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Oral cavity examination occasionally appears in OSCEs and you’ll be expected to identify relevant signs using your clinical examination skills. This guide provides a step-by-step approach to performing an examination of the oral cavity in an OSCE setting. Download the oral cavity examination PDF OSCE checklist, or use our . Gather equipment
IntroductionWash your hands and don PPE if appropriate. Introduce yourself to the patient including your name and role. Confirm the patient’s name and date of birth. Briefly explain what the examination will involve using patient-friendly language. Gain consent to proceed with the examination. Ask the patient to sit on a chair. If the patient has any dentures or implants, ask them to remove them for the assessment. Check if the patient currently has any pain before proceeding with the clinical examination. Don some non-sterile gloves (if not already wearing some). You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation. General inspectionInspect the patient’s face for swelling:
Closer inspectionAsk the patient to open their mouth and inspect the oral cavity using your light source. Note if the patient has difficulty opening their mouth due to pain, suggesting the presence of trismus. LipsWith the patient’s mouth open, use your light source to inspect the lips for abnormalities such as:
Teeth and gumsUsing two tongue depressors inspect the teeth and gums. TeethInspect the teeth for abnormalities:
GumsInspect the gums for abnormalities:
TongueAsk the patient to stick out their tongue and inspect for abnormalities such as:
Buccal mucosa and parotid ductUsing one tongue depressor move the tongue to either side and inspect the buccal mucosa and parotid duct. Buccal mucosaInspect the buccal mucosa for abnormalities:
Parotid ductInspect the parotid duct for abnormalities:
Parotid glandThe parotid glands are the largest salivary glands and are located posterolaterally to the mandibular ramus (bilaterally). On each side of the face, the parotid duct pierces the buccinator muscle and opens into the oral cavity through the buccal mucosa, opposite the maxillary second molar. Palate and uvulaUsing one tongue depressor, gently depress the tongue and inspect the palate and uvula for abnormalities such as:
Palate and uvula anatomyThe palate forms the roof of the mouth and separates the nasal cavity from the oral cavity. It can be further sub-divided into the:
The uvula is a fleshy extension that projects from the back edge of the soft palate. In healthy individuals, it should be positioned in the midline of the palate. Tonsils, pharyngeal arches and uvulaUsing one tongue depressor, gently depress the tongue and inspect the tonsils, pharyngeal arches and uvula for abnormalities. TonsilsInspect the tonsils for abnormalities:
Pharyngeal archesInspect the pharyngeal arches for abnormalities:
UvulaInspect the uvula for abnormalities:
Tonsilar anatomyThe palatine tonsils are located at the right and left sides of the back of the throat between the palatoglossal and palatopharyngeal arches of the soft palate. The palatoglossal arch is also known as the anterior tonsillar pillar and the palatopharyngeal arch is also known as the posterior tonsillar pillar. The tonsils appear as pinkish lumps and play an important role in immunity. Floor of the mouthAsk the patient to lift their tongue to the roof of their mouth and assess the floor of the mouth for pathology such as:
Submandibular and sublingual glandsThe paired submandibular glands are located on the floor of the mouth and are responsible for producing saliva. These glands are responsible for the majority of salivary duct calculi, possibly due to the torturous uphill course of the submandibular gland’s duct. The submandibular gland’s ducts open out on either side of the lingual frenulum as small prominences known as sublingual caruncles. The paired sublingual glands are also located on the floor of the mouth, behind the mandibular canines, and are responsible for producing saliva. The glands are drained by 8-20 ducts known as the ducts of Rivinus. The largest sublingual duct joins the submandibular duct to drain through the same sublingual caruncle. The rest of the ducts open into the mouth on an elevated region of mucous membrane known as the plica sublingualis. PalpationIf permitted by the patient and examiner, proceed to bimanual palpation of the mouth. Bimanual palpation of the mouth1. With one finger palpating the neck externally and the other gloved finger in the oral cavity, gently palpate any identified lumps from both sides. 2. Palpate the lateral walls of the mouth to assess the parotid gland and duct. 3. Palpate the floor of the mouth to assess the submandibular gland and sublingual gland. Any intraoral swelling should be described according to its site, size, thickness, colour, texture, consistency and tenderness. To complete the examination…Explain to the patient that the examination is now finished. Thank the patient for their time. Dispose of PPE appropriately and wash your hands. Summarise your findings. Example summary“Today I performed an examination of the oral cavity on Mr Smith, a 30-year-old male who presented with a submandibular swelling.” “On inspection, dentition was normal and a small, erythematous swelling was noted on the floor of the mouth, beside the lingual frenulum. On bimanual palpation, the lump was hard and non-tender. These findings are consistent with a salivary duct stone.” Which of the following are normal findings of a nose examination?Normal findings might be documented as: “External nose is symmetrical with no discolouration, swelling or malformations. Nasal mucosa is pinkish red with no discharge/bleeding, swelling, malformations or foreign bodies.” Abnormal findings might be documented as: “Bright red nasal mucosa with purulent discharge.”
How would you describe a normal throat?Throat/Mouth – Oral mucosa is pink and moist with good dentition. Tongue normal in appearance without lesions and with good symmetrical movement. No buccal nodules or lesions are noted. The pharynx is normal in appearance without tonsillar swelling or exudates.
What is a normal finding during physical assessment of the mouth quizlet?Normal Findings: Tongue should be pink, moist, a moderate size with papillae present. A common variation is a fissured, topographic-map-like tongue, which is not unusual in older clients. No lesions are present.
What should I examine in throat?Examination of the throat. Examine the mouth and note the condition of the tongue.. Examine back of tongue and tonsils (press down on the tongue with a tongue depressor).. Palpate the base of the tongue (look for tumours that may not be easily visible).. Inspect the uvula and soft palate.. |