OBJECTIVES:

to through a light on
1-Symptoms of throat
diseases

2-Examination of throat
Symptoms of throat diseases

 Sore throat
 Dysphonia (hoarseness of voice)
 Dysphagia (difficulty in swallowing)
 Strider
 Referred otalgia
 Neck lump
Associated questions include:
 Occupation e.g. singer, teacher
 Smoking
 Alcohol habits
 Weight loss
 Heartburn
Dysphonia

 Hoarseness longer than 3 weeks is a laryngeal

carcinoma unless proved otherwise.
Ask about:
 Onset
 Duration
 Persistent or intermittent
 Severity
 Trigger factors e.g. upper respiratory tract infection
 Associated symptoms (weight loss, dysphagia,
strider)
 Smoking and alcohol history
Dysphagia

 Onset
 Duration
 It is painful or painless
 It is constant or intermittent
 It is progressive or not
 It is dysphagia to solid food and/or liquid
 Associated symptoms (weight loss,
hoarseness, strider)
 Smoking and alcohol history
Strider

 It is wheezing noise created due to turbulent

airflow through a narrowing of the larynx or
trachea
 It needs emergency intervention
 It should be contrasted with stertor which is
noisy breathing due to partial airway
obstruction above the larynx
Ask about:
 Onset
 Relationship to the phase of respiration (
inspiratory, expiratory, or both)
 History of trauma
 History of recent respiratory tract infection
 History of inhaled foreign body
 History of neurological problems
Examination of throat
1-Introduce yourself to the patient
2-Position the patient and expose the neck down to the clavicales
3-Ask edentulous patient to remove their dentures
4-Assess the speech
5-Inspection of oral cavity and oropharynx by using tongue depressor
 Inspect the tongue, buccal mucosa, teeth, alveolar ridges, opening of
parotid duct ( opposite the upper second molar), floor of mouth
 Ask the patient to protrude the tongue and move it from side to side and
up and down to allow inspection of the dorsal and venal surfaces of
tongue , lateral borders of tongue, mouth floor and tests hypoglossal
nerve function
 Inspection of palate, tonsils , anterior and posterior tonsillar pillars and
posterior pharyngeal wall
 Ask the patient to say (aah)to check movement of palate
6-Palpation: Bimanually palpate the floor of the
mouth overlying the submandibular duct for
calculi or masses and also palpate the base of
tonguea tumour in this site may not be visible
but easily palpable
7- Examination of postnasal space
8-Indirect laryngoscopy
 Explain the procedure to the patient
 Spray the pharynx with local anasthesia
 Warm a laryngeal mirror and check its
temperature on the back of your hand
 Ask the patient to protrude the tongue and
gently grasp it with a swab held in the left hand
 Ask the patient to breathe normally through the
mouth as the mirror is introduced gently up to
the palate
 Inspect the base of the tongue, the vallecula and
upper part of epiglottis
 Then inspect the posterior pharyngeal wall, the
aryepiglottic folds, the pyriform fossa, the
arytenoids, and the false and true vocal cords
 Note color changes, ulceration or mass
 Check the vocal cords movement by asking the
patient to say (ee)
Some patients can not tolerate laryngeal mirror
examination because of overactive gag reflex, in this
case use fiber optic laryngoscope
9-Examination of neck