Nose, Mouth and Throat

Question 1

Nose, Mouth, and Throat Subjective Data

Answer 1

Nose
1. Discharge
2. Frequent colds (upper respiratory infections or URIs)
3. Sinus pain
4. Trauma
5. Epistaxis (nosebleeds)
6. Allergies
7. Altered smell

Mouth and Throat
1. Sores or lesions
2. Sore throat
3. Bleeding gums
4. Toothache
5. Hoarseness
6. Dysphagia
7. Altered taste
8. Smoking, alcohol consumption
9. Patient-centered care
- Dental pattern
- Dentures or appliances

Question 2

Additional History for Infants and Children

Answer 2

• Does the child have any infection or sores, such as thrush, canker sores/ How frequently?
• Did the child’s teeth erupt on time?
• Patient-centered care?

Question 3

Additional History for Aging Adult

Answer 3

• Any dryness in the mouth? Are you taking any medications
• Have you had any loss of teeth? Can you chew all types of food
• Are you able to care for you own teeth or dentures?
• Have you noticed a change in you sense of taste or smell?

Question 4

Nose, Mouth, and Throat Objective Data

Answer 4

NOSE
1. Inspect external nose for symmetry, deformity, or any lesions

2. Palpation the nose for PATENCY
3. Inspect with nasal speculum:
   - Color and integrity of nasal mucosa
   - SEPTUM (note any deviation, perforation, or bleeding)
   - TURBINATES (note color, any exudate, swelling, or polyps)
4. Palpate the sinus area (note any tenderness)

MOUTH & THROAT
1. Inspect with penlight
- Lips, teeth and gums, tongue, buccal mucosa (note color; whether structures are intact; any lesions)
- Palate and uvula (note integrity and mobility as person phonates)
- Grade tonsils
- Pharyngeal wall (note color, any exudate, or lesions)

2. Palpation
   - When indicated in adults, bimanual palpation of mouth
   - In the neonate, palpate for integrity of palate and assess sucking reflex

Question 5

MOUTH & THROAT:

What equipment is needed to inspect the mouth and throat?

Answer 5

Use gloves

Question 6

NOSE:

What is the normal finding when you palpate and percuss the sinuses?

Answer 6

firm pressure but NO pain

Question 7

Tonsils Grade scale: 1+, 2+, 3+, 4+

Answer 7

1+ Visible
2+ Halfway between tonsils pillars and uvula
3+ Touching the uvula
4+ Touching one another

Question 8

Seasonal Allergic Rhinitis (AR or Hay Fever) or Chronic Allergy

Answer 8

Turbinates are swollen, pale, and grey

Question 9

Nasal Polyps

Answer 9

Smooth, pale gray nodules, which are overgrowths mucosa, are most commonly caused by chronic allergic rhinitis

Question 10

Furuncle

Answer 10

a small boil located in the skin or mucous membrane; appears red and swollen and painful

Question 11

Smooth Glossy Tongue (Atrophic Glossitis)

Answer 11

surface is slick and shiny; mucosa thins and looks red from decreased papillae
- accompanied by dryness of tongue and burning
- Vitamin b12 deficiency (pernicious anemia), folic acid deficiency, and iron anemia deficiency

Question 12

Candidiasis or Monileal Infection

Question 13

Black Hairy Tongue

Answer 13

elongation of filiform papillae and painless overgrowth of mycelial threads of fungus infection on the tongue
- black to yellow
- occurs after use of antibiotics and heavy smoking

Question 14

Angular Cheilitis (Stomatitis, Perleche)

Answer 14

erythema, swelling, and shallow and painful fissures at the corners of the mouth that occur with excess salivation and Candida infection

Question 15

Torus Palantinus

Answer 15

???

Question 16

Developmental Competence: Infants and Children

Answer 16

Mouth and Throat
- sucking tubercle is normal - a small pad in the middle upper lip from friction of breastfeeding or bottle-feeding

• Childs age in months minis number 6 should equal expected number of deciduous teeth

Question 17

Developmental Competence: Aging Adult

Answer 17

• Nose may appear more prominent on face from loss of subcutaneous fat
• Teeth may look slightly yellowed, but color is uniform
• Surface of incisors may show vertical cracks from a lifetime of exposure to extreme temperatures
• Teeth may look longer as gums margins recede