Transcript nose, mouth, and throat

NOSE, MOUTH, AND THROAT
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NOSE, SINUSES, MOUTH, &
OROPHARYNX
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Nasal appearance &
patency
Inspection & palpation
of frontal & maxillary
sinuses
Lips
Teeth & Inner gums
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Buccal mucosa
Tongue
Palate, uvula
Posterior pharynx
Tonsils
NOSE
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1ST segment of the respiratory system
Sensory organ for smell
Nasal cavity-much larger than external nose would
indicate-Extends back over the roof of the mouth
Anterior edge-lined with coarse nasal hairs to filter
coarsest matter from inhaled air; rest of cavity lined
with ciliated mucous membrane to filter out dust and
bacteria
NASAL CAVITY
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Nasal cavity divided medially by the septum into 2
slit like air passages
Anterior part of septum holds rich vascular network,
kiesselbach’s plexus, most common site of
nosebleeds
Nasal Septum may not be absolutely straight in
many people-may deviate toward one passage
Nasal mucosa appear more red in color than oral
mucosa because of rich blood supply present
NASAL CAVITY
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Lateral walls of each nasal cavity contain 3 parallel
bony projectons- superior, middle, and inferior
turbinates
Increase surface area so more blood vessels and
mucous membranes are available to warm, humidify,
and filter the inhaled air.
Underlying each turbinate is a cleft, the meatus
The sinuses drain into the middle meatus, and tears
from the nasolacrimal duct drain into the inferior
meatus
NASAL CAVITY
The olfactory receptors (hair cells) lie at the
roof of the nasal cavity and in the upper 1/3
of the septum
Receptors for smell merge into the olfactory
nerve, cranial nerve I, which transmit to the
temporal lobe of the brain
Structures of the Nasal Cavity
Figure 16-2. p. 373
PARANASAL SINUSES
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Air-filled pockets within the cranium
Communicate with the nasal cavity & lined
with the same type of ciliated mucous
membrane
Functions: lighten wt of skull bones, serve as
resonators for sound production, and provide
mucus, which drains into nasal cavity
Sinus openings –narrow & easily occluded
SINUSES
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Accessible to examination- frontal and
maxillary sinuses
Smaller and deeper are the ethmoid and the
sphenoid sinuses
Only the maxillary and ethmoid sinuses
present at birth
Paranasal Sinuses, Adult and Child
Figure 16-3. p. 373
Mouth
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1st segment of digestion system
Airway for the respiratory system
Oral cavity-short passage that contains teeth, gums,
tongue, and salivary glands
Palate-arching roof of the mouth divided into 2 parts
Hard palate-anterior made up of bone and is a
whitish color
Soft palate-posterior arch of muscle that is pinker in
color and mobile
Mouth
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Uvula-free projection hanging down from the middle
of the soft palate
Floor of mouth-consists of mandible bone, the
tongue, and underlying muscles
Tongue- mass of striated muscle that can change
shape and position; papillae are the rough bumpy
elevations on its dorsal surface; microscopic taste
buds are in the papillae
Frenulum- midline fold of tissue that connects the
tongue to the floor of the mouth
Oral Cavity Structures
Figure 16-4 p. 374
Salivary Glands
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Parotid Gland- the largest that lies within the cheeks
in front of the ear; It’s duct, Stenson’s duct opens
opposite the 2nd upper molar teeth
Submandibular-size of a walnut that lies beneath the
mandible; Wharton’s duct runs up to the floor of the
mouth and opens at either side of the frenulum
Sublingual- smallest almond-shaped lies under the
tongue; has many small openings along sublingual
fold under the tongue
The glands secrete saliva-moistens and lubricates
food, starts digestion, cleans & protects mucosa
Figure 16-5 p. 375
Teeth
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Adults have 32 permanent teeth-16 upper
arch & 16 lower arch
Tooth consests of -crown, neck & root
Gums (gingivae) collar the teeth-thick fibrous
tissue covered with mucous membrane
Pharynx (throat)
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Behind the mouth and nose
Oropharynx-separated from mouth by a fold
of tissue on each side-anterior tonsillar pillar
Tonsils- behind folds-each is a mass of
lymphoid tissue that is same color as
surrounding mucous membrane; Tonsillar
tissue enlarges during childhood until
puberty, then involutes
Pharynx
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Nasopharynx-has Eustachian tube and
pharyngeal tonsils (adenoids) openings here
Laryngopharynx-goes from hyoid bone to
lower border of the cricoid cartilage
Subjective Data
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Epistaxis-nosebleeds
Headache or toothache
Dysphagia-difficulty swallowing
Prolonged use of bottle ( infants) during day
or when going to sleep-risk for both tooth
decay or otitis media
Inspection
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Nose-symmetric, in the midline, and in proportion to
other facial features
Nasal cavity-normal red color, smooth and moist
surface
Nasal septum-observe for deviation, note any
bleeding or perforation
Middle and inferior turbinates-light red color
Note any polyps-smooth, pale gray, avascular, and
nontender
Middle turbinate
Inferior turbinate
Figure 16-7 p. 380
Choanal
Atresia
Foreign
Body
Epistaxis
Perforated
Septum
p. 396
Acute
Rhinitis
Sinusitis
Rhinitis
Allergi
c
Rhiniti
s
Polyps
Furun
cle
Carci
noma
Palpation:
Using thumbs, press over frontal sinuses below
eyebrow, and over maxillary sinuses below
cheekbone
Inspection of mouth:
 Mouth-Use tongue blade to restrict structures and
bright light for optimal visualization
 Lips-color, moisture, cracking, or lesions
 Teeth-Note any absent, loose, or abnormally
positioned teeth
 Gums- should be pink or coral with a stippled
(dotted) surface
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Figure 16-12 p.383
Tongue
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Tongue-should be pink and even; dorsal
surface roughened from the papillae; A thin
white coating may be present; Ventral
inspection-smooth, glistening, and shows
veins
Inspect entire U-shaped area under tongueoral malignancies are most likely to develop
here. Note any lesions, nodules, ulcerations.
Buccal Mucosa
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Should be pink, smooth, and moist without
nodules or lesions
Stensen’s duct-looks like a small dimple
opposite the upper second molar
Fordyce’s granules-small, isolated white or
yellow papules on the mucosa of cheek,
tongue, and lips (small sebaceous cysts-not
significant)
Inspection
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Palate-Shine light up to the roof of the mouth;
anterior hard palate-white and posterior soft
palate-pinker, smooth and upwardly moblie
Observe the uvula-ask person to say ahh
and note the soft palate and uvula rise in the
midline
Inspect Throat
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Using light, observe the oval, rough-surfaced tonsils;
color pink with indentations
Graded: 1+ visible, 2+ halfway between tonsillar
pillars and uvula, 3+ touching the uvula, 4+ touching
each other
Depress tongue with tongue blade to enlarge your
view or the posterior pharyngeal wall; push halfway
back on tongue; push slightly off center to avoid
eliciting the gag reflex
Figure 16-18 p. 387
ORAL LANDMARKS
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Uvula
Frenulum
Hard palate
tonsils