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Disorders of the Oropharynx and Oral Cavity

Terms in this set (85)

linea alba, no
what is this characteristic called? is this a sign of disease?
anterior portion
what part of the tongue is characterized by a smooth, but roughened surface with papillae and small fissures?
posterior portion
what part of the tongue is characterized by an uneven or rugated surface?
ventral portion
what part of the tongue is pink and smooth with large veins and frenulum?
wharton's ducts
what are these structures called?
submandibular and sublingual ducts
wharton's ducts open at the floor of the mouth and drain saliva from the ______________ and _____________
stensen's duct
what is this structure called?
parotid ducts
stensen's ducts open in the rear of the mouth near the second upper molar and drain the _____________
lingual frenulum
what is this structure?
torus mandibularis
what is this characteristic called?
torus palatinus
what is this characteristic called?
reactivation of herpes simplex virus
what causes cold sores?
up to five days until the vesicles crust over
when are people with cold sores contagious
sunlight exposure, physical or emotional stress, systemic illness, trauma, wind, menstruation, heavy alcohol use
what are the triggers for herpes simplex?
herpes simplex virus (cold sores)
What condition is characterized by tingling pain, burning, or itching followed by formation of painful vesicles on an erythematous base on the mouth and lips
Clinical evaluation, HSV-1 serology, PCR, viral culture, direct fluorescent antibody (DFA) assay, and Tzanck smear
what can you do to diagnose herpes simplex (cold sores)?
oral antivirals taken as soon as patient feels tingling
what is the treatment for herpes simplex (cold sores)?
lysine
what can be taken daily to prevent cold sores?
angular cheilitis
inflammation and fissuring in one or both commissure of the mouth
angular cheilitis
what condition is this?
denture wearers, males, HIV, Crohn's/UC
what groups are more at risk for angular cheilitis?
bacterial/fungal infection, saliva accumulation, atopic dermatitis, nutritional deficiencies (B12, B2, folate), immune deficiencies
what are the causes of angular cheilitis?
aphthous ulcers (canker sores)
what condition is this?
stress, local trauma, certain foods, illness, vitamin deficiency
what are the triggers for aphthous ulcers?
aphthous ulcers
What condition is characterized by well-circumscribed lesions on the oral mucosa with central necrotic ulcer with gray, fibrinous exudate and erythematous halo?
if persistent or severe; CBC, gluten sensitivity testing, HIV testing
when would you do diagnostic testing for canker sores? what tests?
infants, neonates, denture wearers, immunosuppressed, patients with dry mouth, patients who have been on antibiotics or steroids
what groups are at risk for oral candidiasis (thrush)
spread to esophagus, lungs, liver, and skin
what can happen when immunocompromised patients get oral candidiasis?
oral candidiasis (thrush)
What condition is this?
White patches on oral mucosa
Slightly raised "cottage cheese" like appearance
Does not scrape off easily
When scraped, leaves an inflamed base
Cracking and redness at corners of mouth (angular cheilitis)
candida albicans
what organism causes oral thrush?
oral candidiasis
what condition is this?
culture, gram stain, or KOH
what tests can you run to confirm oral candidiasis diagnosis
microbial plaque deposits, vitamin C deficiency, hormonal, drug induced
what are the causes of gingivitis?
gingivitis
What condition is characterized by the following?
Deepening of the sulcus between the tooth and gingiva
Band of red, inflamed gingiva along one or more teeth
Swelling of the interdental papillae
Easily induced bleeding
gingivitis
what condition is this?
anemia, vitamin B deficiencies, infections, medications
what are the causes of glossitis?
biopsy, vitamin levels, CBC, rheum studies
what tests can you run to confirm a diagnosis of glossitis?
glossitis
what condition presents clinically as a painful tongue and/or a change in surface appearance?
glossitis
what condition is this?
anemia (iron deficiency, pernicious anemia, folic acid), vitamin deficiency (riboflavin or niacin), diabetes
what causes atrophic glossitis?
atrophy of filiform papillae
what process is responsible for the smooth shiny appearance of atrophic glossitis?
atrophic glossitis
What condition presents as the following?
Tongue pain, burning or dryness
Loss of taste
Smooth, shiny, dry red tongue with a slick appearance
Can be patchy areas
Atrophied papillae
atrophic glossitis
what condition is this?
poor oral hygiene, broad spectrum antibiotics, overgrowth of oral fungus, immunosuppression, excessive use of mouthwash
what are the causes of black hairy tongue
accumulation of keratin on the filiform papillae
what is the process that leads to the characteristic appearance of black hairy tongue?
black hairy tongue
What condition presents with the following?
Elongated papillae
Yellow, brown, or black in color
Velvety, shaggy
Unable to wipe off
Painless
Altered taste sensation
Halitosis
black hairy tongue
what condition is this?
tobacco use, coffee, tea drinking
what factors contribute to black hairy tongue?
brush tongue with toothbrush or tongue scraper, treat with antifungals
what are the treatments for black hairy tongue?
keratosis pharyngeus (tonsillolith)
What condition is characterized by the following?
Small white stones in the crypts of the tonsils
Halitosis
Frequent sore throat
frequent gargling/rinsing after eating, water pick, tonsillectomy
what are the treatments for keratosis pharyngeus?
anaerobic
what category of bacteria grow in tonsilloliths?
keratosis pharyngeus (tonsilloliths)
what condition is this?
rhinovirus, adenovirus, EBV, HSV-1, influenza, parainfluenza, coronavirus
what pathogens cause acute viral pharyngitis?
viral pharyngitis
What condition is characterized by the following?
Sore throat
Gradual onset
Odynophagia (pain with swallowing)
Referred otalgia
Malaise
Erythema, edema, tonsillar hypertrophy
Cervical lymphadenopathy
Cough, sneezing, runny nose, headache
viral pharyngitis
what condition is this?
rapid strep test, throat culture, ASO, monospot
what tests can you do to confirm your diagnosis of viral pharyngitis?
supportive care and assess airway
what is the treatment for viral pharyngitis?
GABHS (Group A Beta hemolytic strep)
what is the number one cause of bacterial pharyngitis?
strep pneumonia, bacteroides fusobacterium, N gonorrhoeae, mycoplasma pneumoniae, staph aureus
what are the less common causes of bacterial pharyngitis?
bacterial pharyngitis
What condition is characterized by the following?
Sore throat
Sudden onset
Fever
Tonsillar exudates
Tender anterior cervical lymphadenopathy
Odynophagia, headache, nausea, vomiting, abdominal pain
Tonsillopharyngeal erythema
Beefy red swollen uvula
Petechiae on the palate
bacterial pharyngitis
what condition is this?
rapid strep test, strep culture, CBC
what tests can you do to confirm your diagnosis of bacterial pharyngitis?
rheumatic fever
if a patient with bacterial pharyngitis does not comply with their medications, what do they become at risk for?
scarlet fever
What condition is characterized by the following?
A rash most commonly associated with bacterial pharyngitis in school age and adolescent children
Blanching, popular rash- "sandpaper" rash
"Strawberry tongue"
scarlet fever
what condition is this?
15-24 year olds
what age group is most at risk for contracting mononucleosis?
epstein-barr virus, saliva, 5-15 days
what pathogen causes mononucleosis? how is it transmitted? what is the incubation period?
heterophile
the body reacts to mononucleosis by developing ______________ antibodies against the virus
mononucleosis
what condition can, rarely, cause hodgkin lymphoma
mononucleosis
What condition is characterized by the following?
High grade fever
Lymphadenopathy (especially ant and post cervical)
Tonsillar pharyngitis with/without exudates
Striking malaise
Splenomegaly or Hepatomegaly
Rash
monospot test and EBV antibody test
what tests can you do confirm a diagnosis of mononucleosis?
splenic rupture, acute airway obstruction, hepatitis, myocarditis, thrombocytopenia, meningitis
what complications are associated with mono?
secure airway, supportive treatment, abx for secondary inf, no contact sports or activities if splenomegaly
what is the treatment for mono?
peritonsillar abscess (quinsy)
What condition is caused by unilateral spread of infection outside the tonsillar capsule into the space located between the tonsil, soft palate, and the pharyngeal muscles?
GABHS (group a beta-hemolytic strep), staph, pneumococcus, and hemophilic organisms
what organisms cause peritonsillar abscesses? list the most common first
peritonsillar abscess
What condition is characterized by the following?
Severe, increasing, unilateral sore throat with swelling
Referred otalgia
Odynophagia
Muffled speech "Hot Potato" voice
Asymmetric cervical adenopathy
Trismus (lockjaw)
Neck Pain
Fever, Headache, Malaise
Displacement of uvula, bulge of the unilateral soft palate with anterior displacement of the ipsilateral tonsil
Drooling, salivation
Halitosis
Tachycardia
peritonsillar abscess
what condition is this?
CBC, CMP, monospot, culture of aspiration, CRP and blood cultures, x-ray, U/S or CT
what tests/imaging can be done to confirm diagnosis of peritonsillar abscess?
airway obstruction, retropharyngeal abscess, aspiration pneumonia, sepsis
what are the complications associated with peritonsillar abscess?
secure airway, needle aspiration, I&D, tonsillectomy, penicillin or clindamycin, analgesics and antipyretics
what are the treatments for peritonsillar abscess?
obstructive sleep apnea, malignancy, febrile convulsions caused by tonsillitis, tonsillar hemorrhage
what are the absolute indications for a tonsillectomy?
recurrent acute pharyngitis, peritonsillar abscess, eating or swallowing disorders
what are the relative indications for an elective tonsillectomy?
7 inf in 1 year, 5 inf/year in last 2 years, 3 inf/year for 3 years, >2weeks missed school or work in 1 year
what constitutes recurrent acute pharyngitis to qualify for tonsillectomy?
hemorrhage (intraoperative or delayed), airway obstruction (due to swelling), dehydration, weight loss, post op sore throat, loss of taste (mechanical damage to glossopharyngeal nerve)
what are the complications associated with tonsillectomies?
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