You will remember some of what you hear,much of what you read, more of what you see,and almost all of what you experienceand fully understand.Moore & Dalley – Clinically Oriented Anatomy
Richard P Madden, DDS, MS Richard P Madden, DDS, MS [email protected]@umn.edu
PHYSICAL EVALUATION I PHYSICAL EVALUATION I (Dent 5121)(Dent 5121)
IntraIntra--oral Examination:oral Examination:Normal AnatomyNormal Anatomy
Lecture ObjectivesLecture ObjectivesAfter todayAfter today’’s lecture, the student will be able to:s lecture, the student will be able to:
Describe how to examine periDescribe how to examine peri--oral and intraoral and intra--oral oral structuresstructures
Identify and describe normal periIdentify and describe normal peri--oral and intraoral and intra--oral oral topographic anatomytopographic anatomy
Identify and describe variations in normal Identify and describe variations in normal topographical anatomy and some of the more topographical anatomy and some of the more common pathological findingscommon pathological findings
See list of anatomic structures, variations of normal, and commoSee list of anatomic structures, variations of normal, and common pathological findings n pathological findings
““Oral and periOral and peri--oraloral““working definitionsworking definitions
IntraIntra--oraloral Oral cavityOral cavity
•• Oral cavity properOral cavity proper The area between the dental arches occupied by The area between the dental arches occupied by
the anterior portion of the tonguethe anterior portion of the tongue•• Oral vestibuleOral vestibule
The area between the teeth and cheeksThe area between the teeth and cheeks
OropharynxOropharynx•• The portion of the pharynx (throat) visualized through The portion of the pharynx (throat) visualized through
the oral cavitythe oral cavity
PeriPeri--oraloral The facial skin around the mouthThe facial skin around the mouth
Normal Lip Surface AnatomyNormal Lip Surface Anatomy
Perioroal and lip examination: Observation then palpation
Philtrum
Vermillion border / Mucocutaneous junction
Lip vermillion
Commisure of the mouth
Angular Cheilitis
Common pathological findings of lipsCommon pathological findings of lips
Actinic Cheilosis
Common pathological findings of lipsCommon pathological findings of lips
Actinic Cheilosis
Common pathological findings of lipsCommon pathological findings of lips
Actinic Cheilosis
Common pathological findings of lipsCommon pathological findings of lips
Recurrent Herpes Labialis
Common pathological findings of lipsCommon pathological findings of lips
Recurrent Herpes Labialis
Common pathological findings of lipsCommon pathological findings of lips
Recurrent Herpes Labialis
Labial MucosaLabial Mucosa
Labial mucosa examination: Observation then palpation
Labial MucosaLabial Mucosa
Labial MucosaLabial Mucosa
Palpation of Labial MucosaPalpation of Labial Mucosa
“Digital and Bi-digital palpation”
Variations of normal labial mucosaVariations of normal labial mucosa
Fordyce Granules
Variations of normal labial mucosaVariations of normal labial mucosa
Fordyce Granules
Morsicatio labiorum
Common pathological findings Common pathological findings of labial mucosaof labial mucosa
Apthous
Common pathological findings Common pathological findings of labial mucosaof labial mucosa
Mucocele
Common pathological findings Common pathological findings of labial mucosaof labial mucosa
Mucocele / Fibrosing mucocele
Buccal mucosaBuccal mucosa
Buccal mucosa examination: Observe then palpate
Parotid papilla
Salivary glandsSalivary glands
Parotidgland
Submandibulargland
Milking the Parotid GlandMilking the Parotid Gland
Palpation of Buccal MucosaPalpation of Buccal Mucosa
Pterygomandibular raphe
A tendinous band running from the pterygoid hamulus of the medial ptyergoid palte to the mylohyoid line of the mandible. The pterygomandibular rapheseparates and gives rise to the superior constrictor of the pharynx and the buccinator muscle.
Pterygomandibular RaphePterygomandibular Raphe
Variations of normal buccal mucosaVariations of normal buccal mucosa
Linea alba
Variations of normal buccal mucosaVariations of normal buccal mucosa
Linea alba
Variations of normal buccalVariations of normal buccal mucosamucosa
Leukoedema
Leukoedema is a diffuse grey-white, milky, opaque appearance of the buccal mucosa mostly disappears upon stretching.
Variations of normal buccal mucosaVariations of normal buccal mucosa
Leukoedema
Variations of normal buccal mucosaVariations of normal buccal mucosa
Fordyce granules
Variations of normal buccal mucosaVariations of normal buccal mucosa
Morsicatio buccarum
Variations of normal buccal mucosaVariations of normal buccal mucosa
Morsicatio buccarum or traumatic hyperkeratosis
Lichenoid Lichenoid mucositismucositis
Lichen planus versus Contact allergy to a dental material
ADDEDADDEDDentifrice stomatitis Variations of normal Variations of normal
buccal mucosabuccal mucosa
Common pathological findings Common pathological findings of the buccal mucosaof the buccal mucosa
Fibroma
Hard PalateHard Palate
Anterior palateAnterior palate
Incisive papilla
Palatal rugae
Median palatal raphe
Hard PalateHard Palate
Incisive papilla
Median palatal raphe
Palatal rugae
Fovea palatine
Palatal rugae
Fovea palatine
Variations of a normal hard palateVariations of a normal hard palate
Torus palatinus
Nicotinic Stomatitis
Common pathological findings of the hard palateCommon pathological findings of the hard palate
Soft palate Soft palate and and
OropharynxOropharynx
Foveapalatine
Examination of the oropharynxAnd palate is accomplished mostly by observation. The soft palate should be gently palpated. Beware of the gag reflex.
OropharynxOropharynx
Anterior tonsillar pillar = glossopalatine arch
Uvula
Posterior tonsillar pillar = glossopharyngeal arch
Posterior pharyngeal wall
OropharynxOropharynx
Soft PalateSoft Palate
Common pathological findings Common pathological findings of the of the oropharynxoropharynx
Tonsillitis
Common pathological findings Common pathological findings of the of the oropharynxoropharynx
Tonsillitis
Gingival Gingival AnatomyAnatomy
Gingiva and Alveolar MucosaGingiva and Alveolar Mucosa
Mucogingival junction
GingivaGingiva
Gingiva and Alveolar MucosaGingiva and Alveolar Mucosa
Gingiva and Alveolar MucosaGingiva and Alveolar Mucosa
Retromolar pad
Variations of normal Variations of normal gingivagingiva
Racial / Physiologic pigmentation
Common pathological findings of the Common pathological findings of the gingivagingiva and alveolar mucosaand alveolar mucosa
Gingivitis
Common pathological findings of Common pathological findings of the the gingivagingiva and alveolar mucosaand alveolar mucosa
Periodontitis
Common pathological findings of Common pathological findings of the the gingivagingiva and alveolar mucosaand alveolar mucosa
Pericoronitis
Common pathological findings of Common pathological findings of the the gingivagingiva and alveolar mucosaand alveolar mucosa
Amalgam tattoo
Common pathological findings of Common pathological findings of the the gingivagingiva and alveolar mucosaand alveolar mucosa
Amalgam tattoo
Common pathological findings of Common pathological findings of the the gingivagingiva and alveolar mucosaand alveolar mucosa
Dorsal TongueDorsal Tongue
Retraction of TongueRetraction of Tongue
Palpate TonguePalpate Tongue
Fungiform and Filiform papillaeFungiform and Filiform papillae
Circumvallate PapillaeCircumvallate Papillae
Foliate Papilla and Lingual TonsilsFoliate Papilla and Lingual Tonsils
Lingual TonsilsLingual Tonsils
Foliate papilla
Ventral TongueVentral Tongue
TongueTongue
Plica fimbriata
TongueTongue
Lingual frenulum
Variations of a normal tongueVariations of a normal tongue
Lingual varicosities
Lingual veinsLingual veins
Lingual veinsLingual veins
Variations of a normal tongueVariations of a normal tongue
Scalloped tongue
Variations of a normal tongueVariations of a normal tongue
Hairy tongue
Variations of a normal tongueVariations of a normal tongue
Fissured tongue
Geographic tongue (erythema migrans)Variation of normal
Geographic tongue (erythema migrans)Variation of normal
Unusual findings of the tongueUnusual findings of the tongue
“Forked” tongue
Floor of MouthFloor of Mouth
Floor of mouth examination: Observe then palpate
Floor of MouthFloor of Mouth
Bi-manual palpation
Floor of MouthFloor of Mouth
Variations of a normal Variations of a normal floor of mouthfloor of mouth
Mandibular tori