H.A 18 Mouth, Throat, Nose, and Sinuses

Mouth contains

tongue, teeth, gums, the salivary glands (parotid gland, submandibular, and sublingual).

The tongue

a mass of muscle, attached to the hyoid bone and styloid process of the temporal bone.

It is connected to the floor of the mouth by a fold of tissue called the frenulum.

The gums (gingiva)

are covered by mucous membrane and normally hold 32 permanent teeth in the adult

Teeth

The top, visible, white enameled part of each tooth is the crown.

The portion of the tooth that is embedded in the gums is the root.

The crown and root are connected by the region of the tooth referred to as the neck.

Papillae

Small bumps cover the dorsal surface of the tongue.

Three pairs of salivary glands

Saliva (watery, serous fluid containing salts, mucus, and salivary amylase) into the mouth

Amylase digests carbohydrates

Throat (pharynx)

Pharyngeal tonsils, or adenoids, are found high in the nasopharynx. Because tonsils are masses of lymphoid tissue, they help protect against infection

Located behind the mouth and nose

• Serves as a muscular passage for food and air

• Nasopharynx

• Oropharynx

• Laryngopharynx

• Masses of lymphoid tissue

• Palatine tonsils

• Lingual tonsils

• Pharyngeal tonsils (adenoids)

Kiesselbach area.

The front of the nasal septum contains a rich supply of blood vessels

Known for nose bleeds

Sinuses

Four pairs of paranasal sinuses: frontal, maxillary, ethmoidal, and sphenoidal

These air-filled cavities decrease the weight of the skull and act as resonance chambers during speech.

lined with a ciliated mucous membrane that traps debris and propels it outside, easily blocked.

Nose

Consists of an external portion covered with skin and an

internal nasal cavity

• External nose: Bridge, Tip, Two oval openings called nares

• Internal nose: Nasal cavity, Nasal septum, Kiesselbach area, Superior, middle, and inferior turbinates

Receptors for cranial nerve I (olfactory)

epistaxis

nosebleeds

local causes: trauma, mucosal irritation, septal abnormality, inflammatory diseases, tumors

systemic causes: blood dyscrasias, arteriosclerosis, hereditary hemorrhagic telangiectasia), and idiopathic causes

rhinorrhea

Thin, watery, clear nasal drainage

Gingivitis

Red, swollen gums that bleed easily occur in early gum disease

Periodontitis

Recession of the gums accompanied by tooth loss occurs in more advanced gum disease

Periodontal disease

correlated with cardiovascular disease.

Dysphagia

difficulty swallowing

odynophagia

painful swallowing

bruxism

Grinding the teeth

precipitate temporomandibular joint (TMJ) problems and pain.

Leukoplakia

(Chalky thick white patches of cells), precancerous condition.

halitosis

bad breath

Sinusitis may also be caused by

infection, a fungus, a deviated nasal septum, nasal polyps, or, in rare cases, an immune system deficiency.

palatine tonsils

located on either side of the oropharynx

pharyngeal tonsils

or adenoids are located high in the nasopharynx.

lingual tonsils

lie at the base of the tongue.

Most lip cancers are

squamous cell carcinomas

caries

Tooth decay

may appear as brown dots or cover more extensive areas of chewing surfaces.

hyperplasia

Enlarged, reddened gums

seen in pregnancy, puberty, leukemia,

Burton line

seen in lead poisoning

A bluish-black or gray-white line along the gum line

Candida albicans

Also called thrush

Whitish, curd-like patches that scrape off over reddened mucosa and bleed easily

Koplik spots

Tiny whitish spots that lie over reddened mucosa are an early sign of measles.

Black hairy tounge

Papillae overgrowth

poor hygiene/antibiotics

Tonsilitis

tonsil infection

Fruity or acetone breath is associated with

diabetic ketoacidosis.

Older adult considerations

Cervical curvature may increase due to kyphosis.

• Accumulation of fat around cervical vertebra “dowager’s hump”

Thyroid may feel more nodular or irregular due to fibrotic

changes. May be lower in neck.

• If have arthritis or osteoporosis, may experience neck pain and

decreased range of motion (flexion, extension, lateral bending,

rotation)

Masses of lymphoid tissue

Palatin tonsils

Lingual tonsils

Pharyngeal tonsils Adenoids

1+

Visible, an obstruction of up to 25% of midline.

2+

Midway between tonsillar pillars and uvula

tonsils obstruct 25-50% of midline

3+

Touch uvula, an obstruction of 50-75% of midline

4+

Touch each other, obstruct 75-100% of midline

Vagus (CN X)

cranial nerve is associated with the movement of the uvula

herpes simplex virus

recurrent vesicular eruptions of the lips and surrounding skin.

Angular cheilitis

presence of fissures at the edges of the mouth.

Actinic cheilitis

Affects the lower lip and is characterized by scales, thickening, and eversion of the lip tissue.

Angioedema

diffuse swelling of the dermis and subcutaneous tissue.

most common site of oral cancer is

underneath the tongue.

carbon monoxide poisoning

The finding of reddish lips

Pallor around the lips is a finding in clients with

anemia

aphthous stomatitis

Painful, recurrent ulcers in the mouth (canker sores).