nose, mouth, throat

nose

entryway resp system

external

internal

warm, humidify, filter air, smell

external nose

bridge

tip

nares → nostrils

internal nose

septum → divide nasal cavity into 2

turbinates (3) → increase surface area for blood vessels, mucous membrane

smell

olfactory receptor = hair cell

enhance taste for nutrition

paranasal sinuses

air-filled space in skull

drain into nasal cavity

paranasal sinuses function

lighten skull weight

help with voice resonance

resonator for sound production

assess frontal sinuses

press firmly under eyebrow for tenderness

tenderness = inflam + infection

assess maxillary sinuses

press up and below cheekbone

tenderness = inflam + infection

mouth structure

lip

teeth

tongue

palate

mouth function

secondary airway

entry to digestive system

taste

taste buds

tongue

soft palate

oral cavity

adult teeth = 32

16 teeth upper/lower

oral palate

hard

soft

uvula

mucosa

salivary gland

hard palate

front

bony

pale

soft palate

back

pink

movable

uvula

midline

centered

mucosa

buccal mucosa → inner cheek

salivary glands

parotid

sublingual

submandibular

throat

pharynx

behind nose/mouth

tonsils

tonsils

made of lymphoid tissue

immune defense

tonsils grading

1+ - visible

2 + - halfway between tonsillar pillar and uvula

3+ - touching uvula

4+ - touching each other

infant/children assess

cleft lip → palpate

• effect feed/swallow

infant/children salivation

start ~3mo

drool is normal

infant/children teeth dev

2.5 yo → 20 baby teeth

6-12 yo → loose baby teeth

infant/children normal findings

epstein pearls → small white cyst

pregnant women

nasal stuffiness → increase vascularity

gingivitis → gum bleeds

epistaxis → nosebleed

epistaxis

nosebleed

sit up right → lean forward → pinch nose 15-20 min

aging adults

increase risk dehydration, poor nutrition, oral infection

aging adults age-related changes

decrease saliva

decrease taste/smell

aging adults oral changes

tooth loss

malalignment

gum recession

aging adults risk

malnutrition

oral infection

lesions

how to test patency of nostrils

push nasal wing shut with fingers → ask pt to sniff inward through nares

abnormal

• obstruction

• explored with nasal speculum

deviated nasal septum

hump or self in one nasal cavity

perforated septum

spot of light from penlight shining in other nares

cocaine use

nasal turbinates

bony ridges curve down from lateral wall

middle/inferior turbinate appear same light-red color as nasal mucosa

nasal polyps

benign growth, accompanied by chronic allergy

pink, fixed, vascular → normal

smooth, grapelike yellow-gray, avascular, mobile, nontender

leukoedema

benign

milky, blue-white

opaque area

always bilateral

mild patch

age: gray-white thick

candidiasis

cause:

• steroid inhaler, HIV, usage of broad-spectrum antibiotics or corticosteroids, leukemia, malnutrition, reduced immunity

clear/raw denuded surface

leukoplakia

chalky, white, thick raised patch with well-defined borders

lateral edges on tongue

causes:

• chronic irritation of smoke/alcohol

fordyce’s granules

small isolated white or yellow papules on mucosa of cheek, tongue, lipids

small sebaceous cyst are painless