physical exam of the Mouth and Throat

physical exam of the Mouth and Throat

The Mouth - physical exam of the Mouth and Throat

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General bodily examination of the digestive system is the examination of the mouth, throat and abdominal region. But more focus would be on the mouth and throat.

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The Mouth

Mouth and throat
The mouth is the starting of the passageway to the digestive tract, but it also functions in the entry or exit of air. The major structure of the exterior of the mouth is the lips. The physician should note the presence of painful, inflamed and dried cracks or fissures of the lips, called cheilitis. These may be caused by exposure to harsh climatic conditions, habitual licking or biting of the lips, particularly with fever in systemic disease. Cheilosis, or angular stomatitis, is fissuring at the angles or corners of the lips and may indicate vitamin deficiencies of riboflavin or niacin.

Any lesions on the lips are noted. The herpes simplex virus produces singular or clusters of vesicular eruptions on the lip, which are often called "cold sores". The lip may also be the site of a original syphilitic chancre, which appears as a firm nodule that ulcerates and crusts. If one suspects a chancre, it is examined with a gloved hand for the doctor's protection.

The mouth and throat are divided into three areas
1. The oral cavity, which extends from the lips to the palatopharyngeal arches
2. The oropharynx, which extends from the epiglottis to the lower edge of the adenoids, and
3. The nasopharynx, which extends from above the lower edge of the adenoids to the nasal cavity.

The major structures that are visible on examination within the oral cavity ad oropharynx are the mucosal lining of the lips and cheeks, gums or gingival, teeth, tongue, palate, uvula, tonsils and posterior oropharynx. Other pharyngeal structures that are not visible one examination are the epiglottis, lingual tonsils, and pharyngeal tonsils or adenoids.

With a cooperative child almost the whole examination can be done without the uyse of a tongue blade. The physician asks the child to open his mouth wide, requests that he moves his tongue in dissimilar directions for full visualization, and has him say "ahh" in order to depress the tongue for full view of the back of the mouth (tonsils, uvula, oropharynx). For a closer look at the buccal mucosa or lining of the cheeks, the nurse can ask the child to use his fingers to move the outer lip and cheek to open side. Performing the examination in front of a mirror is a great aid in enlisting children's cooperation. Other arrival is using a puppet and letting the child survey its wide-open mouth.

Infants and toddlers, however, commonly resist attempts to keep the mouth open. This is because it is an upsetting part of the examination, it is reserved until last (wit examination of the ears) or performed while episodes of crying. However, the use of a tongue blade to depress the tongue is necessary. The tongue blade is settled along the side of the tongue, not the town back area where the gag reflex is elicited. If the child resists in opportunity his mouth, pinching the nostrils done forces the child to breathe by mouth and, therefore, open the mouth.

All areas lined with mucous membranes (inside the lips and cheeks, gigiva, underside of tongue, palate, back of pharynx) are inspected, noting color, any areas of white patches or ulceration, bleeding, sensitivity, and moisture. The membranes should be exciting pink, smooth, glistering, uniform, and moist. Any deviations are noted. For example, reddened areas with white ulcerated centers may be canker sores (aphthae), which may be caused by trauma to the gums while toothbrushing or chewing. Koplik's spots, indicative of measles while the prodromal stages, appear as grayish areas surrounded with a red, irregular areola. They first appear on the buccal mucosa opposite the lower molars. White curdy plaques or patches anywhere on the oral mucosa. But particularly on the exterior of the tongue and hard palate, that bleed when scraped are signs of moniliasis or thrush.

As the physician observes the lining of the mouth, any odor (halitosis) is noted. Mouth odors are characteristics of a amount of important salutary problems, such as poor dental hygiene, gingival disease, continuing constipation, dehydration, malnutrition or systemic illness. A sudden, fouls odor in the mouth may indicate a foreign body in the nose, particularly a bean or pea. The nurse should survey the nose considered and, if possible, remove the object with tweezers.

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