CASE HISTORY PART-2

GUIDED BY – DR. AMIT BASSANAVAR SIR

PRESENTED BY- VIBHUTI BAROT
FINAL BDS
ROLL NO. 40
 EXTRAORAL EXAMINATION

• Pallor
ICTERUS
CYANOSIS
 BLIS TERI NG
PIGMENTAT ION
OEDE MA
 NAILS

Clubbing- Definition is bulbous enlargement of soft part of the terminal

phalanges of the nail.
KOILONYCHIA
TRACHYONYCHIA,
PACHYONCHIS ,
ONCHYOLYSIS
 SYMMETRY OF FACE

Note whether the face is symmetrical or asymmetrical.

 LYMPH NODE

• Normal lymph nodes are difficult to palpate. Nodes draining area of active infection are
usually tender; the overlying skin may be warm and red.
• Causes -
1. Inflammatory—acute lymphadenitis, chronic lymphadenitis, septic, tuberculosis, syphilis,
filariasis, and lymphogranuloma inguinale.
2. Neoplastic—primary (lymphosarcoma), secondary (carcinoma, sarcoma, malignant
melanoma).
3. Hematological—Hodgkin’s disease, non-Hodgkin lymphoma, chronic lymphatic
leukemia. • Immunological—AIDS, serum sickness, drug reaction, SLE and rheumatoid
arthritis
• PALPATION OF SUPERFICIAL LYMPH
NODES
EXAMINATION OF DEEP CERVICAL
NODES
 TEMPOROMENDIBULAR JOINT
EXAMINATION

• Methods of palpation
1. Pretragus palpation—the patient should be requested to slowly open and close the
mouth while the doctor bilaterally palpates the pretragus depression with his/her index
fingers (Fig. 7-20). •
2. Intra-auricular palpation—it is also performed by inserting the small finger into the
ear canal and pressing anteriorly (Fig. 7-21).
Bilateral palpation of TMJ
 MASTICATORY MUSCLE

1. Digital palpation—regional muscles are examined for the tenderness and trigger points using the digital palpation.
2. Masseter muscles—the masseter muscles are most effectively examined by simultaneously pressing them from inside
and outside the mouth in the process of bimanual palpation.
3. Lateral pterygoid muscle—the lateral pterygoid muscles are evaluated by inserting a finger each behind the maxillary
tuberosities, whereas the medial pterygoid is checked by running a finger in an anteroposterior direction along the
medial aspect of the mandible in the floor of mouth.
INTRAORAL EXAMINATION