MOUTH, THROAT

Cards (63)

  • Mouth (Oral Cavity / Vestibule)

    An oval shaped cavity, the beginning of the digestive tract & serves as an airway for the respiratory tract
  • Mouth
    • Formed by the lips, cheeks, hard & soft palates, uvula, tongue & its muscles
    • Posteriorly, mandibular & maxillary arcs
  • Throat (Pharynx)

    Connects the nose, mouth, larynx & esophagus
  • Sections of the throat
    • Nasopharynx (behind the nose)
    • Oropharynx(behind the mouth)
    • Laryngo pharynx (behind the larynx)
  • Lips
    • Muscular folds that surround the mouth; contain sensory receptors; very sensitive
    • Assist with eating, expression & speech
  • Teeth
    • Needed for chewing & have esthetic value
    • 20 deciduous, 32 permanent
    • Deciduous – primary, milk, temporary or baby teeth
    • Permanent – 28 if molars did not erupt
  • Tongue
    • Muscle controlled by CN XIIhypoglossal
    • Needed for chewing, swallowing, & speech
    • Sensory (taste) CN VII & CN IX (facial & glossopharyngeal)
  • Hard Palate
    • Forms the floor of the nasal cavity
  • Soft Palate
    • Posterior to hard palate, Elevates during swallowing to prevent food & saliva from entering the nasopharynx
  • Uvula
    • Fleshy cone like structure in the center of the soft palate & prevents food from entering nasal passages
  • Salivary Glands

    • Secrete saliva which contains amylase to convert starch to maltose
    • 3 major salivary glands (parotid, submandibular, sublingual)
    • Helps in digestion
    • Oral health
    • In the absence of saliva we cannot taste the food we eat
  • Inspection of the Lips
    • Inspect color, condition, lesions, odor
  • Normal findings for lips
    • Midline
    • Symmetrical
    • Skin intact; pink & moist
    • Coloring consistent with ethnic group/race
    • No unusual odors
  • Deviations from normal for lips
    • Asymmetry of placement
    • Congenital deformity
    • Trauma
    • Paralysis
    • Surgical Alteration
    • Redness - Inflammatory or infectious disorder
    • Cyanosis- Vasoconstriction or hypoxia
    • Lesions - Infectious or inflammatory disorder
    • Cheilitis – inflammation of lips; drying, & cracking; Dehydration; Allergy; lip licking
    • Cheilosis - fissures at corners of lips; Deficiency of B vitamins; maceration related to overclosure
    • Halitosis - Infections or gastrointestinal problems, Poor oral hygiene
    • Chancre- Single, painless ulcer of primary syphilis
    • Angioedema - Allergic response based on client's allergic stimulus
    • Herpes Simplex - Herpes viral infection
  • Most adults have 28 teeth, or 32 if the four third molars, or wisdom teeth, are erupted
  • Deviations from normal for teeth
    • Loose, poorly anchored teeth - secondary trauma from periodontal (gum) disease & bacterial plaque buildup on teeth from poor oral hygiene
    • Malalignment - early loss of baby or adult teeth; improper fit of dental restorations; gingivitis; undue pressure on the teeth & gums; misalignment of the jaw after an injury; tumors of the mouth or jaw; common oral health problems in children
    • Dental caries - caused by the action of acids on the enamel surface
    • Discoloration of teeth - Chemicals or medications
    • Mottled enamel
  • Inspection of the Oral Mucosa & Gums
    • Inspect color, condition, lesions of mucosa
    • Note condition of gingiva, bleeding, retraction, or hypertrophy
  • Normal findings for oral mucosa & gums
    • Pink, moist, intact mucosa
    • Gums consistent in color with other mucosa; gums intact; no bleeding
    • Color variants acceptable if consistent with patient's ethnic group/race
  • Deviations from normal for oral mucosa & gums
    • Gum hyperplasia / Gingival hyperplasia- can occur as a direct result of inflammation; often caused by plaque buildup on the teeth from food, bacteria & poor hygiene practices
    • Gum recession - Poor dental hygiene or vitamin deficiency; Aggressive tooth brushing; Hormonal changes
    • Pale or gray gingivae - Chronic gingivitis
    • Abrasions, erosion of underlying mucosa - poorly fitted dentures
    • Inflamed, bleeding gingivae
    • Allergic stomatitis - Reddened, inflamed oral mucosa, sometimes accompanied by ulcerations
    • Aphthous ulcer - Benign & non-contagious
    • Cancers - found on the lips, gums, oral mucosa or other areas of the mouth; associated with tobacco use and alcohol abuse prolonged sun exposure (cancer of the lip)
    • Leukoplakia - White, adherent mucosal thickening. Smoking is the most common cause
  • Inspection of the Tongue
    • Inspect color, texture, moisture & mobility
  • Normal findings for the tongue
    • Pink & moist, Papillae intact
    • Mucosa intact with no lesions or discolorations
    • Freely & symmetrically mobile
    • CN XII intact – hypoglossal
    • Geographic tongue - a normal variation, map-like appearance on the upper surface and sides of the tongue, harmless, benign condition that isn't linked to any infection or cancer
  • Deviations from normal for the tongue
    • Absence of Papillae - reddened mucosa, ulcerations, Allergic, inflammatory, or infectious cause
    • Glossitis - occurs when the tongue becomes inflamed, due to infections, allergic reactions & injuries, among other causes
    • Color changes - May indicate underlying problems; red beefy tongue
    • Black, hairy tongue - due to antibiotic use for a medical condition; by using products that contain bismuth
    • Hypertrophy & discoloration of papillae: Poor oral hygiene, Dry mouth, Dehydration, Smoking or other oral tobacco
    • Cancers
  • Inspection of the Oropharynx
    • Inspect oropharynx for color, lesions & drainage
  • Normal findings for the oropharynx
    • Mucosa is pink, moist, intact
    • The lymphoid - rich posterior wall may have a slightly irregular surface
    • No lesions, erythema, swellings, exudate, or discharge
  • Deviations from normal for the oropharynx
    • Postnasal drainage - Yellowish or green streaks of drainage on the posterior wall. Seen in acute sinusitis with post nasal drip
    • Pharyngeal Diphtheria - Gray membrane / adherent material
    • White or pale patches of exudates with eurythmic mucosa - Infection, including streptococcal bacterial infection or mononucleosis viral infection
    • Exudative pharyngitis - associated with Gonorrhea & chlamydia, sore throat
    • Erythema -Inflammatory response, typically associated with infectious pharyngitis; also common in smokers
    • Herphangina - Scattered vesicles/ulcerations
  • Inspection of the Tonsils
    • Note color, size, and exudate
  • Normal findings for the tonsils
    • Symmetrical, pink, clean crypts
    • Crypts may have normal variation of small food particles
  • Deviations from normal for the tonsils
    • Peritonsillar Abscess
    • Reddened, hypertrophic tonsil, with or without Exudates
    • Acute infection or tonsillitis
    • Lymphoid cobble stoning, caused by enlarged lymphatic tissue
  • Tonsillar Hypertrophy Grading Scale
    Used to note the degree of tonsil enlargement
  • Palpation of the Lips / Tongue
    • Lightly palpate lips and tongue for consistency & tenderness
  • Normal findings for lips and tongue
    • Lips - Soft, nontender, no masses
    • Tongue - Tissue is soft, supple, without nodules, thickenings, masses, or tenderness
  • Deviations from normal for lips and tongue
    • Lips - Areas of induration, thickening, nodularity, or masses; Tender induration that soon develops vesicles
    • Tongue - Areas of induration, thickening, nodularity
  • Normal findings for the glands
    • Stensen ducts - Visible with flow of saliva, no redness, pain or moistness in the area, Fordyce granules present
    • Wharton ducts - Frenulum is at the midline, ducts are visible with salivary flow, moistness in the area
  • Deviations from normal for the glands
    • Stensen ducts - Reddened opening of the ducts
    • Wharton ducts - Presence of lesions, ulcers, nodules or hypertrophied ducts openings on either side of frenulum
  • Palpation of the Glands
    • Palpate parotid, submandibular and sublingual glands
  • Normal findings for palpation of the glands
    • Parotid glands - Nonpalpable & non-tender
    • Submandibular & sublingual glands - May be palpable but should be nontender, supple, and soft
  • Deviations from normal for palpation of the glands
    • Parotid glands - Enlarged, tender parotid glands, Parotitis, Blocked ducts, Infection, Malignancy
    • Submandibular & sublingual glands - Presence of lesions, ulcers, Tenderness, swelling
  • Throat Culture
    • Collected from the mucosa of the oropharynx and tonsillar regions using a culture swab, sample is cultured & examined for the presence of disease-producing microorganisms
  • Parotid gland - produce pure serous
  • Submandibular gland - produce both serous and mucuous but mainly serous