Examination of the oral cavity Flashcards
(99 cards)
1
Q
what does exam of oral cavity include?
A
- EOE
-IOE - palpation
2
Q
what areas do we palpate
A
neck
maxilla
submandibular region
3
Q
what instruments are required for oral examination?
A
- mirror
- hands
- Dental probe
- perio probe
- light
- radiograph order
- blood tests?
4
Q
EOE - what is included?
A
- head, neck, face symmetry and swellings
5
Q
what could assymety indicate?
A
- swelling, pt in a fight
- lymph node enlarged
- stroke
- cancer potential
6
Q
what are the 2 categories of what we examine in IOE?
A
hard tissue
soft tissue
7
Q
IOE - list what is included in hard tissues we examine
A
- teeth
- bone (also included in external examination and palpation)
8
Q
IOE - list what is included in soft tissues we examine
A
- Gums
- Lip and vermillion border
- Buccal mucosa
- Tongue
- Floor of the mouth
- Hard palate
- Soft palate and uvula
- Tonsils and pharyngeal arches
9
Q
define nodule ulcer/lesion
A
10
Q
define postule ulcer/lesion
A
11
Q
define bular ulcer/lesion
A
12
Q
define macuole ulcer/lesion
A
13
Q
define plaque ulcer/lesion
A
14
Q
define ulcer
A
degradation/loss of surface epithelium
connective tissue underneath is exposed
15
Q
how are oral ulcers classified?
A
- severity
- number
- aetiology
16
Q
what are the 2 classifications of ulcers according to severity?
A
acute
chronic
17
Q
what are the 2 classifications of ulcers according to number?
A
solitary
multiple
18
Q
what are the classifications of ulcers according to aetiology?
A
- Infective: caused by viruses usually multiple ulcers
- Caused by immunological disorders: Lichen Pannus, erythema multiform,vesiculobullous lesions
- Caused by other systemic disease: Chrons, vitamin deficiency, diabetes
- Cancerous ulcers : squamous cell carcinoma
- Traumatic: tooth brush, denture or dental instrument
- Thermal ulcer: caused by hot food
- Chemical: dental materials, local Aspirin, chewing tobacco , mouth wash
19
Q
how do we describe an ulcer?
A
20
Q
what kind of ulcers are a cause for concern? (time period)
A
*As a rule persistent ulcers that don’t heal after 10 days(up to 3 weeks) are a cause for concern (mostly about cancer)
21
Q
what do we record during an IOE?
A
- DMF: decayed, missing filled teeth
- check for caries with probe in pits and fissures
- dental anaomolies
- examine gingiva
21
Q
list examples of dental anomolies
A
- fused supernumery teeth
- twinned teeth
- amelogenesis imperfecta
22
Q
how do twinned teeth develop/ come about?
A
- fusion of 2 tooth germs at the development stage
or - splitting of 1 tooth germ into 2 twinned teeth
23
Q
give an example of a systemic tooth anomolie
A
amologenesis imperfecta
24
what do we examine gingiva for?
- bleeding
- inflamm
- signs of gingivitis
- recession
- dental pockets using dental probe (perio disease)
25
what is a normal pocket depth?
0-3mm
26
what pocket depth is considered perio dx?
above 3mm
27
what is a vermillion border?
transition between skin and labial mucosa
28
list some normal occurances we might see at the vermillion border (do not require intervention) at an EOE
29
list some abnormalities we might see at the vermillion border (do not require intervention) at an EOE
30
what is angular cheilitis mostly caused by?
iron and vitamin B deficiency
31
with angular cheilitis what is usually acommpanied with it? (tongue)
tongue inflamed
32
what is does herpes look like
- in form of a bullar or big vesicle filled with fluid
over time dries and can ulcerate
33
jeghers synrome - what is is
dx that causes pollips in the guts
34
aphthous ulcers
occur for no apparent reason
not caused from trauma or systemic dx
35
what are aphthous ulcers associated with
stress
hormonal changes
36
if aphthous ulcer doesnt heal for over 3 weeks, what do we do?
after 3 weeks - red flag
37
define mucocyst
mucocyst related to minor salivary glands related to
38
what causes a mucocele?
blocking of minor salivary gland
39
where do 75-80% of muceles occur in?
lower lip
40
other than the lower lip, where can mucoceles occur? (next most common place)
floor of mouth
41
name some normal occurances in the Buccal Mucosa
42
what does linea alba translate into?
white line?
43
leukoedema - when does it dissapear?
when stretched
44
leukoedema - who is it most common with? ethnicity
black
45
how do we confirim if leukodeama is a leukoedema?
if we stretch the oral mucosa and it dissapears
46
list some abnormalities and pathology of the buccal mucosa
47
what are herpetic ulcers caused by
herpes virus
48
herpetic ulcers - describe their lifetime
at first, ulcers with fuild
then burst causing multiple ulcers
each ulcer represents one vesicle
49
define leukoplakia
white patch/plaque that cannot be rubbed off
50
what is leukoplakia caused by?
caused by continuous irritation/ infections/candida
51
where can leukoplakia occur?
anywhere in oral mucosa
52
erythroplakia - define
red patches
53
where can erythroplakia occur
anywhere in the oral mucosa
54
do we worry about erythroplakia or leukoplakia?
yes - could be cancerous
55
what are the 2 visual forms of cancer in mouth?
mass
non-healing ulcer
56
list the parotid gland lesions
57
what is sialolithiasis?
parotid gland stones
58
sialolithiasis - what investigation do we use to see the blockage?
sialogram - injecting dye into the parotid duct and radiographing it
dye based radiography
59
what can parotid duct stones cause?
pressure and swelling of salivary gland
60
what is parotid sialadenitis?
inflammation of parotid gland
61
what is the manifestation of parotid sialadenitis?
swelling of salivary gland or its papilla
62
parotid sialadenitis - what is it due to?
infection/ blockage from tumor or stone
63
pleomorphic adenoma - cancerous or benign?
benign
64
painful or painless?
painless
65
when is a pleomorphic adenoma alarming?
when it turns into a big size - could turn into malignant tumour
66
list the Immunological lesions
67
where does lichen planus occur
labial or buccal mucosa
68
list the normal occurances in the tongue
69
list the abnormalities and pathology of the tongue
70
what is angular cholitis usually coupled with? (due to iron definiciency)
iron deficiency glossitis
71
geographic tongue - what is it caused by
degeneration of papilla
it is migrational
72
median rhomboid glossitis - what might it harbour
thyroid tissue
73
median rhomboid glossitis - what kind of tissue is it?
developmental
74
where does candida occur?
tongue
cheek
lip
75
how do we know that candidiasis is candidiasis and not leukoplakia?
if we wipe off with cotton bud - it will be wiped and it will leave raw bleeding surface
76
how do we treat candidiasis?
antifungal
77
what could candida be a sign of?
low immunity
too much antibiotics
78
what is the issue clinically with tongue ulcers?
can be hidden and not noticed - e.g. side of tongue
79
most common area for tongue ulcer when cancerous
lower surface
lateral border
80
what is this?
mandibular tori
81
are mandibular tori normal?
yes
82
why would we ever remove mandibular tori?
only if they're interferring with something
83
list the abnormalities and pathologies of the floor of the mouth
plus sublingual
plus lingual varices
84
what is the mucocele called that we find at the floor of the mouth?
ranula
85
what is lingual varices - do they req treatment?
no - come with age
86
when do lingual varices require intervention?
when they have a thrombus in them
87
list the abnormalities of the hard palate
88
torus palatinus - do they req intervention?
no - unless they interfere with something
89
nicotinit stomatitis - causes
reverse smoking
pipe smoking
90
nicotinic stomatitis - what does it entail?
hyperkeratosis
ulceration
91
soft palate - what is included?
uvula and tonsils?
92
what are the Soft palate and uvula abnormalities: inflammation,infections and ulcers?
93
shift of uvula - what could this be an indication of?
growing mass or tumour
94
what do we palpate? by hand
- Jaw bones: continuity
- Submandibular and cervical (neck) lymph node
- Salivary glands
- Swellings of the head and neck
95
list the tonsils and pharynx abnormalities
96
peritonsular abscess - how do we treat?
antibiotics
97
pharingitis - what can it be caused by
bac
virus
chemical irritation (acid reflux)
98
why do we check for jaw bone continuity
for signs of fractures
