Ch. 13 Extraoral & Intraoral Examination

first indication of subclinical disease processes in other parts of the body

changes in oral tissues

use of a single finger for palpation

digital

use of finger and thumb of same hand for palpation

bidigital

une of finger or finger and thumb from each hand simultaneously in coordination for palpation

bimanual

two hands used at the same time to examine corresponding structures on opposite sides of the body

bilateral

abnormality identified by the healthcare professional 

sign

abnormality that is observed by the patient 

symptom

type of oral mucosa that covers the gingiva and hard palate (keratinized)

masticatory muscose

type of oral mucosa that covers inner surface of lips and cheeks, floor of mouth, ventral surface of tongue, soft palate, and alveolar mucosa (non-keratinized) 

lining mucosa

type of oral mucosa that covers dorsum of the tongue

specialized mucosa

threadlike keratinized elevations that cover dorsum of the tongue; are the most numerous

filiform papillae

mushroom-shaped, red papillae spread throughout the dorsum of the tongue

fungiform

10-14 large round papillae arranged in a “V” shape between body and base of the tongue

circumvallate papillae

vertical grooves on the posterior lateral portion of the tongue

foliate papillae

lesion is limited to small focal area

localized

involves most of an area or segment

generalized

discrete, not running together; may be arranged in clusters

seperate lesions

close to each other with margins that merge

coalescing

contains fluid, usually soft and translucent

blisterform

small (< 1 cm), elevated lesion that is circumscribed that may contain serum or mucin and appear white

vesicle

any size lesion that contains pus, which makes it appear a yellow color

pustule

large (> 1cm) lesion usually filled with mucin or serum and sometimes blood

bulla

small (< 5mm ) solid lesion

papule

larger (> 5 mm) solid lesion

nodule

large (>2 cm) solid lesion

tumor

slightly raised solid lesion

plaque

serum filled papule or plaque that is only slightly raised

wheal

attached by a narrow stalk or pedicle

pedunculated

base is as wide as the lesion itself

sessile

most depressed lesions

ulcers

shallow depressed lesion

erosion

flat lesion that is the same level as the skin, can be identified by its color contrasting with the normal tissues

macule

flat lesion that is a pigmented area larger than a macule

patch

permanent mark remaining after a would

scar

linear crack in the epidermis

fissure

a recess, cavity, or dilated tract

sinus

outer layer covering formed by coagulation of drying blood, serum, or pus

crust

red area of variable size and shape

erythema

growing outward

exophytic

hardened

indurated

resembling a small, nipple shaped projection or elevation

papillary

minute hemorrhagic spots that appear as little red dots usually on the cheek

petechiae

loose membranuous layer of exudate

pseudomembrane

any mass of tissue that projects outward or upward from the normal surface level

polyp

marked with points or dots differentiated from the surrounding surfaces by color elevation, and texture

punctate

containing forming, or discharging pus

purlucent

rough, wart-like lesion

verrucous

What are the most common area for oral cancer?

lateral border or tongue, floor of mouth, lips, and soft palate area

entire lesion removed for biopsy

excisional

a representative section taken from lesion for biopsy

incisional

What are indications for biopsy? 

any unusual lesion that can’t be identified clinically

any lesion not healed within 2 weeks

any lesion that does not break through the surface of the epithelium