Oral cancer physical examination: Difference between revisions

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{{Oral cancer}}
{{Oral cancer}}
{{CMG}}{{AE}}{{Simrat}}
{{CMG}}; {{AE}} {{SSW}}; {{GRR}} {{Nat}}
==Overview==
==Overview==
Common physical examination findings of oral cancer include a lump or thickening in the oral soft tissues, soreness, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or swelling of the jaw that causes dentures to fit poorly.
Common [[physical examination]] findings of oral cancer include a lump or thickening in the [[Soft tissue|soft tissues]] of the [[oral cavity]], soreness, difficulty chewing or [[swallowing]], ear [[pain]], difficulty moving the [[jaw]] or [[tongue]], [[hoarseness]], [[numbness]] of the [[tongue]], or [[swelling]] of the [[jaw]] that causes dentures to fit poorly.
==Physical Examination==
==Physical Examination==
* A thorough [[Head and neck anatomy|head and neck]] examination should be a routine part of each patient's dental visit and general medical examination.


==Physical Examination==
===Appearance of the patient===
 
* The patient may appear ill and [[cachexic]].
 
Possible signs and symptoms of oral cancer that your patients may report include: a lump or thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or other areas of the mouth, or swelling of the jaw that causes dentures to fit poorly or become uncomfortable.
 
 
 
 
===Appearance of the Patient===
*This section should give a general description of what a patient with the disease you are describing may look like. You may include a physical description such as obese, thin, cachectic, well appearing, ill appearing, diaphoretic etc.
* For an example of the appearance of a patient section in the physical examination page, click [[Encephalopathy physical examination#Appearance of the Patient|here]].
 
===Vitals===
====Temperature====
*A [[fever]] is often present
*[[Hypothermia]] may be present
 
====Pulse====
=====Rate=====
*[[Tachycardia]] may be present
*[[Bradycardia]] may be present
=====Rhythm=====
*The pulse is regular
*The pules is irregularly irregular
=====Strength=====
*The pulse may be weak
*The pulse may be bounding
*The pulse may be alternating in strength ([[pulsus alternans]])
*A [[paradoxical pulse]] may be present
 
=====Symmetry=====
*The pulses may be asymmetric
 
====Blood Pressure====
*[[Hypotension]] may be present
*[[Hypertension]] may be present
*A [[wide pulse pressure]] may be present
*A [[narrow pulse pressure]] may be present
 
====Respiratory Rate====
*[[Tachypnea]] may be present
*[[Bradypnea]] may be present
* [[Kussmaul respirations]] may be present
 
===Skin===
*[[Cyanosis]] may be present
*[[Jaundice]] may be present
* A rash may be present
* [[Pallor]] may be present
* Lesions may be present
 
<gallery widths=150px>
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>
 
===Head===
* Abnormalities of the head/hair may include ___
* There may be evidence of trauma
 
===Eyes===
*Icteric sclera may be present
* [[Nystagmus]] may be present.
* Extra-ocular movements may be abnormal
*Pupils may not react to light
*Ophthalmoscopic exam may be abnormal with findings of ___
 
===Ears===
* Hearing acuity may be reduced
*[[Weber test]] may be positive
*[[Rinne test]] may be positive
* There may be [[exudate]] from the ear canal
* There may be [[tenderness]] on movement of the pinnae
 
===Nose===
* Nares may be inflamed
* There may be [[epistaxis]]
* There may be [[purulent]] exudate from the nares
* There may be [[tenderness]] to percussion of the sinuses
* The nares may be congested
 
===Throat===
* The throat may be erythematous
* There may be [[exudate]] in the throat
* There may be [[petechiae]] seen in the throat
* There may be tonsillar inflammation
 
===Neck===
*[[Jugular venous pressure]] may be elevated
*[[Carotid bruits]] may be present
*[[Lymph nodes]] may be present
*[[Thyromegaly]] may be present
*[[Hepatojugular reflux]] may be present


===Lungs===
=== HEENT ===
*[[Pulmonary edema]] and [[rales]] may be present
* Dental practitioners and dental care professionals should examine the teeth and entire [[oral mucosa]].
*[[Wheezing]] may be present
* Most common involved sites in the [[oral cavity]] include:
*Consolidation may be present with reduced breath sounds auscultated
** [[Tongue]]
*[[Rales]] may be present
** Lateral and ventrolateral aspects of mouth
*[[Egophony]] may be present
** Floor of mouth
* Chest movement may be assymetric
* Lesions such as [[ulcers]], red or white patches may be visible.
* Any [[ulcer]] with a duration that persists for more than 3 weeks then it should be [[Biopsy|biopsied]].<ref name="pmid24072273">{{cite journal |vauthors=Scully C |title=Rule for cancer diagnosis |journal=Br Dent J |volume=215 |issue=6 |pages=265–6 |year=2013 |pmid=24072273 |doi=10.1038/sj.bdj.2013.884 |url=}}</ref>


===Heart===
*Ear [[pain]] may be present.
*A [[heave]] may be present
*A [[thrill]] may be present
*A [[friction rub]] may be pressent


====Auscultation====
*Soreness of the throat may be present.
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A [[systolic murmur]] best heard at the base may be present
*A [[systolic murmur]] best heard at the apex may be present
*A [[diastolic murmur]] may be present


===Abdomen===
*Difficulty in moving [[tongue]] may be present.
*[[Abdominal distention]] may be present
*[[Numbness]] of the [[tongue]] may be present.
*[[Abdominal tenderness]] may be present
*[[Swelling]] of the [[jaw]] may be present.
*[[Rebound tenderness]] may be present
*An [[acute abdomen]] may be present
*An abdominal mass may be present
*Guarding may be present
*[[Hepatomegaly]] may be present
*[[Splenomegaly]] may be present
*Genitourinary exam if relevant


===Extremities===
*[[Clubbing]] may be present
*[[Cyanosis]] may be present
*[[Edema]] may be present
===Neurologic===
* Mental status may be altered
* Glasgow coma scale is ___
* Clonus may be present
* Hyperactive reflexes may be present
* There are deficits in cranial nerves __
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Needs content]]


{{WH}}
{{WH}}
{{WS}}
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[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Otolaryngology]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Latest revision as of 12:51, 11 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]; Grammar Reviewer: Natalie Harpenau, B.S.[3]

Overview

Common physical examination findings of oral cancer include a lump or thickening in the soft tissues of the oral cavity, soreness, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue, or swelling of the jaw that causes dentures to fit poorly.

Physical Examination

  • A thorough head and neck examination should be a routine part of each patient's dental visit and general medical examination.

Appearance of the patient

  • The patient may appear ill and cachexic.

HEENT

  • Dental practitioners and dental care professionals should examine the teeth and entire oral mucosa.
  • Most common involved sites in the oral cavity include:
    • Tongue
    • Lateral and ventrolateral aspects of mouth
    • Floor of mouth
  • Lesions such as ulcers, red or white patches may be visible.
  • Any ulcer with a duration that persists for more than 3 weeks then it should be biopsied.[1]
  • Ear pain may be present.
  • Soreness of the throat may be present.

References

  1. Scully C (2013). "Rule for cancer diagnosis". Br Dent J. 215 (6): 265–6. doi:10.1038/sj.bdj.2013.884. PMID 24072273.

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