Tongue cancer physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
During the thorough physical examination the physician should check the roof and floor of your mouth, the back of your throat, the [[lymph nodes]] in your neck, the inside of the cheeks, the lips and the top, sides and underside of the tongue. Physician will be looking for red or white patches, lumps, swelling or any other unusual problems. A dental evaluation is also performed, with attention to dental hygiene, integrity of the mandible, and dentition status. | During the thorough physical examination the physician should check the roof and floor of your mouth, the back of your throat, the [[lymph nodes]] in your neck, the inside of the cheeks, the lips and the top, sides and underside of the tongue. Physician will be looking for red or white patches, lumps, swelling or any other unusual problems. A dental evaluation is also performed, with attention to dental hygiene, integrity of the mandible, and dentition status. | ||
Patients may present with red lesions, mixed red and white lesions, or white plaques. | |||
Extremely advanced cancers present as ulceroproliferative growths with areas of necrosis and extension to surrounding structures, such as bone, muscle and skin. | |||
In the terminal stages, patients may present with orocutaneous fistula, intractable bleeding, severe anaemia and cachexia. | |||
Cancer of the buccal mucosa may present as an ulcer with indurated raised margin, exophytic or verrucous growth or with the site of origin depending upon the preferential side of chewing and placement of betel quid. | |||
In advanced stages, these lesions infiltrate into the adjacent bone and overlying skin. | |||
Cancers of the floor of mouth may arise as a red area, a small ulcer or as a papillary lesion. | |||
Advanced stages are associated with drooling. | |||
Cancer of soft palate and uvula often appear as an ulcerative lesion with raised margins or as fungating masses. | |||
Cancer of the base of tongue presents late in the course of the disease as a grossly ulcerated, painful, indurated growth. | |||
submandibular lymph node enlargement. neck swellings implying clinically obvious lymph node metastasis. | |||
===HEENT=== | ===HEENT=== | ||
*During a complete HEENT examination, specific attention is directed at the size and site of the [[lesion]] and infiltrating characteristics of the lesions. The physician should also perform a thorough bimanual examination of the tumor, the [[submandibular]] triangles, and the surrounding floor of mouth. | *During a complete HEENT examination, specific attention is directed at the size and site of the [[lesion]] and infiltrating characteristics of the lesions. The physician should also perform a thorough bimanual examination of the tumor, the [[submandibular]] triangles, and the surrounding floor of mouth. | ||
Revision as of 02:24, 29 November 2017
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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 tongue cancer include otalgia, submandibular gland asymmetry, and cervical lymphadenopathy.
Physical Examination
During the thorough physical examination the physician should check the roof and floor of your mouth, the back of your throat, the lymph nodes in your neck, the inside of the cheeks, the lips and the top, sides and underside of the tongue. Physician will be looking for red or white patches, lumps, swelling or any other unusual problems. A dental evaluation is also performed, with attention to dental hygiene, integrity of the mandible, and dentition status.
Patients may present with red lesions, mixed red and white lesions, or white plaques.
Extremely advanced cancers present as ulceroproliferative growths with areas of necrosis and extension to surrounding structures, such as bone, muscle and skin.
In the terminal stages, patients may present with orocutaneous fistula, intractable bleeding, severe anaemia and cachexia.
Cancer of the buccal mucosa may present as an ulcer with indurated raised margin, exophytic or verrucous growth or with the site of origin depending upon the preferential side of chewing and placement of betel quid.
In advanced stages, these lesions infiltrate into the adjacent bone and overlying skin.
Cancers of the floor of mouth may arise as a red area, a small ulcer or as a papillary lesion.
Advanced stages are associated with drooling.
Cancer of soft palate and uvula often appear as an ulcerative lesion with raised margins or as fungating masses.
Cancer of the base of tongue presents late in the course of the disease as a grossly ulcerated, painful, indurated growth.
submandibular lymph node enlargement. neck swellings implying clinically obvious lymph node metastasis.
HEENT
- During a complete HEENT examination, specific attention is directed at the size and site of the lesion and infiltrating characteristics of the lesions. The physician should also perform a thorough bimanual examination of the tumor, the submandibular triangles, and the surrounding floor of mouth.
- Otalgia
Neck
- Submandibular gland asymmetry
- Cervical lymphadenopathy
Nodal masses may become painful as they enlarge and develop central necrosis. When they extend beyond the lymphatic system, nodal masses may cause cranial nerve, respiratory, swallowing and upper extremity symptoms.