Nose, Sinuses, Mouth, And Throat Assessment Flashcards
Dorsum
Anterior slope of nose which end inferiority at the tip and laterally at the ala
What does the Upper respiratory tract do?
Entry point for food and air
Warms, filters, humidifies, mad transports air to the lower respiratory tract
Where do nasal bones attach?
Superiorly at the bridge to the frontal bone and laterally to the lacrimal and maxillary bones
Ankyloglossia
limited tongue movement, speech disruption, tight frenulum fixing the tongue to the floor of the mouth
Gingivitis
red, swollen, possibly bleeding gums, sore
Risk factors for gingivitis
poor oral hygiene, hormonal fluctuations, vitamin B deficiency
Gingival Hyperplasia
swelling of gums, enlargement of gum tissue, may over reach teeth
Risk factors for Gingival Hyperplasia
hormonal fluctuations, leukemia, side effect of dilantin
Dental Caries
progressive destruction of tooth, pain with hot and cold, early may appear chalky, later becomes brown or black and forms a cavity
Baby Bottle Tooth Decay
decay and destruction of upper front teeth, caused by infants taking sweet juice or milk to bed, or bottle feeding past the age of one
Carcinoma
initially indurated lesion with rolled irregular edges; later may crust or scab. Risk factors: tobacco use, heavy alcohol consumption, chemical composure
Black Hairy Tongue
fungal infection of the tongue involving elongation of the papillae, may follow antibiotic therapy
Leukoplakia
white patchy lesions with well-defined borders. Risk factors: chronic irritation, smoking, excessive alcohol use
Candidiasis
opportunistic yeast infection of the buccal muscosa and tongue, white and sticky mucus on tongue or muscosa
Candidiasis may occur when?
In newborns, antibiotic or corticosteriod therapy, immunosuppresion
Aphthous (Canker Sores)
vesicular oral lesion that evolves into a white ulceration with a red margin, pain at and around site, visible oral lesion
Aphthous risk factors
stress, fatigue, allergies, autoimmune disorder
Herpes Simplex Virus
clear vesicular lesions with indurated base caused by herpes simplex 1 virus, lesions evolve into pustules that rupture, weep, and crust, typical course is 4-10 days
Torus Palatinus
bony prominence in the middle of the hard palate, foul odor, whistling sound, recurrent crusting, bleeding from the nose, hole in the septum
Strep Throat
infection of the tonsils involving streptococcus bacterium, sore throat, chills, difficult painful swallowing, headache, laryngitis
Acute tonsillitis or Pharyngitis
inflammation of the pharyngeal walls or lymphoid tissue
Kaposi Sarcoma
rapidly proliferating malignancy of the skin or mucus membranes; oral involvement includes tongue, gingiva and palate, non healing oral lesions
Bifid Uvula
congenital complete or partial spilt of uvula; adenoidectomy may be contraindicated, visual split in uvula
Cleft Lip
malformation of oral cavity, opening or fissure of the lip and palate
Perforated Septum
hole in the nasal septum
illicit drug use, nasal trauma, nose picking, chronic epitaxis
Deviated septum
deflection of the center wall of the nose
may be congenital or nasal trauma
Nasal Polyps
grapelike swelling of the nasal and sinus mucosa leading to nasal obstruction
Sinusitus
infection of one or more paranasal sinuses
Facial pain or pressure, thick nasal discharge, fever, cough, halitosis
Rhinitis
inflammation of the nasal mucosa
watery, itchy nose with frequent sneezing and congestion
epitaxis
Nosebleed, commonly includes Kiesselbach plexus
Allergy testing may be preformed via
skin or blood
Approaches to allergy skin testing
prick testing or intradermal testing
Radioallergosorbent testing (RAST)
blood test that measures allergen specific IgE antibody
Churg-Strauss Syndrome
nasal crusting or polps
Sjogren’s syndrome
atrophy and drying of the oral mucosa; may lead to epitaxis
Older adult consideration
Nose appears more prominent Edentulous gums recede teeth yellow teeth may loosen fissures may appear on the tongue
Angular Cheilitis
maceration of the skin at the corners of the mouth
smooth, glossy tongue
tongue and buccal mucosa may appear smoother and shiny from papillary atrophy and thinning of buccal mucosa
Tonsils
not visible in infants, enlarge in toddlers, remain proportionally large in toddlers and gradually decrease as they mature
Mouth, nose and throat involvement with Down Syndrome includes?
protruding tongue and flat nasal bone
Bednar Apththae
ulcerative abrasions on the posterior hard palate that result from hard sucking
Epstein Pearls
appearing as small, white, glistening pearly papules along the median border of the hard palate and gums
normal finding in newborns
represents small retention cyst that dissipate in the first couple of weeks
Rubeola Measles
maculopapular rash that occurs within the first 24 hours of fever, inflammation of the nasal mucus membrane accompanied with nasal discharge and cough symptoms
Coryza
nasal discharge
Koplik Spots
grains of salt on an erythematous base on the buccal mucosa opposite the first and second molar
Movement of the tongue should extend to?
alveolar ridge
How do you figure the number of deciduous teeth in children younger than two?
the child’s age in months minus the number 6
All the deciduous teeth should be present at what age?
2 1/2
Ingestion of excessive iron may cause?
green or black discoloration of teeth
Maternal ingestion or child ingestion of tetracycline may cause?
discoloration of teeth
Examining the nose of children is best accomplished by?
gently pressing upward on the tip of the nose and visualizing the nares with light from the otoscope
Assessing nasal breathing should include?
Feeling for symmetrical airflow from each nostril
Choanal Atresia
present when one nostril is not patent
emergency as an infant but can go undetected as an adolescent
Sucking tubercle
formation of a small pad of tissue in the middle of the upper lip
Milia
small white bumps across the bridge of the nose
Allergic Salute
upward rubbing of the nose induced by itching, causes ridge across the bridge of the nose
In pregnant women, increased nasal congestion may occur in response to?
hormonal fluctuations
In pregnant women, increased nose bleeds my be secondary to increased?
congestion
Epulis
localized gingival enlargement may lead to a tumor like mass that forms on the gums
Patients with stroke, head injury, or other nueromuscular disorders are at risk for?
dysphagia
Inspection of the throat
press down slightly with tongue depressor
visualize pharynx, tonsils, soft palate, and anterior, posterior tonsillar pillars
Tonsillar grading scale
1+-4+
Swelling and redness of Wharton duct suggest?
Inflammation of the submandibular gland
No movement of the uvula when the patient says “ah” indicates?
Dysfunction of cranial nerve X
Infection of the mouth may produce?
Ludwig angina
Inspection of teeth and gums
note numbers and position of teeth
note general appearance and signs of decay
note odor of patient’s breath
swollen of red gums may indicate?
gingivits
Foul breath may suggest?
infection
Inflamed buccal mucosa suggest?
infection
Petechiae
may result from trauma, infection, or decreased platelet count
Stenson duct
appears as a dimple just opposite of the the second upper molar
Inspection of buccal Mucosa
hold light in nondominant hand and tongue blade in other
separate areas
note color and pigmentation
inspect entire u shaped floor of the mouth
note parotid duct
Fordyce Granules
small isolated white or yellow papules may be noted on the cheeks, tongue, and lips.
these are insignificant
Inflammation and infection of nasal mucosa may be present with?
viral, bacterial or allergic rhinitis
Excessive clear, watery drainage suggest?
allergic rhinitis
Anosomia
decrease in smell, may occur with trauma, congestion, polyps or sinus infection
Recurrent strep infections are indications for consideration for removal of? and why?
Removal of tonsils because of the risk for rheumatic fever with resultant kidney or heart disease
Hemangioma
benign mass of blood vessels, present at birth and may expand with crying
Thumb sucking past the age of 6-7 may cause?
malocclusion of the teeth
Unilateral clear discharge that is unresponsive to treatment may indicate?
rare cerebrospinal fluid leak
Cough may be secondary to?
GERD
Common mouth and upper respiratory symptoms
facial pressure/headache/pain, snoring, sleep apnea, obstructive breathing, nasal congestion, epitaxis, halitosis, anosomia, cough, pharyngitis, dysphagia, dental aching, hoarseness, oral lesions
Abrupt loss of smell may indicate?
brain tumor
Ludwig Angina
swelling that pushes the tongue up and back and eventually causes airway obstruction
Torus palatinus
bony ridge running in the middle of the hard
Gustatory Rhinitis
clear rhinorrhea stimulated by smell and taste of food
In older adults, in the oral cavity a thinning of the soft tissue of the cheeks and tongue results in?
increased risk of ulcerations, infections and oral cancer
With advancing age, number of taste buds and production of saliva?
decreases
What age group is the obligatory nose breathers?
infants
When is the ability to smell fully developed?
at birth, but lack lining of cilia in nose
frontal and sphenoid sinuses appear by age?
3 years and continue to develop through adolescence
Taste is present at birth but salivation develops at age?
3 months
development of teeth, temporary and permanent begin?
in utero
teeth erupt in infants and toddlers between the age?
5 and 27 months
At what age do children start to loose deciduous teeth?
6 years of age
By what age are permanent teeth present?
12 to 13
The throat is the common channel for?
respiratory and digestive systems
Where does the throat begin?
inferior border of the soft palate and uvula
Tonsils
back of the throat between anterior and posterior pillars
What does the lymphatic tissues of the tonsils and adenoids provide?
immunological defense
Chronic infections of tonsils may cause?
hypertrophy and may produce chronic airway obstruction
Tonsilitis
inflammation of tonsils
Hypertrophy of the tonsils and adenoids may develop secondary to?
sinusitis or otitis (middle ear infection)
How many permanent teeth do we have?
32
How many anterior incisors in an adult?
8, have flat surfaces for biting
How many molars in adults?
12, biting and grinding food
the teeth contribute to?
grinding and mastication of food to prepare for swallowing.
Teeth has three layers, which are?
Crown, neck and root
crown has three layers
enamel, dentin, pulp
dentin has tubules that connect to?
nerve fibers
Which cranial nerves innervate secretions of major and minor salivary glands?
Cranial VII and IX
Saliva begins what process?
digestion, by releasing enzymes upon contact with food
Saliva protects the oral mucosa from?
heat, chemicals and irritants
Saliva’s function is?
transmit taste information, rinses the oral cavity to maintain pH, provides lubrication for movement of food
Salivary production increases with?
smelling and seeing food, smoking, tasting, chewing, swallowing
xerostomia
decreased salivary flow, related to emotional response, aging, damage to glands and disorders
Three major salivary glands
parotid, submandibular, sublingual
blood supply to the tongue
lingual, exterior maxillary, and ascending pharyngeal arteries
Innervation of the tongue includes lingual nerve fibers from which cranial nerves?
CN V, VII, IX, X, XII
uvula
midline at the inferior portion of soft palate
roof of mouth contains two palates which are?
hard and soft
soft palate forms the?
uvula and separates mouth from pharynx
The floor of the mouth is highly vascular which allows?
rapid absorption of sublingual medications
The oral cavity is the structure for?
taste, mastication, and speech articulation
adenoids
lymphoid tissue located in the rood of the nasopharynx and laterally in the eustachian tube orifice
Sinuses
hollow, bony, air filled cavaties within the forehead and facial cavaties, lighten the weight of the skull and provide timbre adn resonance to the voice
Cranial nerve VII is responsible for? external movement of?
external movement of nose, vasodilatation, and mucus production
osteomatal complex
middle turbinate and middle meatus area
function of cilia?
trap particles and sweep them posteriorly to promote mucus drainage
Columella
divides the oval nares
