{"id":1555,"date":"2010-12-06T11:27:53","date_gmt":"2010-12-06T11:27:53","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/inpection-a-palpation-the-oropharynx\/"},"modified":"2023-10-25T11:39:56","modified_gmt":"2023-10-25T10:39:56","slug":"inpection-a-palpation-the-oropharynx","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\/inpection-a-palpation-the-oropharynx\/","title":{"rendered":"Inpection &#038; Palpation: The Oropharynx"},"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<li><span style=\"color: #003366;\">Lidocaine spray 10%.<\/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-1553\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-32.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-32.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-32-300x225.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. <\/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\/122522874?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;\">Ask the patient to keep their head straight.<\/span><\/li>\n<li><span style=\"color: #003366;\">Ask them to open their <span style=\"text-decoration: underline;\">mouth wide<\/span>, keeping the <span style=\"text-decoration: underline;\">tongue on the floor<\/span> of the mouth. <\/span><\/li>\n<li><span style=\"color: #003366;\">Shine the light on the <span style=\"color: #33cccc;\"><strong>pharyngeal arches<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">You are now able to inspect the <span style=\"color: #33cccc;\"><strong>palatal arches<\/strong><\/span> and the <span style=\"color: #33cccc;\"><strong>uvula<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Pay particular attention to the <span style=\"text-decoration: underline;\">symmetry<\/span> of the palatal arches and the position of the uvula. This should be positioned in the <span style=\"text-decoration: underline;\">middle<\/span> and <span style=\"text-decoration: underline;\">hang straight down<\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">For this inspection, you can hold the tongue down with a spatula if necessary, by pressing on the front two-thirds of the tongue. With the tongue inside the mouth as described above, you will not hurt the patient, because the tongue is not pressed onto the teeth. You will also not touch the gag reflex site on the back of the tongue <em><strong>[Figure 43]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Ask the patient to say \u201c<em>ah<\/em>\u201d and check if the palatal arches move upwards symmetrically and whether the uvula stays in the middle.<\/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-1554\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-43.jpg\" alt=\"\" width=\"400\" height=\"299\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-43.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/EarNoseMouth_enm-fig-43-300x224.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 43<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Aim the light onto the <span style=\"color: #33cccc;\"><strong>tonsillar fossae<\/strong><\/span>, which are located <span style=\"text-decoration: underline;\">bilaterally<\/span>, between the <span style=\"color: #33cccc;\"><strong>palatoglossal arch<\/strong><\/span> and the <span style=\"color: #33cccc;\"><strong>palatopharyngeal arch<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">In children, you will nearly always be able to detect the <span style=\"color: #33cccc;\"><strong>tonsils<\/strong><\/span>. It is important that they are not <span style=\"text-decoration: underline;\">inflamed<\/span>, i.e. showing no signs of infection (<em>redness and coating<\/em>). If they are visible in an adult who does not have a cold, but who does complain of general malaise, a thorough examination of at least the <span style=\"text-decoration: underline;\">head<\/span> and <span style=\"text-decoration: underline;\">neck lymph node stations<\/span> is indicated.<\/span><\/li>\n<li><span style=\"color: #003366;\">Finally, inspect the <span style=\"color: #33cccc;\"><strong>posterior oropharyngeal wall<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Assess the colour and presence of <span style=\"color: #33cccc;\"><strong>hyperaemia<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">In patients with a severe cold, you will be able to see <span style=\"text-decoration: underline;\">mucus running down<\/span> from the nose. <\/span><\/li>\n<li><span style=\"color: #003366;\">In children with <span style=\"text-decoration: underline;\">grossly enlarged adenoids<\/span>, <span style=\"color: #33cccc;\"><strong>lymphoid tissue<\/strong><\/span> can occasionally be visible on the posterior pharyngeal wall as a continuation of the adenoids. <\/span><\/li>\n<li><span style=\"color: #003366;\">Again, you should check for any <span style=\"text-decoration: underline;\">swellings<\/span> on the posterior pharyngeal wall. <\/span><\/li>\n<li><span style=\"color: #003366;\">If necessary, these can be palpated following administration of an anaesthetic (<em>lidocaine spray<\/em>) to the entrance and the posterior wall of the oropharyngeal area. <\/span><\/li>\n<li><span style=\"color: #003366;\">Describe the swelling in more detail.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Required Instruments\u00a0 Head lamp [Figure 32]. Gloves. Tongue spatula. Lidocaine spray 10%. 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. Your eyes should be at the same height [&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-1555","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>Inpection &amp; Palpation: The Oropharynx - 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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