Physical examination maneuver

Physical Exam

Posterior Pharynx Inspection

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How to Perform

With the patient's mouth wide open and the tongue relaxed, press a tongue depressor on the middle of the tongue and shine a light into the mouth. Inspect the soft palate, uvula, anterior and posterior pillars, tonsils, and posterior pharyngeal wall, noting color, swelling, exudate, asymmetry, or lesions. Ask the patient to say "ah" and watch the soft palate and uvula rise.

How to Interpret

Showing 5 of 18 findings

Peritonsillar Abscess

Uvular deviation away from the swollen side
Rule in
InconclusiveWide CI
Rule out
Minimally helpful
Evidence:Moderate

Streptococcal Pharyngitis

Whitish-yellow exudate on the tonsils or pharyngeal wall
Rule in
Minimally helpful
Rule out
Not helpful
Evidence:Strong
Petechiae — pinpoint red or purple spots — on the soft palate
Rule in
InconclusiveWide CI
Rule out
Not helpful
Evidence:Strong
Red, injected pharynx
Rule in
—
Rule out
—
Evidence:Moderate

Tonsillar Malignancy

Persistent unilateral tonsillar enlargement (marked asymmetry) in the absence of acute infection
Rule in
Very helpful
Rule out
Helpful
Evidence:Strong

Related Bedside Tests

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Lung Auscultation
Rule in:VHChronic Obstructive Pulmonary Disease, VHPneumothorax, HMainstem Bronchus Intubation +29 more
Rule out:VHChronic Obstructive Pulmonary Disease, HPleural Effusion, SHInterstitial Lung Disease +28 more
Head and Neck Lymph Node PalpationMembers
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Head and Neck Lymph Node Palpation
Rule in:VHInfectious Mononucleosis, HMalignant Lymphadenopathy, SHThyroid Carcinoma +9 more
Rule out:SHMalignant Lymphadenopathy, MHInfectious Mononucleosis, ICConjunctivitis +9 more
FreeAxillary Lymph Node Palpation
Axillary Lymph Node Palpation
Rule in:SHBreast Cancer, SHHIV Infection, SHInfectious Mononucleosis +4 more
Rule out:MHInfectious Mononucleosis, NHBreast Cancer, NHHIV Infection +4 more
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Inguinal Lymph Node Palpation
Rule in:SHInfectious Mononucleosis, ICMalignant Lymphadenopathy, IELymphoma +2 more
Rule out:MHInfectious Mononucleosis, NHMalignant Lymphadenopathy, IELymphoma +2 more
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Spleen Palpation
Rule in:VHSplenomegaly, HMalaria, SHCirrhosis +13 more
Rule out:SHMyelofibrosis, MHInfectious Mononucleosis, MHSplenomegaly +13 more
Mouth and Tongue InspectionMembers
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Mouth and Tongue Inspection
Rule in:HHypoxemia, SHAnemia, SHHepatopulmonary Syndrome +16 more
Rule out:HHepatopulmonary Syndrome, SHHypovolemia, MHAnemia +16 more

Related Systems / Regions

Head, Eyes, Ears, Nose, Throat

Related Diagnoses

Allergic PharyngitisAnaphylaxisAngioedemaChronic PharyngitisChronic Postnasal DripDiphtheriaHand-foot-and-mouth DiseaseHerpanginaInfectious MononucleosisObstructive Sleep ApneaPeritonsillar AbscessStreptococcal PharyngitisTonsillar MalignancyTonsillitisUvulitisVagus Nerve Palsy

Related Chief Complaints

Asymmetrical TonsilsBad BreathBlisters in the MouthBlood in the SalivaBull NeckChange in VoiceChoking on LiquidsConstant Throat ClearingDifficulty BreathingDifficulty Opening the MouthDifficulty SwallowingDroolingDrooping of the Soft PalateEar PainExtreme TirednessFeverGargly VoiceGray Membrane in the ThroatHeadacheHoarse VoiceHot Potato VoiceLip SwellingLump in the ThroatMalaiseMouth BreathingMouth UlcersMucus in the ThroatMuffled VoiceNasal RegurgitationNeck LumpNo CoughNoisy BreathingOne-sided Enlarged TonsilOne-sided Throat PainPainful SwallowingPainless Throat MassPersistent Sore ThroatPostnasal DripRash on the Hands and FeetRed ThroatSevere Sore ThroatSnoringSore ThroatStops Breathing During SleepSwelling at the Back of the ThroatSwollen NeckSwollen Neck GlandsSwollen TonsilsSwollen UvulaTender Neck GlandsThroat TightnessTonsillar ExudateTrismusUnexplained Weight LossUvula DeviationWeak CoughWhite Patches on the Tonsils

References

Research in progress on one or more findings above; ratings may change.

  • Ebell MH, Smith MA, Barry HC, Ives K, Carey M. The rational clinical examination. Does this patient have strep throat? JAMA. 2000;284(22):2912-2918. PMID: 11147989.
  • Ebell MH, Smith MA, Barry HC, Ives K, Carey M. The rational clinical examination. Does this patient have strep throat? JAMA. 2000;284(22):2912-2918. doi:10.1001/jama.284.22.2912. PMID 11147989.
  • Gao EY, See ASY, Tan BKJ, Chan SWD, Zhou Y, See A, Kiong KL, Chan CY, Koh LH, Tan HKK, Abhilash B, Lim CM. Tonsillar Asymmetry and Malignancy: A Meta-analysis of Diagnostic Accuracy. Otolaryngol Head Neck Surg. 2026;174(3):643-654. doi:10.1002/ohn.70132. PMID 41614350.
  • Voruz F, Revol R, Combescure C, Monnier Y, Becker M, Dulguerov N. Diagnosis of peritonsillar abscess—a prospective study comparing clinical with CT findings in 133 consecutive patients. Diagnostics (Basel). 2025;15(2):228. PMID: 39857112.
  • Kenny BJ, Bordoni B. Neuroanatomy, Cranial Nerve 10 (Vagus Nerve). [Updated 2022 Nov 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Bookshelf ID NBK537171. PMID: 30725856.
  • Truelove SA, Keegan LT, Moss WJ, et al. Clinical and Epidemiological Aspects of Diphtheria: A Systematic Review and Pooled Analysis. Clin Infect Dis. 2020;71(1):89-97. doi:10.1093/cid/ciz808. PMID: 31425581. PMCID: PMC7312233.
  • Ebell MH, Smith MA, Barry HC, Ives K, Carey M. The rational clinical examination. Does this patient have strep throat? JAMA. 2000;284(22):2912-8. PMID: 11147989.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.