Nurs 3614- Chap 18- mouth, throat, nose and sinuses PDF

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Chap 18- Assessment of the mouth, throat, nose and sinuses 1. D  escribe the structure and function of the mouth Also known as the aka O  ral Cavity (mouth&tongue) Formed by the lips, cheeks, hard and soft palates, uvula, and the tongue and its muscles. Oral Cavity contains tongue, teeth, gums, and the openings of the salivary gland. The mouth is the beginning of the digestive tract and function: serves as an airway for the respiratory tract. The upper and lower lips form the entrance to the mouth, function: serving as a protective gateway to the digestive and respiratory tracts. The roof of the oral cavity is formed by ❖ the anterior hard palate ❖ the posterior soft palate.- contains uvula the  uvula = structure hangs in the posterior midline of the oropharynx. frenulum= which is a soft tissue hold the tongue to the floor of the mouth The gums (gingiva) are covered by mucous membrane and normally hold 32 permanent teeth in the adult (Fig. 18-2). The crown= The top, visible, white part of the tooth. The root= is the part of the tooth that is embedded into the gum. The crown and root are connected by the neck. Small bumps called papillae  cover the dorsal surface of the tongue. Taste buds, scattered over the tongue’s surface, carry sensory impulses to the brain. The parotid glands, located below and in front of the ears, empty through Stensen ducts, which are located inside the cheek across from the second upper molar. The submandibular glands, located in the lower jaw, open under the tongue on either side of the frenulum through openings called Wharton ducts. The sublingual glands, located under the tongue, open through several ducts located on the floor of the mouth.

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 Describe the structure and function of The Throat Also known as the Aka Pharynx. Location: behind the mouth and nose Function: Serves  as a muscular  passage for food and air(think  of singing),(like a passageway) Oropharynx(middle of throat, from the tonsils to the tip of the larynx).

Masses of Lymphoid Tissue: Palatine Tonsils ● ●

Lingual Tonsils (at the base of tongue) Pharyngeal tonsils (adenoids) (found high in the nasopharynx)

Function: These are here to help prevent infection

Describe

the structure and function of The Nose

❖ Consists of an external portion covered with skin and an internal nasal cavity

❖ Nose and paranasal sinuses constitute the first part of the respiratory system and are responsible for receiving , filtering and warming, moistening air to be transported to the lungs Structure: Composed of bone and cartilage , and lined with mucous membrane External nose:

❖ Bridge ❖ Tip ❖ Nares (two oval openings) Internal nose: ❖ Nasal cavity ( divided in half) ❖ Nasal septum; ❖ Superior, middle, and inferior turbinates(help to increase surface area, warm air and filter

The nasal septum separates the cavity into two halves.

The front of the nasal septum contains a rich supply of blood vessels and is known as Kiesselbach area. This is a common site for nasal bleeding. The superior, middle, and inferior turbinates are bony lobes, sometimes called conchae, that project from the lateral walls of the nasal cavity. Function: These 3 turbinates increase the surface area that is exposed to incoming air. As the person inspires air, nasal hairs (vibrissae) filter large particles from the air. Ciliated mucosal cells then capture and propel debris toward the throat, where it is swallowed. The rich blood supply of the nose warms the inspired air as it is moistened by the mucous membrane. A meatus underlies each turbinate and receives drainage from the paranasal sinuses and the nasolacrimal duct.

Sinuses 4 types Frontal, Maxillary, Ethmoidal, Sphenoidal Sinuses decrease the weight of the skull and act as resonance chambers during speech. Lined with ciliated mucous membranes, they help trap debris Frequent sight of infection just because they can be blocked so easily 2. D  iscuss risk factors associated with oropharyngeal cancer.

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Using tobacco products Heavy alcohol use Drinking alcohol and smoking together Being infected with a certain types of HPV Being exposed to sunlight (lip cancer only) Male gender Age over 55 Fair skin Poor oral hygiene Poor diet/nutrition Weakened immune system Graft-versus-host disease Genetic syndromes such as Fanconi anemia, dyskeratosis congenita

❖ Lichen planus Risk Reduction for oropharyngeal cancer.

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Stop smoking Limit alcohol consumption Balanced diet Precautionary measures at workplace Practice regular oral hygiene Avoid excessive exposure to ultraviolet light Avoid sources of oral irritation

3. D  ifferentiate between normal and abnormal findings. Normal Cultural Findings Pink lips are normal in light-skinned clients, as are bluish or freckled lips in some dark-skinned clients, especially those of Mediterranean descent Torus palatinus in female Eskimos, Native Americans, and Asians Bifid (split) uvula in Native Americans and Asians

Abnormal Findings of the Mouth and Throat

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Herpes simplex type I Cheilosis of lips Leukoplakia Hairy leukoplakia

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Smooth, reddish, shiny tongue without papillae due to vitamin B12 deficiency Black, hairy tongue Canker sore Gingivitis Receding gums

Abnormal Findings of the Sinus Nasal Polyp

are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. Perforated Septum

nasal septum, the bony/cartilaginous wall dividing the nasal cavities, develops a hole or fissure. 5. D  escribe assessment findings seen with older client’s mouth, throat, nose and sinuses.

❖ Gums recede, ischemic, and undergo fibrotic changes. ❖ Decreased ability to smell and taste. ❖ Oral mucosa drier and more fragile (epithelium lining of the salivary gland degenerates as you get older) ❖ Varicose veins in ventral surface of tongue.

6.  Describe pathophysiology and assessment findings related to these abnormalities: oropharyngeal cancer, sinusitis, pharyngitis a  nd t onsillitis. Sinusitis Acute ● Symptoms last less than 4 weeks ● Often begins with a common cold ● Usually resolved within 10 days Chronic Usually lasts longer than 12 weeks Symptoms of Sinusitis:

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Thick, yellow-green nasal discharge Postnasal drip Cough Toothache Fever Nasal obstruction or congestion Pain, tenderness, and swelling around eyes, cheeks, nose, or forehead. Frontal headache Reduced sense of smell and taste

Risk factors for sinusitis: ● ● ● ● ● ● ● ●

Respiratory Tract Infections Allergic reactions Deviated Nasal Septum Nasal polyps or tumors Facial Trauma GERD HIV Cystic Fibrosis

Risk Reduction Tips for Sinusitis: ● ● ●

Avoid catching colds or influenza Avoid allergy triggers; Manage allergies Stay hydrated

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Influenza vaccine Asthma control Pharyngitis

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Painful inflammation of the pharynx Bright red throat with white or yellow exudate Usually involves tonsils

Tonsillitis O+ It was removed ● ● ●

Red, enlarged to 2+, 3+, or 4+ Covered with exudate May be indurated(hard) with patches of white or yellow exudate

3+, white patches Biggest risk Risk for Aspiration Impaired Swallowing...