Assessment of Mouth, Throat, Nose and Sinuses (Return Demonstration)

Summary

This script outlines a detailed procedure for assessing a patient's mouth, throat, nose, and sinuses. It covers steps such as inspecting the external nose, palpating sinuses for tenderness, and assessing nasal patency. Additionally, it includes a thorough examination of the mouth, gums, tongue, and oral structures, checking for symmetry, texture, and signs of abnormalities. The assessment also involves inspecting the tonsils, evaluating their size, and testing the gag reflex. The procedure emphasizes the importance of careful observation and palpation to ensure a comprehensive evaluation of the patient's upper respiratory and oral health.

Takeaways

• 😀 The assessment of the mouth, throat, nose, and sinuses includes inspecting for symmetry, color, texture, and abnormalities.
• 😀 Ensure that the external nose is symmetric, straight, and free from flaring or discharge. Light palpation helps detect tenderness, masses, or bone/cartilage displacement.
• 😀 Patency of both nasal cavities is tested by occluding one nostril at a time and asking the patient to sniff.
• 😀 The nasal mucosa should appear dark pink, moist, and free of exudate during examination.
• 😀 Sinuses, both frontal and maxillary, are palpated and percussed for tenderness. Non-tender sinuses are a positive result.
• 😀 The lips should be pink, moist, symmetric, and smooth. The client should be able to purse the lips and whistle when asked.
• 😀 The buccal mucosa is examined for color, moisture, texture, and lesions, appearing uniformly pink, moist, soft, and elastic.
• 😀 Gums should be pink and free of discolorations, retractions, or abnormalities. The client should be asked to open their mouth for examination.
• 😀 The tongue should be centrally positioned, pink, moist, and slightly rough in texture. Tongue movement is checked for resistance.
• 😀 The base of the tongue, floor of the mouth, and frenulum should be inspected for any abnormalities or limiting movement, including checking for Wharton's ducts and a short frenulum.
• 😀 The hard and soft palate should be examined for color, shape, and texture. The uvula should be positioned in the midline and mobile. The tonsils are inspected for size, color, and discharge, graded from 1 to 4 based on their size.
• 😀 The gag reflex is tested by stimulating the posterior one-third of the tongue with a blade. An intact gag reflex is essential.

Q & A

What is the first step in assessing the mouth, throat, nose, and sinuses?

The first step is to introduce yourself to the patient, identify them, and explain the assessment process, asking for their cooperation during the examination.

What should be checked during the inspection of the external nose?

During the inspection, you should check for any deviations in shape, size, color, flaring, or discharge. The nose should appear symmetric, straight, and uniform in color, with no discharge or flaring.

How do you assess the patency of the nasal cavities?

Patency is assessed by occluding one nostril at a time and asking the client to sniff. This helps determine if both nasal passages are open.

What should be checked when inspecting the nasal cavities with a flashlight or nasal speculum?

You should check for the presence of redness, swelling, growths, and discharge. The nasal mucosa should be dark pink, moist, and free of any exudate.

What is the method for palpating the maxillary and frontal sinuses for tenderness?

To palpate the maxillary sinuses, press with your thumbs under the cheekbones. For the frontal sinuses, press your thumbs up on the brow on each side of the nose.

What should be observed when inspecting the lips?

Inspect the lips for symmetry of contour, color, texture, and moisture. They should be uniformly pink, moist, and symmetric with a smooth texture.

How do you assess the condition of the tongue?

You should inspect the tongue for its position, color, and texture. The tongue should be centrally positioned, pink in color, moist, and slightly rough.

What is the procedure for inspecting the base of the tongue, floor of the mouth, and frenulum?

Ask the client to touch the tongue to the roof of the mouth. Then, use a pen light to inspect the ventral surface of the tongue, frenulum, and the area under the tongue, checking for Wharton's ducts and any abnormalities like a short frenulum.

What should be checked when palpating the floor of the mouth and tongue?

Palpate the floor of the mouth and tongue for any nodules, lumps, or excoriated areas. Use a gauze pad to hold the tongue and feel for any lesions, ulcers, or nodules.

What is the purpose of inspecting the tonsils during the throat examination?

The tonsils should be inspected for color, discharge, and size. Tonsils are graded on a scale from 1 to 4, depending on their size in relation to the throat opening.