{"id":1552,"date":"2010-12-06T11:27:16","date_gmt":"2010-12-06T11:27:16","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/inspection-a-palpation-the-oral-cavity\/"},"modified":"2023-10-25T11:50:45","modified_gmt":"2023-10-25T10:50:45","slug":"inspection-a-palpation-the-oral-cavity","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-examination-of-the-ear-nose-mouth-throat-and-neck\/the-mouth-and-the-oropharynx\/inspection-a-palpation-the-oral-cavity\/","title":{"rendered":"Inspection &#038; Palpation: The Oral Cavity"},"content":{"rendered":"<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Required Instruments<\/strong>\u00a0<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Head lamp <em><strong>[Figure 32]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Gloves.<\/span><\/li>\n<li><span style=\"color: #003366;\">Tongue spatula.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1541\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-32a.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-32a.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-32a-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 32<\/span><\/strong><\/span><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Examination Technique<\/strong><\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">For the examination of the <span style=\"color: #33cccc;\"><strong>mouth<\/strong><\/span> and the <span style=\"color: #33cccc;\"><strong>oropharynx<\/strong><\/span>, the patient sits on a chair with adequate back support. <\/span><\/li>\n<li><span style=\"color: #003366;\">Sit on a height-adjustable stool beside or in front of the patient.\u00a0<\/span><\/li>\n<li><span style=\"color: #003366;\"> Your eyes should be at the <span style=\"text-decoration: underline;\">same height<\/span> as the patient\u2019s mouth.<\/span><\/li>\n<li><span style=\"color: #003366;\">Wear <span style=\"text-decoration: underline;\">gloves<\/span> when palpating the structures inside the oral cavity. <\/span><\/li>\n<li><span style=\"color: #003366;\">Before starting the examination run the gloves under a tap to make them wet.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/122523068?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Start the examination with an <span style=\"text-decoration: underline;\">inspection of the lips<\/span> <em><strong>[Figure 33]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">For this, aim the beam of light from the head lamp onto the lips. <\/span><\/li>\n<li><span style=\"color: #003366;\">Apart from the <span style=\"text-decoration: underline;\">shape<\/span>, <span style=\"text-decoration: underline;\">smoothness<\/span> and any <span style=\"text-decoration: underline;\">swelling<\/span> of the lips themselves, the condition of the <span style=\"color: #33cccc;\"><strong>corners of the mouth<\/strong><\/span> is also important. <\/span><\/li>\n<li><span style=\"color: #003366;\">Infections of the <span style=\"color: #33cccc;\"><strong>oral cavity<\/strong><\/span> often present themselves as infections of the corner(<em>s<\/em>) of the mouth. <\/span><\/li>\n<li><span style=\"color: #003366;\">To obtain a good view, ask the patient to open the mouth slightly and turn their head a quarter-turn to the right and then to the left, so that both corners of the mouth can be inspected properly <em><strong>[Figure 34]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1542\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-33.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-33.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-33-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 33<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1543\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-34.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-34.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-34-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 34<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">If a swelling is <span style=\"text-decoration: underline;\">detectable<\/span>, or if the patient indicates feeling one in the lips, palpate the swelling and assess its <span style=\"text-decoration: underline;\">size<\/span>, <span style=\"text-decoration: underline;\">consistency<\/span> and <span style=\"text-decoration: underline;\">perimeters<\/span> and whether or not it is <span style=\"text-decoration: underline;\">adherent<\/span> to the surrounding tissue <em><strong>[Figure 35]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1544\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-35.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-35.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-35-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 35<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient to open their mouth a little further and aim the light onto the cheek mucosa <em><strong>[Figure 36]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">If necessary, you can hold the mucosa away from the teeth with a tongue spatula. <\/span><\/li>\n<li><span style=\"color: #003366;\">Assess the <span style=\"text-decoration: underline;\">colour<\/span>, <span style=\"text-decoration: underline;\">intactness<\/span>, and the presence of any <span style=\"text-decoration: underline;\">swellings<\/span> and\/or <span style=\"text-decoration: underline;\">coating<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Locate the <span style=\"text-decoration: underline;\">opening<\/span> of the <span style=\"color: #33cccc;\"><strong>parotid duct<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Palpate the cheek between two fingers of your external hand, which you press against the cheek, and one or two fingers of your internal hand <em><strong>[Figure 37]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Make small circular movements with the internal fingers across the external fingers. <\/span><\/li>\n<li><span style=\"color: #003366;\">If you detect a swelling, describe this in more detail.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1545\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-36.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-36.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-36-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 36<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1546\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-37.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-37.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-37-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 37<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">The state of the <span style=\"text-decoration: underline;\">gums<\/span> and the <span style=\"text-decoration: underline;\">teeth<\/span> gives a good indication of <span style=\"color: #33cccc;\"><strong>oral hygiene<\/strong><\/span>, as does the <span style=\"text-decoration: underline;\">patient\u2019s breath<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Tooth and gum infections produce a <span style=\"text-decoration: underline;\">foul odour<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">The teeth can be percussed with a tongue spatula. This is painful if the root of the tooth is infected. <\/span><\/li>\n<li><span style=\"color: #003366;\">The teeth can also be grasped between thumb and index finger to feel if they are still solidly attached to the jaw <em><strong>[Figure 38]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1547\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-38.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-38.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-38-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 38<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Inspect the tongue for <span style=\"text-decoration: underline;\">intactness<\/span> and presence of any <span style=\"text-decoration: underline;\">coating<\/span> or <span style=\"text-decoration: underline;\">swellings<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">If a swelling is detected, it should be palpated to describe it further. <\/span><\/li>\n<li><span style=\"color: #003366;\">Ask the patient to stick out the tongue, to move it up and down, and left and right <em><strong>[Figure 39]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">If you suspect a <span style=\"color: #33cccc;\"><strong>neurological injury<\/strong><\/span> as the cause of your patient\u2019s symptoms, test the strength of their tongue by asking the patient to press their tongue against the spatula. <\/span><\/li>\n<li><span style=\"color: #003366;\">In this manner, you can also identify abnormalities in the movements of the tongue and compare these movements with the resting position of the tongue.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1548\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-39.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-39.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-39-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 39<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient to hold the tip of the tongue against the palate, so that you can view the floor of the mouth<em><strong> [Figure 40]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">You can now determine the length of the <span style=\"color: #33cccc;\"><strong>lingual frenulum<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Aim your lamp on the floor of the mouth and inspect it for <span style=\"text-decoration: underline;\">intactness<\/span>, presence of <span style=\"text-decoration: underline;\">swellings<\/span> and\/or <span style=\"text-decoration: underline;\">coating<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Palpate the floor of the mouth between two external fingers and one internal finger in the same way as the cheek<em><strong> [Figure 41]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Palpable swellings, e.g. of the lower jaw and sublingual gland, should be further described.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1549\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-40.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-40.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-40-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 40<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1550\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-41.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-41.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-41-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 41<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Allow the patient to return the tongue back into its normal position and ask them to tilt the head slightly backwards. <\/span><\/li>\n<li><span style=\"color: #003366;\">In this position, the palate will be easily accessible for examination. <\/span><\/li>\n<li><span style=\"color: #003366;\">Aim the light on the palate and inspect it for <span style=\"text-decoration: underline;\">intactness<\/span>, presence of <span style=\"text-decoration: underline;\">swellings<\/span> and\/or <span style=\"text-decoration: underline;\">coating<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Thereafter, palpate with one finger the hard and, if necessary, the soft palate<em><strong> [Figure 42]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">When palpating the hard palate pay attention to any potential disruptions of the bony structures <\/span><span style=\"color: #003366;\">(<em>cleft palate<\/em>).<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1551\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-42.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-42.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-42-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 42<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Required Instruments\u00a0 Head lamp [Figure 32]. Gloves. Tongue spatula. Figure 32 Examination Technique For the examination of the mouth and the oropharynx, the patient sits on a chair with adequate back support. Sit on a height-adjustable stool beside or in front of the patient.\u00a0 Your eyes should be at the same height as the patient\u2019s [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[40],"tags":[132],"class_list":["post-1552","post","type-post","status-publish","format-standard","hentry","category-the-mouth-and-the-oropharynx","tag-the-examination-of-the-ear-nose-mouth-throat-and-neck"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Inspection &amp; Palpation: The Oral Cavity - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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