Chapter 12 Flashcards
(87 cards)
1
Q
What are the objectives of Extraoral/Intraoral Exams?
A
- Observe the pt. overall, areas in and about the oral cavity and record areas that deviate from the normal.
- Screen pt. to detect for lesions that may be pathologic, or cancerous.
- Identify suspicious areas that may require a follow up.
- Identify intra/extraoral deviations from norm that may need special care.
- Be able to compare exams from previous appts.
2
Q
What happens if a patient has a communicable disease?
A
Patient may be rescheduled.
3
Q
Why is Early recognition good?
A
It can prevent advanced, irreversable, or untreatable oral disease.
4
Q
Preparation for Examination
A
- Review pts. health history and other parts of their chart and records.
- Examine Radiograph
- Explain procedure to pt.
- Help pt. decide about allowing you to do the exam.
5
Q
The Extraoral exam are accomplished by what?
A
Direct observation and palpation.
6
Q
Direct Observation
A
Pt. position, optimum lighting, and effective retraction for access and visibility aid in accuracy of the exam.
7
Q
What are the different palpation types?
A
- Digital
- Bidigital
- Bimanual
- Bilateral
8
Q
What is Digital palpation?
A
A single finger exam.
9
Q
What is Bidigital palpation?
A
Use of finger and thumb of same hand.
10
Q
What is Bimanual palpation?
A
Use of finger and thumb with each hand applied simultaneously.
11
Q
What is Bilateral palpation?
A
Two hands used at same time to examine corresponding structures on opposite sides of the body.
12
Q
What is the reason for systemic sequence for the exams?
A
- Minimal possibility of overlooking an area.
- Increased efficiency and conserves time.
- Maintain professional atmosphere.
13
Q
Extraoral Examination
A
- Observe pt. during reception and seating to note physical characteristics.
- Observe head, face, eyes, and neck, and skin of face and neck.
- Palpate salivary glands and lymph nodes.
- Observe mandibular movement and palpate TMJ.
14
Q
Intraoral Examination
A
- Preliminary exam of lips and intraoral mucosa.
- View and palpate lips, labial and buccal mucosa, and mucobuccal folds.
- exam an palpate tongue.
- Observe mucosa of floor of mouth.
- Exam hard and soft Palates, Tonsillar region and pharynx.
- Note Evidence of dry mouth.
15
Q
What should the record form have?
A
- Adequate room to record, not just a checklist.
- Should have spaces for successive exams.
16
Q
What Information do you record?
A
Complete description of each finding includes the location, extent, size, color, surface texture, or configuration, consistency, morphology, and history,
17
Q
Location and Extent
A
When a lesion is seen, location is noted in relation to adjacent structures.
18
Q
Localized
A
Lesion limited to small focal area.
19
Q
Generalized
A
Involves most of the area of segment.
20
Q
Single Lesion
A
One lesion of particular type with distinct margins.
21
Q
Multiple Lesions
A
More than one lesion of a particular type.
22
Q
Separate Lesions
A
Discrete, not running together.
23
Q
Coalescing Lesions
A
Close to each other with margins that merge.
24
Q
What type of lesion are Herpetic Lesions?
A
Coalescing
25
Size and Shape of lesions
- Record length and width in mm
- Record Height of an elevated lesion.
- Use probe to measure.
26
Color of lesions
- Red, pink, white, and red and white are most commonly seen.
- More rare lesions may be blue, purple, gray, yellow, black or brown.
27
Surface texture of Lesions
- Lesions may be smooth or irregular surfaces
| - Texture may be papillary, verrucous or warlike, fissured, corrugated, or crusted.
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Consistency of Lesion
Lesions may be soft, spongy, resilient, hard, or indurated.
29
What are Elevated Lesions?
Above the plane of the skin or mucosa. They are considered Blisterform.
30
What are Blisterform Lesions?
Lesions that contain fluid and usually are soft and translucent. They may be vesicles, pustules, or bullae.
31
What is a Vesicle?
A small (1cm or less) circumscribed lesion with a thin surface covering. It may contain serum or mucin and appear white.
32
What is a Pustule?
May be more or less than 5 mm in diameter. Contains puss. Puss gives the pustule a yellowish color.
33
What is a Bulla?
A large (more than 1 cm) lesion filled with fluid, usually mucin or serum, but may contain blood. The color depends on the fluid.
34
What is a Nonblisterform Lesion?
Lesions that are solid and do not contain fluid.They may be papules, nodules, tumors, or plaques.
35
What is a Pedunculated Lesion?
Attached by a narrow stalk or pedicle.
36
What is a Sessile?
A lesion that has a base as wide as itself.
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What is a Papule?
A small (pinhead to 5mm in diameter), solid lesion that may be pointed, rounded or flat-topped.
38
What is a Nodule?
Larger than a papule (greater than 5mm but less that 1 cm).
39
What is a Tumor?
is 2 cm or greater in width. In this context "Tumor" means a general swelling or enlargement and does not refer to neoplasm, either benign or malignant.
40
What is a Plaque?
Slightly raised lesion with a broad, flat top. It is usually larger than 5mm in diameter with a pasted on appearance.
41
What is a Depressed Lesion?
Below the level of the skin or mucosa. They can be regular or irregular outlined, may be flat or raised borders. The depth is usually described as superficial or deep. If deep it is greater than 3mm deep.
42
What is an Ulcer?
Most depressed lesions are ulcers and represent a loss of epithelium. The center is grey to yellow with a red border. An ulcer may occur from the rupture of an elevated lesion.
43
What is an Erosion?
Shallow, depressed lesion that does not extend thru the epithelium.
44
What us a Flat Lesion?
Flat lesions may occur as single or multiple and have regular or irregular form on the same level as normal skin or mucosa.
45
What is Erythema?
Red area variable size and shape.
46
What is Exophytic?
Growing outward.
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What is Indurated?
Hardened
48
What is Papillary?
Resembling small, nipple-shaped projections.
49
What is Petechiae?
Minute hemorrhagic spots on pinhead to pinpoint size.
50
What type of spot are connected to sexual abuse in kids?
Petechiae
51
What is Pseudomembrane?
Loose membranous layer of exudate-containing organisms, found during an inflammatory reaction on the surface of the tissue.
52
What is a Polyp?
Mass of tissue that projects outward or upward from the normal surface level.
53
What is a Punctate?
Marked with points or dots differentiated from the surrounding surface by color, elevation, or texture.
54
What is a Torus?
Bony elevation or prominence usually found on the midline of palate(torus palatinus) and the lingual surface of the mandible(torus mandibularis) in the premolar area.
55
What us a Verrucous?
rough or wartlike.
56
Oral Cancer
- Objective to detect as early as possible.
- If discovered late the cancer can spread to the adjacent structures and to the lymph nodes, and prognosis is less favorable.
- Because early lesions are symptomless, they go unnoticed.
57
Where are the most common sites oral cancer occurs?
The floor of the mouth, the lateral borders of the tongue, the lower lip, and the soft palate.
58
What are the 5 basic forms of early cancer appearance?
1. White areas
2. Red areas
3. Ulcers
4. Masses
5. Pigmentation
59
What is the most indicative of malignancy?
Fissures, ulcers or areas of induration in a white area.
60
What is Leukoplakia?
A white patch or plaque that CANNOT be scraped off. It may be associated with physical or chemical agents and the use of chewing tobacco.
61
Red Areas
Lesions of red, velvety consistency, sometimes with small ulcers, are identified
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What is Eryhtroplakia?
Lesions of oral Mucosa that appear as bright red patches or plaques that cannot be characterized as a specific disease.
63
Early cancer Ulcers
- May be flat or raised.
| - Palpation may reveal induration.
64
Early Cancer Masses
- Papillary masses, sometimes with ulcerated areas, occur as elevations above surrounding tissue.
- Other masses may occur below the normal mucosa and may only be found by palpation.
65
Early Cancer Pigmentation
Brown or black pigmented areas may be located on mucosa where pigmentation does not normally occur.
66
What are the diagnostic aids with Oral Cancer?
- Toluidine Blue
| - Chemiluminescense
67
What are the procedures for follow-up of a suspicious lesion?
Biopsy
68
What are the indications for Biopsy?
- Unusual lesion cannot be identified with clinical certainty.
- Any lesion does not show evidence of healing within a 2 week time period.
- A persistent, thick, white, hyperkeratotic lesion and any mass that does not break thru the surface epithelium.
69
How long do we give a lesion to heal before referring them to a doctor?
2 weeks
70
What is a cytologic smear?
Diagnostic aid in which surface cells of a suspicious lesion are removed for microscopic evaluation.
71
What type of epithelium is a malignant mass?
Squamous.
72
What is a Aphtha?
A little white or reddish ulcer.
73
Crust
Outer scablike layer of solid matter formed by drying of a body exudate or secretion.
74
Cyst
Closed, epithelial-lined sac, normal or pathologic, that contains fluid or other material.
75
Dorsal
Back surface
76
Epidermis
Outermost and non vascular layers of the skin composed of basal layer, spinous layer, granular layer, and horny layer.
77
Corium
The dermis or true skin just beneath the epidermis; well supplied with nerves and blood vessels.
78
Exostosis
A benign bony growth projecting from the surface of bone.
79
Forensic
Pertaining to or used in legal proceedings.
80
Idiopathic
Unknown etiology
81
Lymphadenopathy
Disease of the lymph nodes; regional lymph node enlargement.
82
Morphology
Science that deals with form and structure.
83
Purulent
Containing, forming or discharging pus.
84
Rubefacient
Reddening of the skin.
85
Sclerosis
Induration or hardening
86
Temporomandibular disorder (TMD)
A collective term that includes a wide range of disorders of the masticatory system characterized by one or more of the following: pain in the pre auricular area, temporomandibular joint (TMJ), muscles of mastication, with limitation or deviation in mandibular motion and TMJ sounds during mandibular function.
87
Trismus
Motor disturbance of the trigeminal nerve, especially spasm of the masticatory muscles with difficulty in opening the mouth.
