ORAL DIAGNOSIS M4 PATIENTS GAIT Refers to the manner of walking Cause of defect: neuromuscular defect

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

ANTRUM OF HIGHMORE (MAXILLARY SINUS) Gives resonance to the voice Lessens the weight of the head

SPEECH ABNORMALITIES 1. DYSARTHRIA 2. Slurring of speech

GAIT ABNORMALITIES 1. HEMIPLEGIC GAIT Characterized by semicircular lateral swing of the affected leg during strides Typical of cerebral damage caused by stroke

APHASIA Inability to accomplish proper verbal expression

2.

ATAXIC GAIT (DRUNKEN GAIT) Is the staggering, irregular, wide-stance walk Examples: i. ii. Alcoholic intoxication TABES DORSALIS of tertiary syphilis Neurologic deterioration of the nervous system Sense of losing proprioception

3.

Both abnormalities are non-specific indications of intoxication. Neuromuscular deficiency/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. ii. b. c. d. Quantitative rate determination Qualitative rate determination

3.

PARKINSONIAN GAIT (FREEZING GAIT) Consists of limited strides, hanging arms, and muscular stiffness Examples i. Parkinsons disease due to dopamine deficiency

Respiration rate (12-20 breaths/min) Body temperature Blood pressure (measurement using ausculatory method) Height and weight i. For administering emergency drugs to know the dosage

e.

DOPAMINE neurotransmitter of the brain

POSTURE, MOVEMENTS AND SPEECH It is simultaneous with gait My become evident during rest or during movement

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

Patients with endocrine deficiency may manifest tremors Abnormalities: 1. Resting tremors of Parkinsons disease

Midline location of the nose Symmetry/contour of zygoma, ears and mandible

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

ii.

SUBMENTAL VIEW visualizes the anatomic triangles of the neck

iii.

LATERAL VIEW reveals the profile of the facial bones

2.

INFLAMMATORY ORIGIN: OTITIS MEDIA Middle ear infection Tenderness elicited by palpation of the mastoid process is indicative of MASTOIDITIS

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 2. Strabismus, ptosis, diplopia

MASSETERIC HYPERTROPHY is caused by bruxism (night grinding)

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

-Rosette Go 081410

GRAVES DISEASE antibodies of the patient attacks the thyroid Specific cause of exopthalmia in patients with hyperthyroidism

PORPHYRIA