face and neck regions

chpt 1 garcia

structures of the face and neck and any other structure associated with them are oriented according to

ANATOMICAL POSITION

a change in surface feature in a patient may signal

a condition of clinical significance and must be noted in the patient record as well as correctly followed up by the examining dental professional

regions of the face include

• frontal

• orbital

• nasal

• infraorbital

• zygomatic

• buccal

• oral

• mental

lymph nodes when palpable

should be noted in the patient record

lymph nodes

bean-shaped bodies grouped in clusters along the connecting lymphatic vessels

frontal region of the face includes

forehead and area above the eyes

frontal region examined

visually inspected and bilaterally palpated

orbital region includes

eyeball and all of its supporting structures contained in the bony eye socket

orbital region explained

visually inspecting the eyes and their movements and responses to light and action

nasal region includes

• external nose

• root of the nose

• apex of the nose

• nares

• nasal septum

• ala

external nose

main feature of the nasal region

root of the nose

located between the eyes

apex of the nose

the tip

nares

nostril

nasal septum

midline that separates the nares

ala

winglike cartilaginous structures that laterally bound the nares

nasal region examined

visually inspected and bilaterally palpated starting at the root and proceeding to the apex

infraorbital region

located inferior to the orbital region and lateral to the nasal region

zygomatic region

overlies the bony support for the cheek, the zygomatic arch

temporomandibular joint (TMJ)

zygomatic arch

extends from just below the lateral margin of the eye toward the middle part of the external ear

TMJ

location where the upper skull forms a joint with the lower jaw

TMJ examined

palpate the lower jaw moving, finger is placed gently into the external ear canal during movement

buccal region includes

• soft tissue of the cheek

• masseter muscle

• angle of the mandible

buccal and zygomatic regions include

parotid salivary gland

infraorbital, zygomatic and buccal regions examined

visually inspecting and bilaterally palpating each side of the face while asking the patient to clench their teeth multiple times

infraorbital, zygomatic and buccal regions examined

NORMAL/ HEALTHY FINDINGS

firm and smooth without tenderness or increased size or firmness

joint movement should be smooth, continuous and silent

should be free of pain

infraorbital, zygomatic and buccal regions examined

ATYPICAL FINDINGS

tenderness and pain associated with maxillary sinusitis and noise or deviation of lower jaw on opening

infraorbital, zygomatic and buccal regions examined

ABNORMAL FINDINGS

facial paralysis or stroke, temporomandibular disorder with limitations of movement, subluxation or pain on TMJ movement

oral region includes

• lips

• oral cavity

• vermillion border

• vermillion zone

• mucocutaneous junctuion

• philtrum

• tubercle of upper lip

• labial commissure

• maxilla

• mandible

vermillion border

each lip begins as this and includes only those areas that are redder in color with variations as to tone

vermillion zone

darker reddish appearance than the surrounding skin

mucocutaneous juction

part that outlines lips from the surrounding skin

philtrum

on the midline of the upper lip, extending downward from the nasal septum, is a vertical groove

tubercle of the upper lip

philtrum terminates a thicker area of the midline of the upper lip

labial commissure

where upper and lower lips meet at each corner of the mouth

maxilla

the bone underlying the upper lip is the upper jaw

mandible

the bone underlying the lower lip is the lower jaw

lips examined

bidigitally palpate as well as visually inspected in a systemic manner, from one commissure to the other

mental region includes

• chin

• mandible

• mandibular symphysis

• ramus

• coronoid process

• coronoid notch

• mandibular condyle

• mandibular notch

chin

major feature of mental region

mandibular symphysis

marks the midline of the mandible

ramus

on lateral aspect of the mandible, stout flat plate extends superiorly and posteriorly from the body of the mandible on each side

coronoid process

at the anterior border of the ramus is a thin, sharp margin

coronoid notch

main part of the anterior border of the ramus forms a concave forward curve

mandibular condyle

posterior border of ramus is thickened and extends from the angle of the mandible to a projection

mandibular notch

between the coronoid process and the condyle is a depression

mental region examined

visually inspected and bilaterally palpated

neck regions extend from

skull and lower jaw down to clavicles and sternum

superficial cervical nodes

deep cervical nodes

sternocleidomastoid muscle

large strap muscle, easily palpated on each side of the neck of a patient, with its borders dividing the neck into further regions

hyoid bone

suspended in the neck, many muscles attach to controlling the position of the tongue

thyroid cartilage

found anterior midline and inferior to the hyoid bone

larynx

voice box

thyroid gland

an endocrine gland, also palpated on a patient within the midline cervical area

parathyroid glands

endocrine glands that are located close to or within posterior aspect of each side of the thyroid gland but cannot be palpated

submandibular salivary gland and the sublingual salivary gland

can both be palpated in the neck region

hyoid bone effectively palpated

by feeling inferior to and medial to the angles of the mandible

thyroid gland examined

place one hand on the side of the trachea and gently displacing the thyroid tissue to the other side of the neck, while other hand palpates the displaced gland tissue

submandibular salivary gland and region examined

palpate inward from the inferior border of the mandible near its angle as the patient lowers the chin

then push tissue over the bony inferior border of the mandible on each side, where it is grasped then rolled

submandibular and sublingual salivary glands and region examined

during intraoral examination by palpating floor of the mouth behind each mandibular canine, with one hand placed intraorally and one extrorally