Comprehensive Nose, Mouth, and Throat Anatomy and Disorders for Medical Students

What are the external structures of the nose?

Bridge, tip, nares, vestibule, and columella

What are the internal structures of the nose?

Septum and turbinates (superior, middle, inferior)

What is the function of the turbinates?

Increase surface area for air filtration, warming, and humidification

Name the three salivary glands

parotid, submandibular, sublingual

How many permanent and deciduous teeth do humans have?

32 permanent, 20 deciduous

What are tonsils made of?

Lymphoid tissue between anterior and posterior pillars

Describe the tonsil grading scale.

1+ = Visible

2+ = Halfway to uvula

3+ = Touching uvula

4+ = Touching each other

What are the regions of the pharynx?

Nasopharynx (behind nasal cavity; contains adenoids and eustachian tube)

Oropharynx (behind tonsillar pillars)

When does salivation begin in infants?

Around 3 months

What nasal changes occur during pregnancy?

Nasal stuffiness and nosebleeds due to increased vascularity

What oral change is common in pregnancy?

Gums become soft, hyperemic, and may bleed

What are common aging changes in the nose?

More prominent appearance, stiffer hairs, reduced smell

What oral changes occur in aging adults?

Gum recession, tooth loss, decreased saliva and taste, tongue atrophy, TMJ changes, nutritional risk

Who most often has a bifid uvula?

Asians and Native Americans

Cleft lip and palate are most common in which groups?

Asians and Native Americans

What is torus palatinus and who has it most frequently?

Bony ridge on hard palate; common in Native Americans, Inuits, and Asians

What is leukoedema and who is it most common in?

Grayish-white benign lesion on buccal mucosa; common in Black individuals

Which groups have higher rates of poor dental hygiene and oral cancer?

Blacks, Hispanics, Native Americans, Alaska Natives

What to assess for the nose?

Discharge, colds, sinus pain, trauma, nosebleeds, allergies, smell changes

What to assess for the mouth/throat?

Sores, sore throat, bleeding gums, toothache, hoarseness, dysphagia, taste change, smoking/alcohol use, self care behaviors

What additional questions are asked for children?

Thumb sucking, bottle use, tooth eruption/loss

What should be inspected on the external nose?

Deformity, symmetry, inflammation, lesions

How is nasal patency tested?

By occluding one nostril and sniffing—absence = obstruction

What does bright red swollen mucosa indicate?

Upper respiratory infection (URI)

What does pale, boggy mucosa indicate?

Chronic allergies

What does sinus tenderness indicate?

Sinusitis or allergies

What are normal vs. abnormal lip findings?

Normal = smooth, moist; Abnormal = cracking, lesions, cyanosis

What dental findings are abnormal?

Missing teeth, caries, malocclusion

What gum findings are normal in Black individuals?

Dark melanotic line near gingiva

What causes a large tongue?

Hypothyroidism, acromegaly, mental retardation

What causes a small tongue?

Malnutrition

What is leukoedema?

Grayish, benign area on buccal mucosa

What is leukoplakia?

Chalky white precancerous patch

What is torus palatinus?

Benign bony ridge on hard palate

What does deviation of the uvula indicate?

Cranial nerve X (vagus) damage

Which cranial nerve is tested when the patient says "ahh"?

CN X (vagus)

What does 3+ or 4+ tonsil enlargement indicate?

Acute infection

What diseases cause white tonsillar membranes?

Mononucleosis, leukemia, diphtheria

What cranial nerves are tested by gag reflex?

CN IX (glossopharyngeal) & CN X (vagus)

What cranial nerve moves the tongue?

CN XII (hypoglossal)

When should ears, nose, and throat be examined in children?

At the end of the exam

What are common nasal abnormalities?

Epistaxis, foreign body, acute/allergic rhinitis, sinusitis, nasal polyps

Name common lip disorders.

Cleft lip, angular cheilitis, herpes simplex 1

Name common oropharyngeal disorders.

Cleft palate, bifid uvula, oral Kaposi's sarcoma, acute tonsillitis

Common teeth/gum disorders?

Baby bottle decay, caries, malocclusion, gingivitis, gingival hyperplasia

What causes white patches on mucosa (precancerous)?

Leukoplakia

What causes white patches that wipe off easily (fungal)?

Candidiasis (thrush)