Oral cancer physical examination: Difference between revisions

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Revision as of 18:59, 8 September 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Common physical examination findings of oral cancer include a lump or thickening in the oral soft tissues, soreness, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or swelling of the jaw that causes dentures to fit poorly.

Physical Examination

Possible signs and symptoms of oral cancer that your patients may report include:

a lump or thickening in the oral soft tissues,
soreness
difficulty chewing or swallowing
ear pain
difficulty moving the jaw or tongue
hoarseness
numbness of the tongue or other areas of the mouth,
swelling of the jaw that causes dentures to fit poorly or become uncomfortable

Appearance of the Patient

The general appearance of the patient is ill appearing, cachectic.

Ears

Ear pain may be present

Throat

Soreness of the throat may be present

Oral Cavity

Difficulty in moving tongue may be present
Numbness of the tongue may be present
Swelling of the jaw may be present

References

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 Common physical examination findings of oral cancer include a lump or thickening in the oral soft tissues, soreness, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or swelling of the jaw that causes dentures to fit poorly.
 ==Physical Examination==
+Possible signs and symptoms of oral cancer that your patients may report include:
-==Physical Examination==
+*a lump or thickening in the oral soft tissues,
+*soreness
+*difficulty chewing or swallowing
-Possible signs and symptoms of oral cancer that your patients may report include: a lump or thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or other areas of the mouth, or swelling of the jaw that causes dentures to fit poorly or become uncomfortable.
+*ear pain
+*difficulty moving the jaw or tongue
+*hoarseness
+*numbness of the tongue or other areas of the mouth,
+*swelling of the jaw that causes dentures to fit poorly or become uncomfortable
 ===Appearance of the Patient===
-*This section should give a general description of what a patient with the disease you are describing may look like. You may include a physical description such as obese, thin, cachectic, well appearing, ill appearing, diaphoretic etc.
+The general appearance of the patient is ill appearing, cachectic.
-* For an example of the appearance of a patient section in the physical examination page, click [[Encephalopathy physical examination#Appearance of the Patient|here]].
-===Vitals===
-====Temperature====
-*A [[fever]] is often present
-*[[Hypothermia]] may be present
-====Pulse====
-=====Rate=====
-*[[Tachycardia]] may be present
-*[[Bradycardia]] may be present
-=====Rhythm=====
-*The pulse is regular
-*The pules is irregularly irregular
-=====Strength=====
-*The pulse may be weak
-*The pulse may be bounding
-*The pulse may be alternating in strength ([[pulsus alternans]])
-*A [[paradoxical pulse]] may be present
-=====Symmetry=====
-*The pulses may be asymmetric
-====Blood Pressure====
-*[[Hypotension]] may be present
-*[[Hypertension]] may be present
-*A [[wide pulse pressure]] may be present
-*A [[narrow pulse pressure]] may be present
-====Respiratory Rate====
-*[[Tachypnea]] may be present
-*[[Bradypnea]] may be present
-* [[Kussmaul respirations]] may be present
-===Skin===
-*[[Cyanosis]] may be present
-*[[Jaundice]] may be present
-* A rash may be present
-* [[Pallor]] may be present
-* Lesions may be present
-<gallery widths=150px>
-UploadedImage-01.jpg | Description {{dermref}}
-UploadedImage-02.jpg | Description {{dermref}}
-</gallery>
-===Head===
-* Abnormalities of the head/hair may include ___
-* There may be evidence of trauma
-===Eyes===
-*Icteric sclera may be present
-* [[Nystagmus]] may be present.
-* Extra-ocular movements may be abnormal
-*Pupils may not react to light
-*Ophthalmoscopic exam may be abnormal with findings of ___
 ===Ears===
-* Hearing acuity may be reduced
+*Ear pain may be present
-*[[Weber test]] may be positive
-*[[Rinne test]] may be positive
-* There may be [[exudate]] from the ear canal
-* There may be [[tenderness]] on movement of the pinnae
-===Nose===
-* Nares may be inflamed
-* There may be [[epistaxis]]
-* There may be [[purulent]] exudate from the nares
-* There may be [[tenderness]] to percussion of the sinuses
-* The nares may be congested
 ===Throat===
-* The throat may be erythematous
+*Soreness of the throat may be present
-* There may be [[exudate]] in the throat
+===Oral Cavity===
-* There may be [[petechiae]] seen in the throat
+*Difficulty in moving tongue may be present
-* There may be tonsillar inflammation
+*Numbness of the tongue may be present
+*Swelling of the jaw may be present
-===Neck===
-*[[Jugular venous pressure]] may be elevated
-*[[Carotid bruits]] may be present
-*[[Lymph nodes]] may be present
-*[[Thyromegaly]] may be present
-*[[Hepatojugular reflux]] may be present
-===Lungs===
-*[[Pulmonary edema]] and [[rales]] may be present
-*[[Wheezing]] may be present
-*Consolidation may be present with reduced breath sounds auscultated
-*[[Rales]] may be present
-*[[Egophony]] may be present
-* Chest movement may be assymetric
-===Heart===
-*A [[heave]] may be present
-*A [[thrill]] may be present
-*A [[friction rub]] may be pressent
-====Auscultation====
-*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
-*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
-*[[Heart sounds#Third heart sound S3|S3]]
-*[[Heart sounds#Fourth heart sound S4|S4]]
-*[[Heart sounds#Summation Gallop|Gallops]]
-*A [[systolic murmur]] best heard at the base may be present
-*A [[systolic murmur]] best heard at the apex may be present
-*A [[diastolic murmur]] may be present
-===Abdomen===
-*[[Abdominal distention]] may be present
-*[[Abdominal tenderness]] may be present
-*[[Rebound tenderness]] may be present
-*An [[acute abdomen]] may be present
-*An abdominal mass may be present
-*Guarding may be present
-*[[Hepatomegaly]] may be present
-*[[Splenomegaly]] may be present
-*Genitourinary exam if relevant
-===Extremities===
-*[[Clubbing]] may be present
-*[[Cyanosis]] may be present
-*[[Edema]] may be present
-===Neurologic===
-* Mental status may be altered
-* Glasgow coma scale is ___
-* Clonus may be present
-* Hyperactive reflexes may be present
-* There are deficits in cranial nerves __
 ==References==
 {{Reflist|2}}