Oral cavity & oropharynx

7,128 views

Published on

2 Comments
10 Likes
Statistics
Notes
No Downloads
Views
Total views
7,128
On SlideShare
0
From Embeds
0
Number of Embeds
25
Actions
Shares
0
Downloads
0
Comments
2
Likes
10
Embeds 0
No embeds

No notes for slide

Oral cavity & oropharynx

  1. 1. ORAL CAVITY & OROPHARYNX
  2. 2. Palpation of the floor of the mouth
  3. 3. 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
  4. 4. Exam: Lips
  5. 5. 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
  6. 6. Exam: Lips-palpation • Color, consistency • Area for blocked minor salivary glands • Lesions, ulcers
  7. 7. Exam: Lips • Frenum: – Attachment – Level of attached gingiva
  8. 8. Exam: Lips-sun exposure
  9. 9. Exam: Lips • Palpate in the vestibule, observe color
  10. 10. Examination: Buccal Mucosa • Linea alba • Stensen’s duct
  11. 11. Examination: Buccal Mucosa • Lesions – white, red • Lichen Planus, Leukedema
  12. 12. Gingiva • Note color, tone, texture, architecture & mucogingival relationships
  13. 13. Gingiva
  14. 14. Gingiva
  15. 15. Exam: Hard palate
  16. 16. 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
  17. 17. 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
  18. 18. Exam: Tongue
  19. 19. Exam: Tongue • You may observe lingual varicosities
  20. 20. Exam: Tongue • You may observe geographic tongue (erythema migrans)
  21. 21. Exam: Tongue • You may observe drug reaction
  22. 22. Exam: Tongue • Observe signs of nutritional deficiencies, immune dysfunction
  23. 23. Exam: Tongue • You may observe oral cancer
  24. 24. Palpation of the floor of the mouth
  25. 25. 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
  26. 26. 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
  27. 27. Exam: Floor of mouth
  28. 28. Exam: Floor of mouth • Squamous Cell Carcinoma
  29. 29. Exam: Floor of mouth • Squamous Cell Carcinoma
  30. 30. Exam: Leukoplakic area Edentulous Mandibular Ridge
  31. 31. Retromolar trigone • The small area behind the wisdom teeth.
  32. 32. TMJ & OcclusionTMJ & Occlusion
  33. 33. Occlusion • Orthodontic classification
  34. 34. Occlusion
  35. 35. Systematic Oral Examination • Done at initial exam & at recalls unless patient history requires sooner • You must visualize all areas of the oral cavity
  36. 36. 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
  37. 37. Visualize all areas
  38. 38. 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
  39. 39. Exam: Soft palate • How does soft palate raise upon “aah”? • Vibrating line, tonsilar pillars, tonsils, oropharynx
  40. 40. ORAL CAVITY & OROPHARYNX

×