EO/IO Inspection Quiz 3 Flashcards Preview

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Flashcards in EO/IO Inspection Quiz 3 Deck (67)
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1
Q

Objectives of Oral Exam (1)

A

Note Normal Deviations
Oral Cancer Screening
Determine need for postponement of treatment
Early detection of lesions

2
Q

Objectives of Oral exam (2)

Identify

A

Identify conditions that may require medical eval

Identify need for treatment adaptation

3
Q

Objectives of Oral exam (3)

Provide

A

Provide baseline comparison

Provides info for legal record

4
Q

Compare: Normal/Normal Deviations/Abnormal

A
Symmetry/Asymmetry
Color
Size (mm/cm)
Location
Shape (define border)
Consistency (hard, soft, fluid inside)
Texture (rough, smooth)
Painful (are they aware)
Mobility (deeply rooted, mobile)
5
Q

History of Lesion

A

Duration (When first noticed?)
Changes (in size and look)
Sign/Symptoms associated w/ it (differentiate)
Reoccurrence (Did you have it and now it’s back)

6
Q

Systematic Sequence

A

Increases patient confidence in you
Prevents overlooking and missing imp. details
Increase efficiency and conserves time

7
Q

Types of Exams

A
Complete
Screening (limited, classify)
Limited (emergency, important to them)
Follow-up
Maintenance (reoccuring 3,4,6 months)
8
Q

Method used in Conducting an Oral Exam

A

Observation, Palpation, Ausculation (clicking/popping), Olfactation, Instrumentation, Percussion (tap to check teeth) Electrical (pulp tester)

9
Q

Palpation

A

Digital, Bidigital, Manual, Bimanual, Bilateral, Circular Compression

10
Q

Most Common Sites in the Oral Cavity for Lesions

A
Lateral border of tongue
Gingiva
Soft Palate complex (HPV)
Floor of mouth
Lower lip (More common in men)
Salivary Glands
11
Q

Oral Cancer Risk Factors

A

Age, Gender (M>F) Sunlight, Tobacco/Alcohol use (combined as well) Previous malignancy, Area, Environmental/Occupational, Socioeconomic, Specific Disease (HIV), Repeated Trauma

12
Q

Questions to ask the patient

**Make sure to always ask questions

A
Are they aware?
Do they know when the lesion occured?
Have they noticed any changes?
Are they having any symptoms?
Have they had any testing?
13
Q

Careful Communication

A
Be reassuring
Don't act alarmed
Stress the need for a follow-up
Could be normal/treatable
Referral just means to get checked out, could be normal/benign
14
Q

Oral Inspection Form (Extraoral)

A
General Appearance
Skin
Eyes
Facial Symmetry
Lymph Nodes
Glands
TMJ 
Breath Odor
Lips
15
Q

Oral Inspection Form (Intraoral)

A
Labial and Buccal Mucosa
Alveolar Ridge
Hard Palate (8+9 and back)
Soft Palate
Floor of mouth
Tongue
Pharynx
Tonsillar region
Salivary Ducts
Papilla
Marginal and attached Gingiva
16
Q

Sequence of Exam (Extraoral)

A

Overall appearance, Face, Skin, Eyes, Neck, Nodes

17
Q

Sequence of Exam, Nodes

A
Pre/Post auricular
Occipital
Submental and submandibular
Cervical chain
Supraclavicular TMJ joint
Symmetry
Sound
Asymptomatic/Symptomatic
18
Q

Sequence of Exam (Intraoral)

A

Lips(P), Breath odor(O), labial and Buccal mucosa, Tongue(P), Floor of mouth, Saliva(d), Hard then soft palate(P), Uvula(D), Tonsillar region/throat(D), other

19
Q

Sequence of Exam (Labial and Buccal Mucosa)

A

Vestibule (P) Muccobuccal folds (P) Frena (O movement, attachment) Opening of stenson’s duct (Express) Buccal mucosa (P)

20
Q

Sequence of Exam (Tongue)

A

Dorsal & Ventral sides (P) Lateral borders (retract, P, use mirror) Base of tongue (O attachment) Extension (describe deviation, sometimes veers)

21
Q

Where are women most likely to get oral cancer?

A

Baseline of tongue

22
Q

Sequence of Exam (Floor of mouth)

A

Ventral surface of tongue (P) Whartons duct(Express) Mucosa(palpate, use mirror) Frena (attachment)

23
Q

Occlusal Screening/Oral habits

A

Angle’s Classification
Habits
Occlusal Discrepancies

24
Q

Periodontal Exam

A

Papilla
Marginal Gingiva
Attached Gingiva

25
Q

Periodontal Summary Statement

A

AAP Case Type

26
Q

Describing and Documenting SF

A

Size and Shape, Color, Location and Configuration, Texture, attachment and depth, consistency, mobility, symptomatology

27
Q

Size and shape (SF)

A

Determined by L,W,H
Margin traits: Smooth/flat, raised/elevated/depressed
Contour of the border: Regular/irregular

28
Q

Color (SF)

A

Most common: red, white,red and white, pink

Others: yellow, black, brown or blue

29
Q

Location and Configuration (SF)

A

Generalized or localized

Discrete, grouped, confluent, or coalescing, linear

30
Q

Flat Lesions

A

Are on the same level as the normal skin and oral mucosa

Macule or patch

31
Q

Macule

A

Small flat, discolored spot that exhibits no change in skin texture or thickness
Less than 1 cm in size
Color: brown, black, red, or any color lighter than skin
EX: freckles, petechia

32
Q

Patch

A

Flat, discolored area on skin or mucosa
Greater than 1 cm in size
EX:Snuff patch, Birth marks

33
Q

Elevated Lesions-Nonblisterform

A

Area where surface of the lesions are raised above the normal level of the skin or oral mucosa
Denser/Firmer cell filled
EX: Papules, Plaque, Nodule, Tumor

34
Q

Papule

A

A solid raised lesions that is usually less than 1 cm in diameter
Ex: moles and skin tags

35
Q

Plaque

A

Superficial raised lesion often formed by the coalescence of closely grouped papules. Greater than 1 cm in diameter and slightly raised by still flat
Ex: leukoplakia, psoriasis

36
Q

Nodule

A

Raised marble-like lesion dectectable by touch usually 1 cm or more in diameter- hard mass
Ex: wart, enlarged lymph node

37
Q

Tumor

A

General swelling or enlargement, 2 cm or greater in width

38
Q

Fluid Filled Lesions-Blisterforms

A

Elevated lesions filled with clear fluid or pus
Softer, more fluctuant
EX: Vesicle, Bulla, Pustule, Wheal

39
Q

Vesicle

A

Small blister filled with a clear fluid, Usually less than 1 cm in diameter

40
Q

Bulla

A

Large blister filled with clear fluid. Greater than 1 cm in diameter
EX: Burn blister

41
Q

Pustule

A

Small raised lesion filled with pustule

EX: acne, boil, abscess

42
Q

Wheal

A

Raised, irregular area of localized edema. Usually from an allergic reaction lasting 24 hours
EX: Mosquito bite, Hives

43
Q

Depressed Lesions

A

Surface of the lesion is below the normal level of the skin or oral mucosa. Can be superficial or deep
EX: Ulcer, Erosion

44
Q

Ulcer

A

Crater-like Lesion of the skin or mucosa where the top of 2 layers of skin are lost
Superficial is less than 3 mm depth
Deep ulcer is greater than 3 mm depth

45
Q

Erosion

A

Shallow, depressed lesion that does not extend through the epithelium to the underlying tissue
(usually 1st layers, lip pickers)

46
Q

Linear Cracks

A

Crack

Fissure

47
Q

Crack

A

Long narrow break in the surface of the skin or mucosa

EX: lips crack

48
Q

Fissure

A

Linear crack in the top two layers of skin or mucosa

EX: corners of mouth

49
Q

Other Descriptive Terms

A

Exophytic (growing outside)
Petechiae (pinpoint red dot)
Sclerosis (hardening)
Verrucous (wartlike)

50
Q

DBCTA

A

Diameter, Border, Color, Type, Anatomic Location

51
Q

Oral Cancer

A

Devastating when detected late
50% survival rate w/n 5 years after treatment
Squamous cell carcinoma makes up 90% of all malignant neoplasms in oral cavity. Associated with sun, tobacco, alcohol, and HPV

52
Q

Appearance of Early Cancer

A

White area, Red area, Red and White area, Ulcers, Masses, Pigmentation (Doesn’t need to be all, can be just one)

53
Q

Diagnostic Aids

A

Toluidine Blue

Chemiluminescence

54
Q

Toluidine Blue

A

Identify changes in mucosa that could be malignant. Rinse or painted on. Rinsed w/ acetic acid and the retaining dye should be biopsied.

55
Q

Chemiluminescence

A

Rinse w/ 1% acetic acid and used light which will help detect abnormal cells

56
Q

Checking Suspicious lesions

A

Biopsy
Exfoliative cytology
Cytologic Smear

57
Q

Biopsy

A

Total or partial removal of the lesion by excision means so the tissue can be examined for the purpose of diagnosis (Best Method)

58
Q

Exfoliative Cytology

A

Diagnostic Aid in which cells are removed from the lesion and slides fixed and mailed in for results.
Usually comes back as suspicious so need biopsy anyway

59
Q

Cytologic Smear

A

Diagnostic aid in which cells are removed from the lesion for microscopic evaluation.
Can get false positives, not reliable

60
Q

Healthy Characteristics of Gingiva

A

Pink, Flat, Knife-like edge, Stippling (looks like an orange peel)

61
Q

Unhealthy Characteristics of Gingiva

A

Erythemic, Bulbous, and Rolling (on marginal)

Cratered (Blown up with fluid), Irregular border, Blunted, Smooth, Smooth/Shiny (w/ a lot of edema)

62
Q

Papilla Healthy

A

Pink, Melatonic, Flat, Firm, Stippled

Can be either healthy/unhealthy: Pointed, Shiny, Smooth

63
Q

Papilla Unhealthy

A

Erythemic, Cyanotic, Bulbous, Blunted, Cratered, Edematous, Irregular, Fibrotic

64
Q

Marginal Gingiva Healthy

A

Pink, Melatonic, Flat, Firm, Shiny, Smooth

65
Q

Marginal Gingiva Unhealthy

A

Erythemic, Cyanotic, Rolled, Festooned, Recessed, Clefting, Edematour, Stippled, Irregular, Fibrotic

66
Q

Angiodema

A

Swollen on lower lip

67
Q

Bells Palsy

A

Affects one side