1. Nose, Mouth, & Throat
MUST USE PENLIGHT

2. Health History Nose & paranasal sinuses
Discharge (color, amount, odor, clarity)
Frequent colds
Sinus pain
Trauma
Epistaxis
Allergies
Altered smell

3. Mouth & Throat Sores or lesions Sore throat Bleeding gums Toothache
Hoarseness
Altered taste
Smoking
Self-care behaviors – brushing, flossing, dental visits

4. Nose Inspect nose for deviations in shape, size, or color
Flaring of nostrils
Discharge
Patency of nostrils
Asymmetry of nasal septum is normal (abnormal if airflow is obstructed)
Nasal mucosa is usually redder than oral mucosa
Kiesselbach’s Triangle – site of most nosebleeds. Most vascular area of nose

5. Nasal Discharge/Drainage
Allergic Rhinitis
Clear drainage.
Turbinates and M/M will be swollen,
Boggy
Pale under eyes
Cold or Viral Infection
White drainage

6. Sinusitis
Copious, purulent drainage, with associated pain and tenderness over affected sinuses
Unilateral drainage
In children – suspect foreign body
Bloody – suspect neoplasm
Serosaingous – suspect CSF, head injury. With compression of the jugular vein, if it is CSF, you will see an increase in flow

7. Nosebleeds/Epistaxis
Suspect hypertension, bleeding disorders or dryness of M/M
Allergies
Check history of nose sprays

8. Mouth & Oropharynx
Inspect lips for symmetry, color, edema, or surface abnormalities
Ask client to open and close mouth, palpate TMJ
Oral mucosa is normally light pink and moist
Inspect palate
Inspect tonsils
Inspect the buccal mucosa

9. Grading Tonsils 1+ Visible
2+ Halfway between tonsilar pillars and uvula
3+ Touching the uvula,
Common in 4-9 year olds
4+ Touching each other

10. Tongue, Teeth, & Gums
Assess for swelling, color, coating, or ulceration
Test hypoglossal nerve – stick out tongue
Inspect floor of mouth
Inspect teeth for decay, missing teeth, and malocclusions
Inspect gums for signs of inflammation and hemorrhage
Assess CN IX and X (Glossopharyngeal and Vagal) Ahh, Uvula should move upward and midline
Assess for mouth odors

11. Teeth Note number Note color – pearly white to yellow
20 Deciduous
32 Permanent
Note color – pearly white to yellow
Presence of plaque, tartar, cavities (brown spots)
Eruption
Deciduous - begins at 5-9 mos. Complete by 2 ½ years
Permanent - begins at 6 years