Chapter 16Structure of the Nose cont’d.Review Anatomy: Structure and Function of the NoseReview AnatomySlide 5Slide 6Subjective Data: Health HistorySlide 8Physical Exam: InspectionNasal Inspection (using nasal speculum or otoscope).Inspect and Palpate Sinus AreasInspect Mouth, Oropharynx and TeethMouth, Tongue, Buccal Mucosa and PalateInspect Uvula and TonsilsGrading of TonsilsDevelopmental ConsiderationsSlide 17Transcultural ConsiderationAbnormal Findings: NoseAbnormal Findings: LipsAbnormal Findings: Teeth and GumsAbnormal Findings: TongueAbnormal Findings: ThroatChecklist for a Complete Nose, Mouth & Throat AssessmentNsg 326 Clinical AssessmentNursing DiagnosesDocumentationChapter 16Chapter 16Nose, Mouth and ThroatNose, Mouth and ThroatStructure of the Nose cont’d.Structure of the Nose cont’d.Review Anatomy: Review Anatomy: Structure and Function of the Structure and Function of the NoseNose►Structures of the external noseStructures of the external noseFunction in the Function in the respiratory systemrespiratory system►Structures of theStructures of thenasal cavitynasal cavitySeptumSeptumTurbinatesTurbinatesReview AnatomyReview Anatomy►Paranasal sinuses (adult and child)Paranasal sinuses (adult and child)FrontalFrontalMaxillaryMaxillaryEthmoidEthmoidSphenoidSphenoidReview AnatomyReview Anatomy►MouthMouthFunction in the digestive and respiratory systemsFunction in the digestive and respiratory systemsHard and soft palatesHard and soft palatesUvulaUvulaTongueTongueSalivary glandsSalivary glands►ParotidParotid►SubmandibularSubmandibular►SublingualSublingualTeethTeethReview AnatomyReview Anatomy►ThroatThroatOropharnxOropharnxTonsilsTonsilsNasopharynxNasopharynxSubjective Data: Health Subjective Data: Health HistoryHistory►NoseNoseDischargeDischargeFrequent colds (upper Frequent colds (upper respiratory infections)respiratory infections)Sinus painSinus painTraumaTraumaEpistaxis (nosebleeds)Epistaxis (nosebleeds)AllergiesAllergiesAltered smellAltered smellSubjective Data: Health Subjective Data: Health HistoryHistory►Mouth and throatMouth and throatSores of lesionsSores of lesionsSore throatSore throatBleeding gumsBleeding gumsToothacheToothacheHoarsenessHoarsenessDysphagiaDysphagiaAltered tasteAltered tasteSmoking and/or alcohol consumptionSmoking and/or alcohol consumptionSelf-care behaviorsSelf-care behaviors►Dental care patternDental care pattern►Dentures or appliancesDentures or appliancesPhysical Exam: InspectionPhysical Exam: Inspection►Nose: Nose: PositionPositionAny deformities, discharge or any flaring?Any deformities, discharge or any flaring?ColorColorAny lesions, discharge or edema of turbinatesAny lesions, discharge or edema of turbinates►Lips:Lips:Color, condition, lesionsColor, condition, lesionsAssess for breath odor and any pursed-lip Assess for breath odor and any pursed-lip breathingbreathingNasal Inspection Nasal Inspection (using nasal speculum or otoscope).(using nasal speculum or otoscope).►External noseExternal noseTest patency of nostrilsTest patency of nostrils►Nasal cavityNasal cavity►Color and integrityColor and integrity►SeptumSeptum►Deviation, perforationDeviation, perforation and bleedingand bleeding►TurbinatesTurbinates►Color, exudate, swelling and polypsColor, exudate, swelling and polypsInspect and Palpate Sinus Inspect and Palpate Sinus AreasAreas►Palpate frontal and maxillary sinusesPalpate frontal and maxillary sinuses►Advanced Procedure:Advanced Procedure:►Perform transilluminationPerform transilluminationInspect Mouth, Oropharynx and Inspect Mouth, Oropharynx and TeethTeeth►MouthMouthColor, condition, lesionsColor, condition, lesions►GumsGumsColor, condition, retraction, hypertrophy, Color, condition, retraction, hypertrophy, edema, bleeding and lesionsedema, bleeding and lesions►TeethTeeth►TongueTongue►OropharynxOropharynxColor, condition, lesions, drainage, exudates Color, condition, lesions, drainage, exudates and edemaand edemaMouth, Tongue, Buccal Mucosa and Mouth, Tongue, Buccal Mucosa and PalatePalate►Mouth: Mouth: InspectInspectLipsLipsTeethTeethGumsGums►Tongue: Inspect &Tongue: Inspect & palpatepalpate►Buccal mucosaBuccal mucosa►PalatePalateInspect Uvula and TonsilsInspect Uvula and Tonsils►Uvula:Uvula:►Tonsils: Tonsils: SizeSizeTest cranial nerve XIITest cranial nerve XIIGrading of TonsilsGrading of TonsilsDevelopmental Developmental ConsiderationsConsiderations►Infants and childrenInfants and childrenSalivation starts at 3 monthsSalivation starts at 3 monthsDroolingDroolingTeeth developmentTeeth developmentNose developmentNose development►Pregnant femalePregnant femaleNasal stuffiness and epistaxisNasal stuffiness and epistaxisGums may be hyperemic and softenedGums may be hyperemic and softenedDevelopmental Developmental ConsiderationsConsiderations►Aging adultAging adultNose Nose Oral cavityOral cavityDental changesDental changesDiminished sense of tasteDiminished sense of tasteDecreased salivationDecreased salivationTranscultural ConsiderationTranscultural Consideration►Bifid uvulaBifid uvula►Cleft lip and cleft palateCleft lip and cleft palate►Torus palatinusTorus palatinus►Size of teethSize of teeth►Agenesis (absence of teeth)Agenesis (absence of teeth)►Loss of teethLoss of teeth►Dental cariesDental cariesAbnormal Findings: NoseAbnormal Findings: Nose►Choana atresiaChoana atresia►Foreign bodyForeign body►EpistaxisEpistaxis►Perforated septumPerforated septum►Acute rhinitisAcute rhinitis►Allergic rhinitisAllergic rhinitis►SinusitisSinusitis►PolypsPolyps►FuruncleFuruncleAbnormal Findings: LipsAbnormal Findings: Lips►Cleft lipCleft lip►Herpes simplex Herpes simplex (fever blisters)(fever blisters)►Angular cheilitisAngular cheilitis►Chancre sores Chancre sores (syphilis)(syphilis)Abnormal Findings: Teeth and Abnormal Findings: Teeth and GumsGums►Baby bottle tooth decayBaby bottle tooth decay►Dental cariesDental caries►MalocculusionMalocculusion►Gengival hyperplasiaGengival hyperplasia►GingivitisGingivitis►EpulisEpulisAbnormal Findings: TongueAbnormal Findings: Tongue►Geographic tongueGeographic tongue►Smooth glossy Smooth glossy tonguetongue►Hypoglossal Hypoglossal paralysisparalysis►Black