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Test Your Extraoral and Intraoral Clinical Assessment Knowledge
1. Dental hygienists are responsible for forming a dental hygiene diagnosis on all patients with orofacial lesions and then conferring with a dentist, who then forms a differential diagnosis.
Though dental hygienists are not permitted to make a differential or definitive diagnosis for orofacial lesions, the dental hygienist is still responsible for forming a dental hygiene diagnosis to confer with the overseeing dentist. This is both a legal and ethical part of the dental hygiene appointment.
Fehrenbach, M. J. (2020). Extraoral and Intraoral Clinical Assessment. In J. A. Pieren & D. M. Bowen, Darby and Walsh Dental Hygiene (5th ed., pp. 195-222). Saunders.
2. Digital palpation is used when palpating the vestibule. Circular compression is used when palpating the lips, labial and buccal mucosa, and the tongue.
Digital palpatation is used when palpating the vestibule. Bidigital palpatation is used when palpating the lips, labial and buccal mucosa, and the tongue.
Palpation methods include:
- Digital palpation using one finger to press against the tissue is used to palpate vestibules, the floor of the mouth, and the lingual border of the mandible.
- Bidigital palpation using the forefinger and thumb to press against the tissue is used to palpate the lips, labial and buccal mucosa, and tongue.
- Manual palpation using all fingers of one hand to move or compress tissues simultaneously is used to palpate the lymph nodes or thyroid gland.
- Bimanual palpation using one finger intraorally and another extraorally is used to palpate the floor of the mouth and submandibular and sublingual salivary glands and lymph nodes.
- Bilateral palpation using finger(s) of both hands simultaneously is used to palpate the lymph nodes or to compare both sides at one time.
- Circular compression is used to palpate a suspected lesion for more information.
Fehrenbach, M. J. (2020). Extraoral and Intraoral Clinical Assessment. In J. A. Pieren & D. M. Bowen, Darby and Walsh Dental Hygiene (5th ed., pp. 195-222). Saunders.
3. Which of the following is considered an abnormal finding during an extraoral head and neck exam?
Examples of abnormal findings during an extraoral head and neck exam include:
- Needle marks resulting from drug use or domestic abuse trauma
- Soft, tender, enlarged, and freely movable nodes indicating acute infection
- Hard, non-tender, and fixed nodes indicating chronic infection, cancer, or trauma from domestic abuse
- Infections from piercings
- Pigmented, red, or ulcerous lesions indicating skin cancer, especially on the sun-exposed auricle
- Facial paralysis (Bell’s palsy) or stroke
- Temporomandibular disorder (TMD) with limitations of movement
- Subluxation or pain with TMJ movement
- Yellow coloration of sclera indicating jaundice
- Bluish coloration of sclera indicating trauma
- Inflammation, infection, and necrosis of tissue, leading to nasal septum perforation and saddle nose deformity with repeated cocaine snorting
Fehrenbach, M. J. (2020). Extraoral and Intraoral Clinical Assessment. In J. A. Pieren & D. M. Bowen, Darby and Walsh Dental Hygiene (5th ed., pp. 195-222). Saunders.
4. A lesion attached to surrounding tissue by a stalk-like base is described as _____.
The history, location, distribution, size, shape, texture, color, and consistency should be described when documenting lesions. Descriptive terms for shape include how a lesion is attached to surrounding tissues. If the base of a lesion is broad, usually as wide as the lesion itself, its attachment is described as sessile. In contrast, pedunculated lesions have a narrow pedicle or stalk-like attachment.
Fehrenbach, M. J. (2020). Extraoral and Intraoral Clinical Assessment. In J. A. Pieren & D. M. Bowen, Darby and Walsh Dental Hygiene (5th ed., pp. 195-222). Saunders.
5. A macule is a palpable, circumscribed, solid elevation, such as an oral fibroma on the buccal mucosa. A papule is a flat, nonpalpable lesion, such as petechiae on the palate due to infectious mononucleosis.
A papule is a palpable, circumscribed, solid elevation measuring less than 0.5 cm, such as an oral fibroma on the buccal mucosa. A macule is a flat, nonpalpable lesion measuring less than 1 cm, such as petechiae on the palate due to infectious mononucleosis.
Fehrenbach, M. J. (2020). Extraoral and Intraoral Clinical Assessment. In J. A. Pieren & D. M. Bowen, Darby and Walsh Dental Hygiene (5th ed., pp. 195-222). Saunders.
6. A single oral lesion with a well-defined border can be described as coalescing.
An oral lesion with well-defined borders is described as circumscribed, while multiple lesions with margins that merge are described as coalescing. Lesions with ill-defined borders are often difficult to determine where the lesion ends and normal tissue begins.
Fehrenbach, M. J. (2020). Extraoral and Intraoral Clinical Assessment. In J. A. Pieren & D. M. Bowen, Darby and Walsh Dental Hygiene (5th ed., pp. 195-222). Saunders.
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