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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 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
Second Step: Palpate Lymph Nodes • Look for changes in: • Size • Mobility • Consistency
Lymph nodes to palpate include the: • Preauricular • Postauricular • Submandibular • Anterior & posterior cervical • Occipital • Supraclavicular • Parotid salivary gland
Intraoral ExamVisually and digitally assess the: • Lips • Labial mucosa • Buccal mucosa • Gingiva • Tongue • Floor of the mouth • Palate
Changes to observe include: • absence of symmetry • enlargements • swellings • dry or crusty areas • lesions • color changes
Lips • Assess: • Color • Texture • Presence of lesions on the upper and lower vermilion borders
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.
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
Buccal mucosa Retract with a finger, mirror or tongue depressor. Look for changes in: • color • texture • mobility • swelling • lesions
Buccal Mucosa - Bidigital Palpation Repeat procedure on the other side of the mouth.
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
Tongue Observe the dorsum of the tongue for: • swelling • ulceration • coating • changes in papillae pattern • variations in • size • color • texture
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.
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.
Floor of the mouth • With the tongue still raised: • Inspect the floor of the mouth
Floor of the mouth Look for changes in: • color • texture • swellings • ulcerations
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
Palate With the patient’s head tilted back: observe the hard and soft palate
Oropharynx Visually assess the oropharynx
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.
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
Fissured tongue Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_014.htm
Median rhomboid glossitis Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_051.htm
Geographic tongue Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_013.htm
Hairy tongue Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_057.htm
Mandibular Tori & Palatal Torus Used with permission from John L. Giunta, BS, DMD, MS http://www.forsyth.org/oralpathology/case_044.htm
Lips Herpetic lesions
Lips Angular cheilitis
Lips Actinic cheilitis
Buccal mucosa Linea alba
Labial mucosa Aphthous ulcers
Buccal mucosa Fordyce granules