Preventive dentistry
Terms
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- Purpose of head and neck examination?
- Detect abnormalities of systemic disease or magignant or benign lesions. 20% of head and neck cancers occur in oral cavity (tongue ventrolateral, floor of mouth, soft palate/tonsillar pillars, behind mandibular molars.
- Describe the various techniques involved in performtion a thorough head and neck examination?
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Palpation (digital is one finger, bi is two; manual is one hand, bi is two)
Ausculatation, diascopy, probing, percussion -
Structures of the neck
Anterior cervical? - lymph nodes, carotid arteries, thyroid glands, trachea muscles
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Structures of the neck
posterior neck? - posterior cervical lymph nodes, trapezius muscle
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Structures of the neck
suboccipital regions?
submandibular? -
1.suboccipital lymph nodes, trapezius lymph nodes
2.submandibular -
Structures of the neck
submental?
buccal? -
1. submental lymph nodes, sublingual glands
2. massester muscle, parotid glands -
structures of the neck
preauricular regions? - TMJ, Preauricular lymph nodes
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Variations of normal
mandibular tori - lobular bony hard enlargements on the lingual of the mandible
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Variations of normal
palatal torus - lobular bony hard enlargement on the midline of the hard palate
- exostoses
- lobular bony hard enlargement on the buccal surfaces of the posterior mandible and maxilla
- extopic sebaceous glands
- small yellow to peach colored papules most common on the buccal and labial mucosa
- linear alba
- elevated white line along the occlusal plane on the buccal mucosa
- leukodema
- grey-white, opaque or milky surface that can be smooth or sightly wrinkled. diffuse and symmetrically distributed on the buccal mucosa
- physiological pigmentation
- extent of oral pigmentation is usually related to the extend of skin pigmentation, most apparent on the gingival and labial mucosa
- erythema migrans (benign migratory glossitis, geographic tongue)
- multiple red patches surrounded by a thickened white border, will resolve in one area and appear in other areas, usually asymptomatic
- fissured tongue
- typicall a central groove with multiple smaller grooves branching off, may occur in combination with migratory glossitis
- hyperplastic lingual tonsils
- increased in size of lingual tonsils that are often a response to an infectious stimulus
- varicosities
- dilated veins or venules that are blue or purple, compressible and branch with pressure. They are most common on ventral tongue, floor of mouth, lips, and buccal mucosa
- plaque
- flat, slightly elevated lesion
- macule
- flat area of color change
- papule
- solid, raised, less than 5 mm diameter
- nodule
- solid, raised, greater than 5 mm diameter
- fissure
- slit like groove
- vessicle
- fluid filled, less than 5 mm diameter (blister)
- bulla
- fluid filled, greater than 5 mm diameter (large blister)
- postule
- fluid filled with purulent material
- erosion
- loss of surface epithelium
- ulcer
- loss of surface epithelium
- erythematous
- red
- edematous
- swollen due to accumulation of watery fluid
- exophytic
- growing outward
- endophytic
- growing inward
- indurated
- abnormally hard
- fixed
- attached to adjacent or surrounding structures
- sessile
- base is as wide or wider than the rest of the lesion
- pedunculated
- lesion is on a stalk or has a base that is narrower than the rest of the lesion
- papillary
- numerous surface projections
- verrucous
- rough, watery surface
- leukoplakia
- clinical term for a white plaque or patch, 5-25% shows dysplasia on biopsy, 4% progress to squamous cell carcinoma
- erythroplakia
- clinical term for a red plaque or patch, 90% show severe dysplasia, carcinoma in situ, or superficially invasive squamous cell carcinoma
- erythroleukoplakia
- clinical term for a mixed white and red plaque or patch