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ORAL DIAGNOSIS M4

PATIENTS GAIT

Refers to the manner of walking

Cause of defect: neuromuscular defect

ANTRUM OF HIGHMORE (MAXILLARY SINUS)

Gives resonance to the voice

Lessens the weight of the head

GAIT ABNORMALITIES

1. HEMIPLEGIC GAIT

Characterized by semicircular lateral swing

of the affected leg during strides

Typical of cerebral damage caused by

stroke

2. ATAXIC GAIT (DRUNKEN GAIT)

Is the staggering, irregular, wide-stance

walk

Examples:

i. Alcoholic intoxication

ii. TABES DORSALIS of tertiary

syphilis

Neurologic deterioration of

the nervous system

Sense of losingproprioception

3. PARKINSONIAN GAIT (FREEZING GAIT)

Consists of limited strides, hanging arms,

and muscular stiffness

Examples

i. Parkinsons disease due to

dopamine deficiency

DOPAMINE neurotransmitter of the brain

POSTURE, MOVEMENTS AND SPEECH

It is simultaneous with gait

My become evident during rest or during movement

Patients with endocrine deficiency may manifest

tremors

Abnormalities:

1. Resting tremors of Parkinsons disease

2. Intentional tremor of multiple sclerosis

Often associated with ataxic gait

3. Choreic/Athetoid movements

Characteristic manifestation of

cerebral palsy

Involves slow repetitive

movements of the proximal

extremities, trunk and face

SPEECH ABNORMALITIES

1. DYSARTHRIA

Slurring of speech

2. APHASIA

Inability to accomplish proper verbal

expression

3. Both abnormalities are non-specific indications

of intoxication. Neuromusculardeficiency/disorders (eg. Stroke, cerebral

palsy) and cortical defects

DETERMINATION OF VITAL SIGNS

Final aspect of general patient assessment

Consists of:

a. Pulse rate/rhythm (60-90/min)

i. Quantitative rate determination

ii. Qualitative rate determination

b. Respiration rate (12-20 breaths/min)

c. Body temperature

d. Blood pressure (measurement using

ausculatory method)

e. Height and weight

i. For administering emergency drugs

to know the dosage

PHYSICAL EXAMINATION OF SPECIFIC EXTRAORAL

STRUCTURES

1. FACIAL FORMS/SYMMETRY

Examined by inspection and palpation of the

ff. perspective/view:

i. FRONTAL VIEW

Pupil alignment

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Midline location of the

nose

Symmetry/contour of

zygoma, ears and

mandible

ii. SUBMENTAL VIEW

visualizes the anatomic

triangles of the neck

iii. LATERAL VIEW

reveals the profile of the

facial bones

iv. SUPRAORBITAL VIEW

achieved by looking down

the patients face from

above and behind the

head

Effective position to

observe deviation of

mandible during opening

SKIN OF THE FACE/NECK

EYES/EARS/NOSE

Abnormalities of the eyes can suggest the ff.:

1. DEVELOPMENTAL ABNORMALITIES

Strabismus, ptosis, diplopia

2. INFLAMMATORY DISEASE

Example: erythema of the

palpebral conjunctiva is a sign of

CONJUNCTIVITIS

3. MANIFESTATION OF SYSTEMIC DISEASE

JAUNDICE/ICTERUS of the sclera

is indicative of liver disease

EXOPTHALMOS/bilateral

protrusion of the eyeballs is

indicative of

hyperthyroidism/thyrotoxicosis

PHOTOPHOBIA (intense aversion

to bright light) is a sign of

PORPHYRIA

GRAVES DISEASE

antibodies of the patient attacks the thyroid

Specific cause of exopthalmia in patients with

hyperthyroidism

PORPHYRIA

Too much accumulation of blood pigment

PORPHYRIN

Tertiary syphilitic patients and drug-dependent

patients averse from light

EARS

Conditions affecting the ears that are of diagnostic

significance are:

1. DEVELOPMENTAL ORIGIN:

Congenital defects of the middle

and inner ear resulting to deafness

2. INFLAMMATORY ORIGIN:

OTITIS MEDIA

Middle ear infection

Tenderness elicited by

palpation of the mastoid

process is indicative of

MASTOIDITIS

MASSETERIC HYPERTROPHYis caused by bruxism (night

grinding)

-Rosette Go 081410