This document provides information on performing a general and oral examination. It discusses examining the following areas: 1. General examination which includes assessing vital signs like temperature, pulse, respiration rate, and blood pressure, as well as examining the skin, eyes, nails, and general appearance. 2. Oral examination which consists of an extraoral exam of the jaws, temporomandibular joint, and masticatory muscles, and an intraoral exam of the soft tissues, salivary glands, gingiva, and hard tissues like teeth. 3. It provides details on techniques for examining each area and what abnormalities to look for during the examination. The goal is to assess the patient's general

1. C
GENERAL AND ORAL
EXAMINATION
Presented by- Abhishek Agale

2. content
• General examination-
• Built
• Nourishment
• Gait
• Skin
• Eyes
• Nails
• Vital signs
• Oral examination-
• Extra oral examination
• Intraoral examination

3. General examination
• It is actually the first step of physical
examination and key component of
diagnostic approach.
• Inspection is the major method
during general examination, combining wit
h palpation, auscultation, and swelling.
• Aim to-
• Assess patients general condition
• Detect manifestations of internal and
systemic diseases

4. General appearance
Hand and arms
Skin
Face
Eyes
Mouth
Neck oedema
Lymph nodes

5. Vital signs
• Temperature
• Pulse
• Respiration rate
• Blood pressure

6. pulse
Peripheral pulsations
1. brachial pulse- flex the patients elbow
-Medial to the biceps.
2. carotid artery- at the level of
thyroid cartilage
3.The dorsalis pedis artery- lateral to
the extensor
hallucis tendon .
-Absent in 10%
4. popliteal artery

7. Blood pressure
• Normal B.P.- 120-140 mmHg systolic
• 80 mmHg(normal 120/80 mm Hg )
• Blood pressure variation: blood pressure varies with
emotion, exercise, meal, alcohol, tobacco, bladder
distention, temperature and pain.
• Equipment- stethoscope and sphygmomanometer.

8. temperature
• Normally taken in the mouth or in the axilla
by keeping mercury thermometer for a
minute.
• The normal body temperature
varies from 36 degree celsius to
37.5 Degree celsius.
• Temperature drops in following conditions-
• Shock
• Excessive bleeding
• Metabolic derangement
• Administration if medication

9. Respiratory rate
• Respiratory rate also known as
ventilation rate, respiraton rate,
breathing rate, pulmonary ventitlation
rate
• It refers to no. Of breaths a person
takes during one minute,and must be
made surreptitiously while the pulse is
being recorded.
• Respiratory rate increased in -
• Exercise
• Fever
• Throtoxicosis
• Cancer patient
• Heart disease
• Asthma
• Diabetes mellitus
• COPD

10. GENERAL STATE OF HEALTH
Healthy/ ill/ comfortable/ distressed
Wong baker Faces pain scale

11. Body built
• Sheldon's anthropometric types.
• 1. endomorphic- in whom viscera and abdomen
tend to dominate the body.
• 2. mesomorphic- in whom the muscular
tissue dominates the body.
• 3. ectomorphic- in whom the skin, bones and head
dominates the body.

12. Head, neck,
fingernails
Skull: facial form, symmetry
Eyes: sclera for any color change, such as yellowish discoloration
of jaundice, pupils, eyelids,and any conjuctival lesions
Nose: deformity, obstruction,deviated nasal septum
And mouth breathing.
Neck: lymph nodes, scars, lesions, swelling,
tenderness, pulsation, and deviation of the midline of neck.
Fingernails: biting, deformity, morphology, color
change, clubbing

13. Oral examination
• It includes
• Extraoral examination-
• Jaws, temporomandibular joint, masticatory muscles
• Intraoral examination-
• Soft tissue, salivary gland and saliva, gingiva, hard tissue

14. Extraoral examination
• Jaws-
• size, symmetry, anteroposterior realtionship, deromity, closure patern
and lateral and protrusive movements.
• Temperomandibular joint-
• Clicking, restriction of motion, clicking or snapping, deviation, swelling,
tenderness etc.
• Palpate directly over joint when the patient opens and closes the
mandible, and the extent of mandbular condylar movement can be
assessed.
• Degree of mandibular opening is less than 35 mm considered to be
abnormal in adult there is no upper limit but few patient can
exceed 60mm comfortbly.

15. • Masticatory muscle-
• Tenderness and stiffness of the masticatory muscles are to be
examined
• The masticatory muscle are the masseter, temporalis, medial
pterygoid, and lateral pterygoid.
• They helps in elevation, deopression, lateral movement and
protrusion of mandible during mastication.
• The muscle that commonly undergoes hypertrophy in bruxism is
the masster.
• Sudden contraction of temporalis muscle will result in
coronoid fracture,which is rare.
• Trismus following interior alveolar nerve block is mostly due
to involvement of medial pterygoid muscle.

16. Intraoral examination
• Soft tissue- soft tissue structures in the mouth, such as the oral
mucosa, tongue, frenum, floor of the mouth, tonsiles, and palate.
Soft tissue examinted for any color change, alterations in
the texture, elasticity, ulcers or erosins, growth, white, red or
pigmented lesions, vesicles, or any bleeding spots.
Salivary glands and saliva- saliva flow, enlargement, obstruction pain,
examination of ductal opening, and any purulent discharge.

17. Gingiva- color consistenccy, texture,
surface, size, gingival recession and
inflammation
Hard tissue- occlusion, number of
teeth present, decayed, missing, filled,
crowns, bridges, root stumps,
impacted teeth, mobility, fracture, and
any teeth indicated for exteaction

18. Exam: lips
•Evert 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)
•Palpation: color consistency

19. Exam: buccal mucosa
• Observe color,c haracter of the mucosa
• Normal variations in color among ethic
groups
• Amalgum tattoo
• Palpate tissue
• Observe stenson's duct opening for
inflammation or signs of blockage
• Lesions- red and white
• Lichen planus , leukedema

20. Exam: gingiva
how would you describe the gingiva?
Marginal vs. Generalised
erythematous vs fibrous
drug reaction: anti-epileptic, calcium channel blockers,
immunosuppressant

21. •Thank you