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Clinical examination of ulcer - PowerPoint PPT Presentation


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Clinical examination of ulcer. Extraoral examination. Face : Any swelling symmetry TMJ Mouth opening Lymph nodes Palpabe /x? tenderness Muscle of head & neck : muscle tenderness Neck. Cranial nerve examination Movement of tongue Taste alteration Numbness on face Skin lesion

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Presentation Transcript
extraoral examination
Extraoral examination
  • Face :
    • Any swelling
    • symmetry
  • TMJ
  • Mouth opening
  • Lymph nodes
    • Palpabe/x?
    • tenderness
  • Muscle of head & neck : muscle tenderness
  • Neck
  • Cranial nerve examination
    • Movement of tongue
    • Taste alteration
    • Numbness on face
  • Skin lesion
  • Cachexia
  • Abdomen
  • Respiratory system
  • Pallor (anemia)
  • Fatigue
  • Malaise
intraoral examination inspection of ulcer
Intraoral examination (Inspection of Ulcer)
  • Site
  • Size
  • Shape
  • Number
  • Margin
    • Line of demarcation between normal & abnormal
  • Edge (part between margin and floor)
    • Sloping : healing ulcer
    • Punched out : gummatous ulcer
    • Undermined : TB
    • Raised : BCC
    • Rolled out/everted : SCC
  • Floor (The exposed part of ulcer)
    • Slough : moist dead tissue
    • Scab : dry dead tissue
    • Unhealthy granulation tissue
    • Healthy granulation tissue
    • Subcutaneous fat
    • Muscle/tendon
    • Bone
  • Discharge
    • Serous : healing ulcer
    • Sanguinous/blood stained : malignant/chronic
    • Purulent : bacterial infection
    • Greenish : pseudomonas infection
    • Yellowish : sulphur granules (actinomycosis)
intraoral examination palpation of ulcer
Intraoral examination (Palpation of Ulcer)
  • Local rise of temperature & tenderness
  • Exact dimension
    • depth
  • Induration/thickening f edge
    • in chronic ulcer & malignancy
  • Base
    • Fixity to underlying structure
  • Bleeding on touch
    • Malignant/chronic ulcer
intraoral examination others
Intraoral examination (Others)
  • Buccal mucosa
  • Tongue
    • Movement of tongue
    • Taste alteration
    • Deviation of tongue
  • Floor of the mouth
  • Gingiva
  • Oral hygiene
  • Palate
  • Dentures
    • Assess dentures
    • Assess denture hygiene
  • Dental charting
  • Sharp cusps/restorations