Mouth and throat. Inspection of the lips reveals smooth, moist, pink lips without edema or lesions. The client has 27 slightly yellow teeth with the upper molars resting directly over the lower molars. The wisdom teeth and one canine are absent. The client has evidence of repair work of numerous fillings, one crown, and one veneer. Brown spots are visible on a few teeth. The gums and cheeks are pink, moist, firm, and show no signs of lesions or masses. The buccal mucosa appears pink, smooth, moist, and without lesions. The Stenson’s duct is visible and patent. The tongue is pink, moist, midline, and moderate size. Papillae are present and evenly distributed. There are no fasciculations, hardness, or lesions present. The ventral surface of the tongue is pink, shiny, smooth, moist, and has visible veins. The frenulum is midline with no signs of edema, erythema, lesions, or pain. The Warton’s ducts are visible, moist, and patent. The sides of the tongue are pink, moist, and have no lesions, ulcers, or nodules. The tongue offers strong resistance to force and has a full range of motion. The client was able to distinguish the taste between salt and sugar on his tongue. The hard palate, soft palate, and uvula are pink and moist. The hard palate contains transverse rugae and is intact. The soft palate is smooth and intact. The uvula is midline and rises symmetrically with the soft palate. The gag reflex is intact. There is a slight tooth decay odor from the mouth. The tonsils are absent. Inspection of the throat is pink, moist, and without redness, lesions, or exudate (Weber & Kelley, 2014).
The patient states that he has a dental appointment next month for a cleaning and to...
... middle of paper ...
... in opposition and the stride length is appropriate. Weight is evenly distributed and the client is able to walk on his heels and toes. The client does not fall backwards when performing the “nudge test” (Weber & Kelley, 2014, p. 519).
Temporomandibular joint (TMJ). Inspection and palpation of the musculoskeletal structure of the TMJ reveals smooth movement, with minimal snapping or clicking. The jaw has a full range of motion (ROM) against resistance, and moves laterally approximately 1-2 cm. The jaw protrudes and retracts easily and without pain or spasms (Weber & Kelley, 2014). The mouth opens approximately 2 inches.
Sternoclavicular joint. Inspection and palpation of the musculoskeletal system of the sternoclavicular joint reveals that the joint is midline, and has no visible masses, edema, or erythema. The joint is non-tender (Weber & Kelley, 2014).
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