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Oral cavity & oropharynx

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Oral cavity & oropharynx Presentation Transcript

  • 1. ORAL CAVITY & OROPHARYNX
  • 2.  
  • 3.  
  • 4.  
  • 5.  
  • 6.  
  • 7. Palpation of the floor of the mouth
  • 8. Exam: Lips
    • Observe the color & its consistency-intra-orally and externally
    • Is the vermillion border distinct?
    • Bi-digitally palpate the tissue around the lips. Check for nodules, bullae, abnormalities, mucocele, fibroma
  • 9. Exam: Lips
  • 10.  
  • 11. Exam: Lips
    • Evert the lip and examine the tissue
    • Observe frenum attachment/tissue tension
    • Clear mucous filled pockets may be seen on the inner side of the lip (mucocele). This is a frequent, non-pathologic entity which represents a blocked minor salivary gland
  • 12. Exam: Lips-palpation
    • Color, consistency
    • Area for blocked minor salivary glands
    • Lesions, ulcers
  • 13. Exam: Lips
    • Frenum:
      • Attachment
      • Level of attached gingiva
  • 14. Exam: Lips-sun exposure
  • 15. Exam: Lips
    • Palpate in the vestibule, observe color
  • 16. Examination: Buccal Mucosa
    • Linea alba
    • Stensen’s duct
  • 17. Examination: Buccal Mucosa
    • Lesions – white, red
    • Lichen Planus, Leukedema
  • 18. Gingiva
    • Note color, tone, texture, architecture & mucogingival relationships
  • 19. Gingiva
  • 20. Gingiva
  • 21. Exam: Hard palate
  • 22.  
  • 23. Exam: Tongue
    • The tongue and the floor of the mouth are the most common places for oral cancer to occur
    • It can occur other places; so visualize all areas
    • You may observe:
      • Circumvalate papillae, epiglottis
  • 24. Exam: Tongue
    • Have the patient stick out their tongue
    • Wrap the tongue in a dry gauze and gently pull it from side to side to observe the lateral borders
    • Retract the tongue to view the inferior tissues
  • 25. Exam: Tongue
  • 26. Exam: Tongue
    • You may observe lingual varicosities
  • 27. Exam: Tongue
    • You may observe geographic tongue (erythema migrans)
  • 28. Exam: Tongue
    • You may observe drug reaction
  • 29. Exam: Tongue
    • Observe signs of nutritional deficiencies, immune dysfunction
  • 30. Exam: Tongue
    • You may observe oral cancer
  • 31.  
  • 32. Palpation of the floor of the mouth
  • 33. Exam: Floor of mouth
    • Visualize, palpate - bimanually
    • Wharton’s duct
    • Must dry to observe
      • Does “lesion” wipe off?
    • Where are the two most
    • likely areas for oral cancer?
      • lateral border of the tongue
      • Floor of mouth
  • 34. Exam: Floor of mouth
    • Oral Cancer:
      • Red
      • White
      • Red and White
    • Does the patient have important risk factors for oral cancer?
      • Counseling for smoking and alcohol
        • Cessation
  • 35. Exam: Floor of mouth
  • 36. Exam: Floor of mouth
    • Squamous Cell Carcinoma
  • 37. Exam: Floor of mouth
    • Squamous Cell Carcinoma
  • 38. Exam: Leukoplakic area Edentulous Mandibular Ridge
  • 39. Retromolar trigone
    • The small area behind the wisdom teeth.
  • 40.  
  • 41.  
  • 42. TMJ & Occlusion
  • 43. Occlusion
    • Orthodontic classification
  • 44. Occlusion
  • 45. Systematic Oral Examination
    • Done at initial exam & at recalls unless patient history requires sooner
    • You must visualize all areas of the oral cavity
  • 46. Systematic Oral Examination
    • Oral cancer can occur in other places than the lateral borders of the tongue & the floor of the mouth
    • Be complete
    • Do good, do no harm, do justice, respect autonomy
  • 47. Visualize all areas
  • 48. Exam: Oropharanyx
    • Color, consistency of tissue
    • Look to the back, beyond the soft palate
    • Note occasional small globlets of transparent or pink opaque tissue which are normal and may include lymphoid tissue
  • 49. Exam: Soft palate
    • How does soft palate raise upon “aah”?
    • Vibrating line, tonsilar pillars, tonsils, oropharynx
  • 50.  
  • 51.  
  • 52.  
  • 53.  
  • 54. ORAL CAVITY & OROPHARYNX