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Module 5

Module 5. Oral Cancer Examination. Oral Cancer Exam. To properly perform an oral cancer examination, you will need: a good light source mouth mirror gloves gauze tongue depressor. Extraoral exam:. Visually assess the. head face eyes ears neck.

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Module 5

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  1. Module 5 Oral Cancer Examination

  2. Oral Cancer Exam • To properly perform an oral cancer examination, you will need: • a good light source • mouth mirror • gloves • gauze • tongue depressor

  3. Extraoral exam: Visually assess the • head • face • eyes • ears • neck

  4. Second Step: Palpate Lymph Nodes • Look for changes in: • Size • Mobility • Consistency

  5. Lymph nodes to palpate include the: • Preauricular • Postauricular • Submandibular • Anterior & posterior cervical • Occipital • Supraclavicular • Parotid salivary gland

  6. Preauricular & Parotid Gland

  7. Postauricular

  8. Submandibular & Submental

  9. Anterior Cervical

  10. Posterior Cervical

  11. Occipital

  12. Supraclavicular

  13. Intraoral ExamVisually and digitally assess the: • Lips • Labial mucosa • Buccal mucosa • Gingiva • Tongue • Floor of the mouth • Palate

  14. Changes to observe include: • absence of symmetry • enlargements • swellings • dry or crusty areas • lesions • color changes

  15. Lips • Assess: • Color • Texture • Presence of lesions on the upper and lower vermilion borders

  16. Lips • Bidigitally palpate the lower lip from one commissure to the other for any changes in texture or swellings. Use the same technique for the upper lip.

  17. Labial Mucosa Assess by pulling the upper and lower lip away from the teeth to observe the labial mucosa and frena for changes in: • color • texture • swelling

  18. Maxillary Labial Mucosa

  19. Mandibular Labial Mucosa

  20. Buccal mucosa Retract with a finger, mirror or tongue depressor. Look for changes in: • color • texture • mobility • swelling • lesions

  21. Buccal Mucosa - Bidigital Palpation Repeat procedure on the other side of the mouth.

  22. Gingiva • Begin with facial gingiva and alveolar ridges in the maxillary right posteriorgingiva. • Follow the arch around to the left side. • Drop to the lower left and follow around to the lower right

  23. Tongue Observe the dorsum of the tongue for: • swelling • ulceration • coating • changes in papillae pattern • variations in • size • color • texture

  24. Tongue Grasp the tip of the tongue with a piece of gauze and gently pull out and to the side to allow complete observation Repeat on the other side.

  25. Examine the ventral surface • Ask the patient to place the tip of the tongue on the palate to observe the ventral surface. • Palpate the tongue to feel for any growths.

  26. Floor of the mouth • With the tongue still raised: • Inspect the floor of the mouth

  27. Floor of the mouth Look for changes in: • color • texture • swellings • ulcerations

  28. Floor of the mouth • Bimanually palpate the sublingual area • Place the index finger of one hand inside the mouth • Place the fingertips of the other hand extraorally under the chin

  29. Palate With the patient’s head tilted back: observe the hard and soft palate

  30. Oropharynx Visually assess the oropharynx

  31. Anatomical Landmarks • The next several slides will show normal anatomical features present in the oral cavity, as well as some common features that are innocuous or self-limiting.

  32. Gingiva

  33. Vestibule

  34. Buccal Mucosa

  35. Oropharynx

  36. Dorsum of the tongue

  37. Floor of the mouth

  38. Palate

  39. Features that represent deviations from normal that are observed on the tongue include: • Scalloped edges • Fissured tongue • Median rhomboid glossitis • Geographic tongue (erythema migrans) • Hairy tongue

  40. Fissured tongue Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_014.htm

  41. Median rhomboid glossitis Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_051.htm

  42. Geographic tongue Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_013.htm

  43. Hairy tongue Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_057.htm

  44. Mandibular Tori & Palatal Torus Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_044.htm

  45. Lips Herpetic lesions

  46. Lips Angular cheilitis

  47. Lips Actinic cheilitis

  48. Buccal mucosa Linea alba

  49. Labial mucosa Aphthous ulcers

  50. Buccal mucosa Fordyce granules

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