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Clinical examination of ulcer

Clinical examination of ulcer. Extraoral examination. Face : Any swelling symmetry TMJ Mouth opening Lymph nodes Palpabe /x? tenderness Muscle of head & neck : muscle tenderness Neck. Cranial nerve examination Movement of tongue Taste alteration Numbness on face Skin lesion

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Clinical examination of ulcer

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  1. Clinical examination of ulcer

  2. Extraoral examination • Face : • Any swelling • symmetry • TMJ • Mouth opening • Lymph nodes • Palpabe/x? • tenderness • Muscle of head & neck : muscle tenderness • Neck • Cranial nerve examination • Movement of tongue • Taste alteration • Numbness on face • Skin lesion • Cachexia • Abdomen • Respiratory system • Pallor (anemia) • Fatigue • Malaise

  3. Intraoral examination (Inspection of Ulcer) • Site • Size • Shape • Number • Margin • Line of demarcation between normal & abnormal • Edge (part between margin and floor) • Sloping : healing ulcer • Punched out : gummatous ulcer • Undermined : TB • Raised : BCC • Rolled out/everted : SCC • Floor (The exposed part of ulcer) • Slough : moist dead tissue • Scab : dry dead tissue • Unhealthy granulation tissue • Healthy granulation tissue • Subcutaneous fat • Muscle/tendon • Bone • Discharge • Serous : healing ulcer • Sanguinous/blood stained : malignant/chronic • Purulent : bacterial infection • Greenish : pseudomonas infection • Yellowish : sulphur granules (actinomycosis)

  4. Intraoral examination (Palpation of Ulcer) • Local rise of temperature & tenderness • Exact dimension • depth • Induration/thickening f edge • in chronic ulcer & malignancy • Base • Fixity to underlying structure • Bleeding on touch • Malignant/chronic ulcer

  5. Intraoral examination (Others) • Buccal mucosa • Tongue • Movement of tongue • Taste alteration • Deviation of tongue • Floor of the mouth • Gingiva • Oral hygiene • Palate • Dentures • Assess dentures • Assess denture hygiene • Dental charting • Sharp cusps/restorations

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