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Respiratory Exam
 
 

Oropharynx

 
 
 
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Overview

The oropharynx performs both respiratory and digestive functions, and allows for passage of air into the lower airways. Oropharyngeal examination can reveal pathology of the mucosa or tonsils.

Oropharyngeal Examination

  • How to Perform

  • Ask the patient to open their mouth and make an ‘ahh' sound, in order to contract the palate and uvula. Depress the tongue if required in order to visualise the posterior pharynx.
  • Look For

  • Erythema
  • Swelling of tonsils
  • Exudate
  • Ulcers - viral infection, neoplasm
  • Petechiae on soft palate - pathognomonic for bacterial infection

Pharyngeal Erythema

  • Look For

  • Redness of the posterior pharynx.
  • Causes of Pharyngeal Erythema

  • Viral infection - influenza, coronavirus, rhinovirus, enterovirus, HIV, EBV, CMV, HSV
  • Bacterial infection - group A Streptococcus, pneumococcus, Staph aureus, haemophilus
  • Irritation - postnasal drip, reflux, malignancy, chemical ingestion
  • Tonsillitis

Tonsils

  • Look For

    Enlarged, inwardly displaced tonsils. Look for erythema and pus.
  • Palatine (faucial) tonsils - lateral walls of oropharynx
  • Adenoids - posterior wall of nasopharynx
  • Lingual tonsil - base of tongue
  • Interpretation

  • Asymmetric swelling - may be associated with uvular deviationPeritonsilar abscess (quinsy)
  • Symmetric swellingTonsillitis

Pharyngeal Exudate

  • Look For

  • Pus or mucus on the posterior wall of the pharynx.
  • Interpretation

  • PusBacterial pharyngitis, EBV
  • White patchesCandidiasis
  • Grey, membranous exudateDiphtheria
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