Chapter 9: Assessing the Head, Face, Mouth and Neck

What are normal clinical findings for inspecting teeth?

color of teeth white to ivory, clean, free of debris, smooth edges, 32 to 28 teeth

What are normal clinical findings for tongue assessment?

color pink and saliva present; papillae on dorsal surface; midline position; ventral surface smooth, pink, moist; no lumps or nodules with palpation

What are abnormal clinical findings for tongue assessment?

cracked, dry, red, presence of ulcers or lesions, bleeding, thick white or yellow coating on the tongue; hairy tongue; leukoplakia; squamous cell carcinoma

What is gingivitis?

inflammation of the gums

What are normal clinical findings for a thyroid gland palpation assessment?

lateral lobes may or may not be palpable; if palpable, the lobes are smooth, firm and nontender

What are abnormal clinical findings when inspecting the lips?

lips are asymmetric, swelling, erythema, lesions, cracking of skin, angular cheilitis (cracking in the corners of the mouth), angioedema, pallor and herpes simplex virus

What are normal clinical findings when inspecting the lips?

lips are symmetric, pink, moist and no lesions, swelling or cracking of skin

What are abnormal clinical findings for inspecting teeth?

loose, broken, painful, dental caries, malocclusion of teeth (misalignment)

What is dizziness?

a feeling of faintness, you feel like you are going to pass out

What is vertigo?

a sensation that the environment is whirling around

What are the abnormal clinical findings when inspecting patency of the nose?

absence of sniff, rhinitis and nasal polyp

What are normal clinical findings of a pharynx and tonsil assessment?

uvula rises midline symmetrically; throat is pink; tonsils may be partially protrude or be absent; positive gag reflex

What are the abnormal clinical findings when palpating the maxillary and frontal sinuses?

tenderness is present

What are nasolabial folds?

the creases extending from the nose to each corner of the mouth

What are palpebral fissures?

the opening between the upper and lower eyelids

What are the abnormal clinical findings when inspecting and palpating the nose?

Asymmetry, deviated septum, swelling or inflammation, redness, bruising, lesions, drainage, and tenderness or swelling while palpating

What is a bruit?

A bruit is a vascular swishing, blowing or murmuring sound that reflects partial arterial occlusion

What are abnormal clinical findings for a thyroid gland auscultation assessment?

A bruit is heard

Name the 4 types of headaches

cluster, migraine, sinus and tension

What is important to remember for a buccal mucosa assessment with a patient with dentures?

Have the patient remove the dentures prior to assessment

What is a sinus headache?

May cause tenderness over frontal or maxillary sinuses

What are the characteristics of inspecting for a symmetrical face?

Nasolabial folds and palpebral fissures

What are normal clinical findings for a thyroid gland auscultation assessment?

No bruit is heard

What are the normal clinical findings when inspecting and palpating the face?

No tenderness, no temporal artery tenderness, the TMJ has no clicking sounds or limited ROM

What are the normal clinical findings when inspecting and palpating the nose?

Nose is symmetrical, septum is straight and midline, skin color same as face, no lesions, swelling or deformity

What are the abnormal clinical findings when inspecting and palpating the head?

Pain, tenderness, mass, depression, involuntary movements and macrocephaly

What are the normal clinical findings when inspecting patency of the nose?

Passageway is patent

What are the normal clinical findings when inspecting and palpating the head?

Symmetrical, midline and round; normocephalic; erect and still with no pain, tenderness, masses or depression during palpation

What are the abnormal clinical findings when inspecting and palpating the face?

Temporal arteritis and TMJ disorder causes a clicking, popping or grating sound

What is a tension headache?

Tend to be located in the front or back of the head, very tight and strong

What are abnormal clinical findings of a pharynx and tonsil assessment?

asymmetrical rise of the uvula; throat is deep red, inflamed, with drainage; throat pain or dysphagia; tonsils protruding with or without drainage; tonsillitis or pharyngitis

What are abnormal clinical findings for hard palate and soft palate assessment?

deep red color, ulcerations, lesions or growths, hard palate is a shade of yellow if jaundice is present; irregular palate shape

What are abnormal clinical findings for a thyroid gland palpation assessment?

enlargement of one or both lobes; tenderness, presence of lumps or nodules; texture has variations of firmness

What are abnormal clinical findings for a neck assessment?

neck is asymmetrical, pain with movement, unable to turn neck, torticollis

What is abnormal clinical findings for a thyroid gland inspection assessment?

neck is enlarged, asymmetrical; gland does not move during swallowing

What are normal clinical findings for a neck assessment?

neck is symmetrical, no pain with ROM and full ROM of neck

What are the normal clinical findings when palpating the maxillary and frontal sinuses?

no tenderness

What is the equipment necessary for a mouth assessment?

penlight, glove, tongue blade and sterile gauze

What are normal clinical findings for buccal mucosa assessment?

pink, smooth, moist, no lesions, swelling or bleeding; tight margin around each tooth; no tenderness with palpation

What is a migraine headache?

produce a throbbing pain and may occur at periodic intervals and may last from a few hours to 1-3 days

What is a cluster headache?

produce pain over the eye, temple, forehead, and cheek that cause a burning or stabbing feeling behind one eye. Occur more than once a day and for less than 1 to 2 hours and may follow a pattern for a couple of months and then disappear for months or years.

What are abnormal clinical findings for buccal mucosa assessment?

red, inflamed, or bleeding mucosa, lesions; tenderness with palpation; ulcerations; gingivitis; gingival hyperplasia; periodontal disease; thrush

What is important to remember when assessing a patient's mouth?

this assessment takes time, have a rest period for the patient

What are normal clinical findings for a thyroid gland inspection assessment?

thyroid gland should have a smooth, straight appearance; thyroid gland as well as cricoid and thyroid cartilage move up with swallowing

What are abnormal clinical findings for a trachea assessment?

trachea is deviated to the right or left side and away from the midline

What are normal clinical findings for a trachea assessment?

trachea is midline and space is symmetric on each side on

What are normal clinical findings for hard palate and soft palate assessment?

transverse rugae; irregular ridges are firm, pink to light red, moist; no tenderness; soft palate is pink, moist, no lesions or ulcerations; integrity is intact; nodular bony ridge down the middle of the posterior hard palate

What is thrush?

yeast infection of the mouth that is common in patients with a poor immune system