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Nose
- warms, moistens and filters inhaled air, sensory organ for smell
- 1. Septum - divides nasal cavity
- 2. Turbinates - bony projections within the nasal cavity
- 3. Paranasal Sinuses - air filled pockets within the cranium
- a. Frontal Sinus - frontal bone above and medial to the orbits
- b. Maxillary Sinus - maxilla (cheekbone) along the side walls of the nasal cavity
- c. Ethmoid Sinus - between orbits
- d. Sphenoid - deep within the skull
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Mouth
- first part of digestive system, airway for respiratory system
- 1. Oral Cavity - short passage bordered by the lips, palate, cheeks and tongue; contains teeth, gums, tongue and salivary glands
- 2. Hard Palate - bone, close to front teeth, white color
- 3. Soft Palate - arch of muscle, pink color
- 4. Uvula - free projection hanging down from middle of the soft palate
- 5. Tongue - mass of striated muscle
- 6. Frenulum - midline fold of tissue that connects the tongue to the floor of the mouth
- 7. Salivary Glands
- a. Parotid - within the cheeks in front of the ear extending from the zygomatic arch down to the angle of the jaw
- b. Submandibular - beneath the mandible at the angle of the jaw (size of walnut)
- c. Sublingual - lies within the floor of the mouth under the tongue
- *Salivary glands function is to secrete saliva, starts digestion and cleans and protects the mucosa
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Throat (oropharynx)
- 1. Oropharynx - separated from mouth by a fold of tissue on each side of the
- anterior tonsillar pillar
- 2. Tonsils - mass of lymphoid tissue
- 3. Nasopharynx - above the oropharynx and behind the nasal cavity; adenoids and eustachian tube openings are within the nasopharynx
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Transcultural Considerations
- A. Bifid Uvula - split uvula - 18% Native Americans, 10% Asians, rare in Caucasians and African Americans/Blacks
- B. Cleft Lip/Palate - most common in Native Americans and Asians, least common in African Americans/Blacks
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History (Subjective) Nose
- 1. Nasal d/c
- 2. Frequent URI, or cold sx
- 3. Sinus pain/tenderness/pressure; hx of sinusitis
- 4. Trauma
- 5. Epistaxis
- 6. Allergies
- 7. Altered smell/change in sense of smell
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Mouth and Throat History (Subjective)
- 1. Mouth sores or lesions, canker sores
- 2. Sore throat
- 3. Bleeding gums
- 4. Toothaches, tooth sensitivity (i.e. hot, cold, sweets)
- 5. Hoarseness or voice changes
- 6. Dysphagia/ difficulty swallowing
- 7. Altered or change in taste
- 8. Hx smoking, alcohol consumption - frequency, amount.
- 9. Self-care behaviors - last dental exam, dentures, etc.
- 10. Medications
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Physical Exam/Assessment (Objective)
- A. Inspect and palpate external nose - note symmetry, septum midline and proportion to other facial features. Note patency of nares/nostrils
- B. Inspect nasal cavity - note color, texture/surface, d/c, swelling, bleeding, etc. Inspect turbinates - note color and texture
- C. Palpate Sinuses (frontal and maxillary)
- D. Transillumination of sinuses (if indicated)
- E. Inspect mouth
- 1. Lip color, moisture, cracking or lesions
- 2. Teeth - note #, caries, bite, loose teeth or abnormally positioned teeth
- 3. Gums - color, bleeding, gum margins
- 4. Tongue - color, surface characteristics and moisture. Floor of mouth or under tongue - note white patches, nodules or ulcerations
- 5. Buccal mucosa - color, nodules, lesions (Stensen’s Duct - opening of the parotid salivary gland)
- 6. Inspect palate and uvula
- F. Inspect throat - note tonsils, color, size
- G. Breath odor/halitosis
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Abnormalities
- A. Epistaxis
- B. Foreign Body
- C. Perforated Septum & Deviated Septum
- D. Acute Rhinitis/Allergic Rhinitis
- E. Sinusitis
- F. Polyps
- G. Cleft Lip
- H. Bottle Caries/Tooth Decay
- I. Dental Caries
- J. Malocculusion
- K. Gingivitis
- L. Gingival Hyperplasia
- M. Canker Sores
- N. Candidiasis - Thrush
- O. Geographic Tongue
- P. Cleft Palate
- Q. Acute Tonsillitis/Pharyngitis
- R. Black Hairy Tongue - fungal infection
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