pei-intraoral anat 2009

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  • 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 todays 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--oraloralworking 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