Oral Cancer Screenings: Oral Health Evaluation скачать в хорошем качестве

Oral Cancer Screenings: Oral Health Evaluation

00:00-00:04 Oral health evaluation 00:05 - 00:22 Oral cancer screenings save lives. 2% of all cancers diagnosed are oral cancer. Approximately 40,000 people per year are diagnosed with oral cancer. 7,800 people will die from oral cancer per year. On average 60% will survive more than five years. 00:23 - 00:55 Your patient assessment begins as soon as the patient enters the office. You want to be noticing the patients breathing, posture and how they’re moving. It is important to obtain a full medical history to identify any early detection. Risk factors for oral manifestations include patients with increase sun exposure, tobacco and alcohol users, older patients patients with HPV, malnutrition and pregnant patients. It is important to take your patients vital signs to have them as a baseline and always remember to place the proper PPE. 00:56 -01:02 This clip will show you how you should be seeing your patient and observing them at the same time. 01:03 - 01:39 The next step is to begin your extra oral exam. The operator position is standing and the patient position is upright. The clinician will visually examine the head, face, eyes and neck noting symmetry, scars, tattoos and piercings. The clinician will bilaterally palpate lymph nodes and facial key points including: the pre and post auricular nodes, occipital node, anterior and posterior cervical chain, the supraclavicular nodes, the submandibular and submental nodes, the parotid gland, the thyroid and the TMJ. All of which will be demonstrated in the following clip. 01:58- 02:07 Have your patient take a sip of water and observe as they swallow. Then palpate the thyroid gland. 02:09-02:15 Observe their TMJ by having them open and close their mouth and moving it right to left. 02:16 - 02:45 Next you want to begin your intra-oral exam, starting with the labial and buccal mucosa. Visually examine the lips and retract them to reveal the labial mucosa. Palpate all mucosa and examine the frenum attachments, including the central, maxillary and mandibular. Next, retract the cheeks to reveal the buccal surfaces. Palpate and examine the frenum attachments. Lastly, using a 2 x 2 gauze check the Stensen’s production on both left and right sides. 03:09-03:42 Moving onto the tongue and floor of the mouth. Examine the patient’s left and right side of the tongue. Then have them put their tongue to the roof of their mouth, so you can see the underneath and evaluate the ventral and lingual frenum attachments. Have the patient extend their tongue outwards revealing the dorsal surface. With the tongue extended, palpate the lateral borders, dorsal and ventral surfaces. Using bi-manual palpation, palpate the floor of the mouth. Evaluate the sublingual gland left and right and using a 2 x 2 guys check salivary flow. 04:21-04:26 Next examine the gingiva and alveolar mucosa. 04:27-04:36 Examine and palpate the alveolar mucosa and attached marginal gingiva. Notice any exudate, sinus tract drainage or fistulas. 04:05 -05:20 Lastly, examine the hard and soft palate, maxillary tuberosities, retromolar pads and the pharynx. Examine the hard and soft palate noticing any fistulas, exudate or lesions. Next, palpate the hard palate for palatal Tori. Evaluate and palpate left and right retromolar pads and maxillary tuberosities. Examine pterygomandibular raphe, posterior pharyngeal wall, palatoglossal and palatopharyngeal pillars, palatine tonsils if they’re present and the uvula. 05:26 -05:41 The following are considered variations of normal and should still be documented: Tori on the hard and soft palate, as seen on the soft palate in the picture, melanin pigmentation, fissured tongue and fordyce granules. 05:42 - 05:56 The most important thing is documentation. All lesions should be noted in the patient’s chart. Including size, color, shape and also take a picture. Remember documentation is key!