Air filled
- Narrow openings to nasal cavity, easily occluded, sinusitis
Describe the function of the paranasal sinuses.
- Lighten the skull
- Serve as resonant cavities for sound production
Which paranasal sinuses are palpable?
Frontal, maxillary
Which paranasal sinuses are deep?
Sphenoid, Ethmoid
What is the first organ of digestion?
The mouth
What are the structures within the oral cavity?
Lips, palate, cheeks, tongue, teeth, gums, salivary glands
What are the salivary glands within the mouth?
Parotid, submandibular, sublingual
What is the oropharynx separated from the mouth by?
The anterior tonsillar pillar
Where are the tonsils located?
Behind the pillar and are a mass of lymphoid tissue
When is it common for the tonsils to enlarge?
During childhood, adolescences involutes it
At what age does salivation start?
Three months of age
When do deciduous (temporary) teeth typically erupt?
Around 6-24 months of age
When do permanent teeth typically erupt?
Around the ages of 6-12
When dose the nose finish developing?
In adolescence
What are some changes that may occur to the nose and gums during pregnancy?
- Increased vascularity, nasal stiffness and epistaxis (bleeding) may occur
- The gums may appear hyperaemic (congested with blood), softened, and may bleed with normal tooth brushing.
What are some changes in the nose that occur in an older adult?
- Gradual loss of the subcutaneous layer may make the nose appear larger
- Nasal hair grows coarser, and stiffer and may not filter air as efficiently
- Nasal hair may protrude, leading to clipping, which may lead to an infection
- Diminished olfactory nerve(smell)
What are some changes in the mouth that occur in an older adult?
- Loss of taste buds
- Decrease in salivary cells
- Tissue atrophy- increased risk of oral lesions
- Tooth loss
Cultural Considerations: whom is bifed or cleft uvula most common in?
Aboriginal and Asian descent
Cultural Considerations: whom is cleft palate/lip most common in?
Aboriginal, and asian descent
Rarest in people of African descent
What is Leukoedema, and who is it most common in?
- A greyish-white benign lesions on the buccal mucosa.
- Most common in a person of African descent
What are the odds of a child being born with a full set of teeth?
1 in 3000
What are the odds of an Inuit child of Northern Canada being born with a full set of teeth?
1 in 2100
What is Torus palatines and who is it most common in?
- A bony structure down the centre of the palate
- More common in those of Aboriginal descent.
What may challenge proper dental hygiene practices?
Socioeconomic status
Is there an issue with the lack of oral/dental care access in Canada?
Yes
What can a lack of dental coverage lead to?
Poorer dental hygiene
Does the size of teeth vary across different ethnocultural groups?
Yes
Subjective assessment for a nose.
- Discharge
- Frequent colds
- Sinus pain
- Trauma
- Epistaxis (nosebleeds)
- Allergies
- Altered smell
Subjective assessment for the mouth and throat.
- Sores or lesions
- Sore throat
- Bleeding gums
- Toothache
- Hoarseness
- Dysphagia
- Altered taste
- Smoking, alcohol consumption (oral cancer)
- Self care (dental hygiene, dental care)
What are you looking for when inspecting the external nose?
- Symmetry
- Midline
- Inflammation
- Lesions
- Deformities
- Tenderness
- Deviated septum
How would you assess for patency of nostrils?
Hold one side shut with a finger, then another
What are you looking for when inspecting the nasal cavity? What instrument is used?
- Looking for red mucous
- No swelling, growths, discharge or foreign bodies
-An otoscope with the speculum head is used
Which sinuses are palpable?
Frontal and maxillary
How do you examine a mouth?
Anterior to posterior using a tongue blade
When examining the lips, what are you looking for?
- Colour
- Cracking
- Lesions
- Moistness
- Note normal darker pigment in dark complexions
When examining the teeth, what are you looking for?
- Any loose teeth
- Any caries
- Any missing teeth
- Colour
- Erosion
- Lesions
- Alignment
When examining the gums, what are you looking for?
Check for pink colour, swelling, retraction of margins, and bleeding
When examining the tongue, what are you looking for?
Colour, surface, moisture and saliva
How do you inspect a tongue?
- Grasp tongue and inspect lateral surface
- Check under the front of the tongue for lesions
- Any lesions older than two weeks need a follow up
- Palpate lesions fot induration (mass)
What is the Stensens duct and where is it located?
Opening of the parotid salivary gland by the 2nd molar
What are Fordycf granules?
Small white sebaceous cysts on lips, cheeks and tongue
Location of the hard palate?
Anterior
Location of the soft palate?
Posterior
How do you examine the oropharynx/throat?
-Examine uvula
-Have patient say ahh and watch soft palate and uvula rise (CN X)
-Note halitosis
Note tonsils
What is the difference in examining an infants child mouth?
- Take advantage of wide mouth crying
- Play a game
- Be careful with gag reflex
- “Slide and creep technique”
What is the difference in examining an infants child nose?
- Infants have milia
- Nasal flaring is abnormal
- Newborns are obligate nose breathers
- No nasal speculum
- No sinus palpation under 8 years of age
What is the difference in examining an infants child mouth and throat?
- Sucking tubercle
- Epstein pearls (normal cysts)
- Tonsils not visible in newborns
- Look for a strong, lusty cry
- Strong sucking
How does a Nose, Mouth and Throat vary in older adults?
- Nose more prominent
- Purse string mouth with teeth loss
- Yellowing of teeth
- Wearing and abrasion
- Tongue smoother, mucosa thinned
