Operational Medicine 2001
Examining the Mouth and Pharynx

Function

In the mouth the TEETH mechanically break up food into small particles before it is swallowed. The salivary glands-parotid, submaxillary, and sublingual-secrete saliva, which moistens the food, makes it easier to chew, and lubricates the food mass to aid in swallowing. About 1,500 ml of saliva are secreted daily. Saliva contains one principal enzyme, ptyalin, which initiates chemical digestion of starches, breaking them into the complex sugar maltose.

The TONGUE is a muscular organ attached to the lower jaw at the back of the mouth and is the chief organ of taste. It assists in mastication, swallowing, and speech. PHARYNX

The pharynx (see The Respiratory System) is the passageway between the mouth and the esophagus and is shared with the respiratory tract. The EPIGLOTTIS is a cartilaginous flap that closes the opening to the larynx when food is being swallowed down the pharynx. Food is deflected away from the trachea to prevent particle aspiration.

Exam

The patient must open mouth widely. With a good light and tongue blade inspect the inner cheeks (Buccal mucosa) for color, ulcers, white patches.

Teeth — check for:

• Caries

• Broken teeth.

Gums — check for:

• Iinfection

• Inflammation

• Swelling

• Bleeding.

Tongue — look at the top, bottom and sides.

Throat (Pharynx) — With mouth open:

• Ask patient to say "ah" if you can not see the pharynx use a tongue blade. 

• Ask for an "ah" and note the rise of the soft palate ( a test for the 10^th, Vagus cranial nerve). 

• Inspect the soft palate, anterior and posterior pillars, uvula, tonsils and posterior pharynx. 

• Note any evidence of exudate, swelling, ulceration or tonsillar enlargement. 

• White patches of exudate associated with redness and swelling suggest acute exudative pharyngitis (strep).

For further information, read:

Otorhinolaryngology, in The SeaBee Operational Medical and Dental Guide

Aviation Ear Nose and Throat Medicine, in Operational Settings

ENT in Hospital Corpsman Sickcall Screeners Handbook

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Operational Medicine 2001
Health Care in Military Settings

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