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Patient Care II > Intraoral Exam > Flashcards

Intraoral Exam Flashcards

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1
Q

What are some things to keep in mind while preforming intraoral exams?

A

Don’t lean too far forward, don’t use patient’s chest as table, and keep your patient informed or what you are doing

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2
Q

Are physicians comfortable with doing oral health assessments?

A

NO

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3
Q

What should you look for during intraoral exam?

A

Cancer
Signs of systemic ds.
Tissue trauma
Infections
Pain
Esthetic concerns
Occlusal dysfunction
Etc

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4
Q

What is the underlying cause of 72% of oropharyngeal squamous cell carcinomas?

A

HPV

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5
Q

How does cancer behave in younger populations?

A

tends to be much more aggressive and have a poorer prognosis

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6
Q

How should you write your treatment notes?

A

With professional language (vs. speaking with patient in lay language)

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7
Q

What is a biopsy?

A

the removal of part or all of the suspicious area of tissue and microscopic evaluation by a pathologist

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8
Q

What is the gold standard for determining a diagnosis?

A

Biopsy

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9
Q

What is the misdiagnosis rate of oral lesions?

A

43% based on clinical observations alone

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10
Q

What % of oral cancers are squamous cell?

A

90%

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11
Q

What percent of all cancers is oral cancer?

A

3%

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12
Q

What is the 5-year survival rate of oral cancer?

A

57%

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13
Q

Who does oral cancer affect the most?

A

men 2x more than women

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14
Q

How many of diagnoses occur at stage I or II?

A

40%

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15
Q

How many of diagnoses occur at stage III or IV?

A

60%

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16
Q

What is the survival rate for stage I or II?

A

80-90%

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17
Q

What is the survival rate for stage III or IV?

A

33% (3 years); 67% (recurrence in 2yrs)

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18
Q

How should you describe a lesion?

A

number
size
shape
color
profile
base
border
texture

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19
Q

What are the risk factors of oral cancer?

A

Tobacco (#1 overall)
Alcohol (#2 overall)
Viruses: HPV & HIV
Sun exposure
Inadequate nutrition
Genetic predisposition
Chronic inflammation
Radiation exposure
Carcinogen exposure

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20
Q

What is the #1 risk factor for oral cancer?

A

Tobacco

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21
Q

What is the #2 risk factor for oral cancer?

A

Alcohol

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22
Q

How much oral cancer could be prevented by eliminating tobacco and alcohol use?

A

75%

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23
Q

What are some ways to prevent oral cancer?

A

Lip balm w/ sunscreen
HPV vaccine
(Avoid HPV exposure)
Diet rich in fresh fruit and vegetables

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24
Q

What is the reduction rate after 5 yrs without tobacco?

A

35%

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25
What are the high risk areas for oral cancer?
Floor of mouth lateral border of tongue ventral surface of tongue oropharynx
26
What is a tonsillar crypt?
individuals have large crypts in the tonsils that collect food debris, bacteria and hardened material ( tonsil stones). These patients often complain of halitosis.
27
What is a bifid uvula?
sometimes a bifid uvula is an indication of a submucous clef palate. Can cause speech and swallowing difficulties
28
What are signs and symptoms of oral cancer?
nonhealing ulcer bleeding lymphadenopathy hardness paresthesia drooling
29
What is the process of a routine oral cancer exam?
Question pt. about risk factors (Tobacco, alcohol, sunlight, HPV) Examine face (Discolorations, swellings, asymmetry) Palpate lymph nodes Palpate lips Palpate labial and buccal mucosa (Vestibule, Mucobuccal folds, frenums, buccal mucosa) Examine and bimanually palpate floor of mouth Examine / palpate tongue (Dorsal, ventral, lateral borders, base) Examine hard and soft palate (palpate hard) Examine tonsils and oropharynx
30
What is the basic techniques of an intraoral exam?
Inspection and palpation
31
What is erytherma?
Red area of variable size and shape. Usually in patches
32
What is petechiae?
round red pinpoint areas of hemorrhage. Usually cause by trauma, viral infection or bleeding problems
33
When did we see an increased number of reports of petechiae?
During covid
34
What are macule?
Small (<1 cm) circumscribed area of color change Brown, black, blue, red Not elevated or depressed Ex: freckle (=ephelis)
35
What is eschar?
a sloughing (shedding) of epithelium caused by disease, trauma, or chemical burn
36
What can cause eschar?
Aspirin burn
37
What are tori?
bony elevation or prominence
38
What is a patch?
Large (>1 cm) circumscribed area of color or texture change (or both) Not elevated or depressed
39
What is an ulcer?
A denuded area extending below the basal layer Gradual tissue disintegration Usually, painful Ex: aphthous or herpes simplex
40
What is an apthous ulcer?
Caused by trauma, very painful
41
What is crust?
an outer layer, covering, or scab, from a coagulation of blood, serum, pus, or any combination
42
What is plaque?
A solid, flat, area >1cm. Often keratinized (white)
43
What is a papule?
A superficial, elevated, solid lesion <1 cm. Any color Solid base or pedunculated
44
What is a vesicle?
Small (<1 cm) fluid filled, elevated lesion with a thin surface covering = Small blister Lymph or serum
45
What is a pustule?
Small (<1 cm.) vesicular-type lesion containing purulent material rather than clear fluid Creamy white or yellow
46
What is a nodule?
An elevated, deep solid lesion .5 – 2.0 cm. Overlying mucosa not fixed
47
What is an irritation fibroma?
classified as a tumor because this lesion is persistent and progressively increases in size; typically due to chronic irritation
48
What is a bulla?
A large vesicle >1 cm. = large blister Contains serum Usually at the mucosal – submucosal junction
49
What is the intraoral sequence?
Lips Buccal mucosa Buccal vestibules Tongue Oropharynx Palate Floor of mouth Lymph nodes
50
How should you examine the lips?
Outside = extraoral evert (inside) palpate lumps, bumps, etc
51
What is linea alba?
white line parallel to occlusal plane Asymptomatic Atypical Caused by trauma Chewing cheek
52
What does leukoedema look like?
More common in African-Americans “milky” white surface or blue-grey Symmetrical Atypical Doesn’t rub off Disappears / decreases when stretched normal
53
What is lichen planus?
Common inflammatory disease involving the skin and mucous membranes
54
What does licen planus look like?
Interlacing white striae (Wickham) with erythema of the surrounding mucosa. usually appearing bilaterally Painful erythematous erosions and ulcers may also occur. On the skin, usually appears as purplish, itchy, flat bumps Affects men and women equally but oral lichen planus is more common in women.
55
What are fordyce granues?
Sulfur-colored Very common Asymptomatic Atypical 1-3mm papules in the oral cavity Or lip vermillion
56
When inspecting the soft palate, what should you do?
Depress tongue Say “Ah” Look for: Ulcers Patches Etc.
57
What should you do when inspecting the hard palate?
Anterior palate Look for: Rugae (normal) = Horizontal ridges Torus palatinus (normal) = Bony lump Ulcerations Lesions
58
What are torus palatinus?
Bony lump(s) Asymptomatic Atypical 20-30% of people Females: males = 2:1 No tx necessary
59
What are torus mandibularis?
Bony lump(s) Asymptomatic Atypical More common w/ bruxism? 8-16% of people Males = females No Tx necessary
60
What is nicotine stomatitis?
Lesion of the hard palate. Lesion is white, rough, asymptomatic, and leathery appearing Contains numerous red dots or macules Caused by extreme heat in the mouth
61
Where is the most common place for cancer to occur on the tongue?
the lateral border and the base of the tongue.
62
What are atypical findings that can occur on the tongue?
the dorsal surface of the tongue are common-fissuring, scalloping, enlarged papilla and benign migratory glossitis
63
What is benign migratory glossitis?
THE LESIONS OFTEN HEAL IN ONE AREA AND THEN MOVE (MIGRATE) TO A DIFFERENT PART OF THE TONGUE. ALSO CALLED GEOGRAPHIC TONGUE ERYTHEMATOUS, WELL DEMARCATED ARES OF PAPILLARY ATROPHY USUALLY ASYMPTOMATIC BUT CAN CAUSE DISCOMFORT, PAIN OR BURNING SENSATION IN SOME CASES, OFTEN RELATED TO EATING SPICY OR ACIDIC FOODS
64
What is leukoplakia?
White or grayish thick keratotic patch-like lesion on the mucosa which cannot be rubbed off
65
What is hairy leukoplakia caused by?
Caused by the Epstein-Barr virus and is usually associated HIV infection or other immunosuppressive conditions
66
Where does hairy leukoplakia occur?
Typically occurs on the lateral border of the tongue. Either unilateral or bilateral. White rough patches.
67
What is a hairy tongue caused by?
Trapped debris Bacteria Fungus Coffee Tobacco Antibiotics and other drugs can cause.
68
What should you look for on the floor of the mouth?
Tongue to palate Lumps, bumps, swellings Mandibular tori Submandibular duct is also called-Wharton’s duct. Drains saliva from the submandibular and sublingual glands. Accounts for 60% of saliva.
69
What are lingual varicosities?
Normal w/ age
70

Patient Care II (3 decks)

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