Physical examination

The entire oral cavity should be thoroughly inspected with a good light and a tongue depressor paying attention to mucosal abnormalities arising from the various anatomical

sites. The tonsils should be inspected. The oral tongue and base of the tongue should be palpated and bimanual examination should be done for the floor of the mouth and submandibular glands. The neck should be palpated systematically to look for enlarged lymph nodes, bearing in mind that oral cavity and oropharyngeal tumours tend to metastasize to submental, submandibular and upper jugular or jugulodigastric lymph nodes before spreading to lower level lymph nodes (mid- and lower jugular lymph nodes).

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