Oral Motor Examination

Front 1

examination of oral anatomy scarring and asymmetries

Back 1

1. lip configuration
2. hard palate configuration (need a flashlight-- open mouth, look at dimensions, make note if palate is high and arched)
3. soft palate and uvula dimensions relative to the distance to the posterior pharyngeal wall (uvula needs to come in contact with posterior pharyngeal wall)
4. faucial arches (note tonsil tissue)
5. lingual configuration (look at tongue-- shrinkage? disfiguration?)
6. adequacy of sulci at the sides and front of mandible (make note of scar tissue)
7. dentition and secretion (over/underbite?)
8. floor of the mouth (ligament and salivary glands)

Front 2

labial function: rate, range, symmetry, and coordination

Back 2

1. spread lips as wide as possible /i/
2. round lips as much as possible /u/
3. rapidly alternate these two 10 times
4. diadochokinetic rate /pa/
5. close the mouth tightly during rest and during saliva swallowing (difficulty in nasal breathing?)
6. repeat a sentence with a bilabial stop consonants

Front 3

labial strength

Back 3

1. put a tongue blade between the lips and have the patient close lips tight so that you cannot pull it out
2. should test left, center, and right side of the lips

Front 4

anterior lingual function: range of motion and coordination

Back 4

1. extend and retract tongue as far as possible
2. touch each corner and and rapidly alternate
3. move tongue to the side and clean inside of cheek
4. elevate tongue ti to alveolar ridge with mouth open and rapidly alternate elevation and depression of tongue tip (top to bottom)
5. diadochokinetic rate /ta/
6. repeat a sentence with tip-alveolar stop consonants /t/ and /d/
7. slide the tongue along the palate from front to back

Front 5

posterior lingual function: range of motion and coordination

Back 5

1. open the mouth and lift back of the tongue /k/ for several seconds
2. diadochokinetic rate /ka/
3. repeat a sentence with back velar stop consonants /k/ and /g/

Front 6

lingual strength

Back 6

(put a tongue blade in various parts of the tongue and have the patient resist the blade’s movement)
1. tongue tip (put on top and have them lift/put in front and have them push)
2. lateral sides of the tongue
3. center of the tongue

Front 7

chewing and food manipulation

Back 7

(with a 4x4 gauze pad)
1. dip in juice
2. remove excessive liquid
3. ask the patient to move the gauze laterally onto the teeth, chew on it, and move to the other side

Front 8

soft palate and pharyngeal wall

Back 8

*need flashlight
1. sustain “ahhhh” for several seconds
2. observe soft palate movement and pharyngeal wall movement (soft palate should go up)
3. rapidly repeat “ah”
4. elicit palatal reflex: laryngeal mirror contact juncture of hard and soft palate or inferior edge of soft palate and uvula (when you touch it, soft palate should elevate) to observe velar movement
5. elicit gag reflex: contact tongue blade or the posterior pharyngeal wall to observe pharyngeal wall and soft palate contraction (back part of tongue or pharyngeal wall)

Front 9

laryngeal function examination

Back 9

1. voice quality, hoarse voice suspect reduced laryngeal closure (if hoarse or breathy = air leakage)
2. laryngeal diadochokinetic rate /ha/
3. cough and clear throat as hard as possible
4. slide up and down vocal scale
5. take a breath and prolong /z/ or /s/ on exhalation (record how long they can do it)