Oral Mucosa Flashcards

1
Q

What are the major components of oral mucosa/epithelium?

A

Stratified squamous–> avascular
Basement membrane–> divides epithelium & CT
Connective Tissue–> underlies epithelium & contains vascular & neural elements

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2
Q

What are the functions of oral mucosa?

A
Protective
Secretory
Taste*
Absorption
Sensory
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3
Q

What are the 3 types of oral mucosa?

A

Masticatory
Lining
Specialized

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4
Q

Where is masticatory mucosa found?

A

Hard palate
Gingiva
Dorsum of tongue

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5
Q

What types of epithelium is masticatory mucosa composed of?

A

Parakeratinized and orthokeratinized epithelium

Para= immature form of ortho

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6
Q

Which type of mucosa has the fastest cell turnover time? Longest?

A
Lining= fastest @ 4-12 days
Masticatory= longest @ 12-24 days
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7
Q

What are the cell layers of masticatory mucosa?

A

Stratum Germinativum/basal layer
Stratum Spinosum/Prickle layer
Stratum Granulosum/granular layer
Stratum corneum/keratin layer

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8
Q

Which type of epithelium has cells that contain only keratin and no nuclei?

A

Orthokeratinized

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9
Q

Which type of epithelium has cells that contain keratin and nuclei but no organelles?

A

Parakeratinized

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10
Q

What are microplicae?

A

Cellular ridge-like folds/may produce mucin for protection of tissue surface

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11
Q

Function of melanocytes and their embryonic origin

A

Produce melanin, derived from CT

Embryology= neural crest cells

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12
Q

Function of Granstein & Lagerhans cells

A

Antigen processing/act as phagocytes

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13
Q

Function of Merkel cells

A

Clear cells with tactile receptors & react to pressure

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14
Q

Where is lining mucosa found?

A

Labial, buccal and alveolar mucosa; sulcus, junctional epithelium, col region, floor of mouth, ventral surface of tongue & soft palate

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15
Q

What type of epithelium makes up lining mucosa?

A

Stratified squamous nonkeratinized epithelium

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16
Q

Cell layers of nonkeratinized stratified squamous epithelium

A
  • Stratum basal- same as germinativum
  • Stratum intermedium- corresponds w/ spinosum (larger cells, fewer intercellular bridges)
  • Stratum superficiale- coresponds w/ corneum, nuceli are normal, organelles present
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17
Q

Where is specialized mucosa found? why is it specialized and what is its function?

A

Dorsal and lateral surfaces of tongue

Combo of masticatory and lining mucosa

taste function

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18
Q

Function of basement membrane? What are the two portions?

A

Divides epithelium and CT, two portions come one from each layer

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19
Q

What are the 2 layers of the basal lamina?

A

Lamina lucida- outer clear layer (closest to epithelium)

Lamina densa- Inside dense layer (closest to CT)

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20
Q

What is the attachment mechanism for the basal lamina?

A

Hemidesmosomes w/ attachment plaques

Tonofilaments

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21
Q

What are epithelial ridges/rete ridges and where are they located?

A

Concave and curving side of the basal lamina

Increases surface area contact to CT

Located throughout all oral mucosa but most prominent in masticatory

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22
Q

What is the epithelial component of the basement membrane?

A

Basal lamina- 2 layers, thin, collagenous network

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23
Q

What is the CT component of the basement membrane?

A

Lamina reticularis- one layer, thick, ACELLULAR, collagenous network

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24
Q

What is the attachment mechanism of the lamina reticularis?

A

Anchoring fibers; penetrate and pierce the lamina densa above it, interacts with hemidesmosomes and tonofilaments, stabilizes epithelial cells

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25
Q

What are connective tissue papilla?

A

Convex, curved area of the lamina reticularis side of the basement membrane

Increases surface area contact to EPITHELIUM

Most prominent in masticatory mucosa

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26
Q

Cells of subepithelial CT

A
Fibroblasts
Myofibroblasts
Mast cells
Macrophages
Tissue WBC's
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27
Q

What do fibroblasts produce in subepitheial CT?

A

Collagen, reticulin, elastin fibers and ground substance

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28
Q

What do myofibroblasts produce in subepithelial CT?

A

Modified fibroblasts (PDL, gingiva, wound healing)

Combo of fibroblasts and muscle cell= contractile

Also assoc. with eruption

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29
Q

WHat do mast cells produce?

A

Heparin

Histamine

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30
Q

What are the tissue WBC’s?

A

PMN’s, eosinophils, lymphocytes, monocytes

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31
Q

What are the tissue layers of the subepithelial CT?

A
Lamina propria
Submucosa layer (deep ayer)
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32
Q

What does the lamina propria layer contain?

A

Collagen fibers

My contain elastic fibers

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33
Q

What is teh attachment mechanism for the lamina propria?

A

Interdigitates w/ epithelium along the lamina reticularis/CT papilla

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34
Q

WHat are the 2 layers of the lamina propria?

A
Papillary layer (closest to epithelium)- loose CT, BV/nerves
Dense layer (below papillary)- dense CT, lots of collagen
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35
Q

What is the submucosa layer and what does it attach to?

A

Loose CT that attaches to deeper structures

Thick: attach to muscle- soft palate
Thin: attach to bone- gingiva, hard palate, alveolar mucosa

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36
Q

What supplies blood to the lamina propria?

A

Capillary plexus

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37
Q

What supplies blood to the submucosa layer?

A

BV

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38
Q

What is the external surface of the lips and cheeks?

A

Epidermis

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39
Q

What is the epithelial component of the lips and cheeks?

A

Keratinized epithelium w/ dermis (CT) and has increased amount of rete ridges & CT papilla

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40
Q

What is the vermillion zone?

A

Specialized epidermis

Red zone, keratinized epithelium w/ dermis & has increased amount of rete ridges and CT papilla

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41
Q

WHat does the vermillion zone form?

A

Mucotaneous junctions: Jct. of epidermis and labial mucosa, commisures of lips

42
Q

What type of mucosa is the labial and buccal mucosa?

A

Lining mucosa

Thick, nonkeratinized epithelium w/ lamina propria
Increased rete ridges & CT papilla

43
Q

Describe the submucosa layer (CT) of the labial and buccal mucosa

A

Loosely attached to muscle, contains minor salivary glands

Associated structures: Lips- labial frenum. Cheeks- buccal frenum, linea alba, fordyce granules, parotid papilla, buccinator muscle, buccal fat pad

44
Q

What type of mucosa is alveolar mucosa?

A

Lining mucosa

Covers alveolar ridge but not the hard palate

45
Q

Describe the epithlium of the alveolar mucosa

A

Thin, nonkeratinized epithelium w/ lamina propria & has decreased amounts of rete ridges and CT papilla

46
Q

Describe the attachment of the submucosa layer of the alveolar mucosa

A

Loosely attached to periosteum of bone and contains minor salivary glands

47
Q

What are the associated structures of alveolar mucosa?

A

MGJ: junction of alveolar mucosa and attached gingiva

48
Q

Where is the gingiva located?

A

Extends from the GM to the MGJ

49
Q

What type of epithelium is gingiva? Describe the epithelial components

A

Masticatory mucosa

Thick para/orthokeratinized epithelium
Increased rete ridges/pegs
Lamina propria has increase CT papilla
So submucosal layer

50
Q

What are the 5 gingival ligaments that support the gingiva and are not considered part of the periodontium?

A
Circular
Alveogingival
Dentoperiosteal
Dentogingival
Transseptal/Interdental
51
Q

Where is the sulcular epithelium located?

A

From the sulcus to the col area

52
Q

What type of mucosa is sulcular epithelium? describe

A

Lining mucosa

Extremely thin, nonkeratinized epithelium
Decreased rete pegs
Has lamina propria and decreased CT papilla
No submucosal layer

53
Q

Where is free gingiva located?

A

GM to free gingival groove, coronal to attached gingiva

54
Q

What is the gingival margin?

A

Most coronal part of free gingiva

Junction between free gingiva and gingival sulcus

55
Q

What is the free gingival groove?

A

Depression that demarcates the end of free gingiva, beginning of attached gingiva

Level w/ floor of sulcus
May not be prominent/visible

56
Q

What is the gingival sulcus?

A

Shallow groove that separates free gingiva from surface of tooth

Extends from GM to junctional epithelium (bottom of pocket)

57
Q

What is the function of gingival crevicular fluid?

A

Provides adhesion, defense and participates in inflammatory response

58
Q

What is junctional epithelium? Function?

A

Forms floor of gingival sulcus

Attaches gingiva directly to the tooth surface using hemidesmosomes

At same level of free gingival groove

59
Q

Where is attached gingiva? What is its attachment?

A

Extends from free gingiva to MGJ

Attaches to alveolar bone

60
Q

What are interdental papilla?

A

Tissue that fills space between 2 adjacent teeth

61
Q

What are the 3 regions of interdental papilla?

A

Labial/buccal and lingual/palatal surfaces- pyramid shape, contains gingival ligaments

Col region- Crater-like depression of IP. Located below contact area of adjacent teeth

62
Q

What innervates the alveolar bone?

A

Subperiosteal arteriole and branches of Zuckerkandle & Herschfelds

63
Q

What vascularizes the gingiva?

A

Maxillary artery

PDL vessels/ dental branches

64
Q

What innervates the gingiva?

A

Trigeminal nerve

PDL nerve branches/dental branches

Alveolar bone/ subperiosteal nerves

65
Q

Describe the epithelial qualities of junctional epithelium

A

Nonkeratinized lining mucosa
No retepegs or CT papilla

Wedge-shaped and continuous w/ sulcular epithelium
Located on tooth, forms floor of gingival sulcus

66
Q

What is the function of the external basal lamina of JE?

A

Composes the basement membrane

Separates epithelium cells and lamina propria

67
Q

What are the layers of the external basal lamina/basement membrane?

A

Lamina lucida- closest to epithelium
Lamina Densa-
Lamina reticularis

68
Q

What is the function of internal basal lamina?

A

Attaches epithelium to the tooth via hemidesmosomes

High mitotic activity- cells move from EBL to IBL- desquamate through sulcus

69
Q

What are the layers of internal basal lamina?

A

Lamina lucida- closest to epithelial cells

Lamina densa- closest to tooth surface

70
Q

What is the attachment mechanism for Internal and external basal lamina?

A

Hemidesmosomes attach basal lamina to enamel

Starts on enamel but could eventually reside on cementum or even dentin

71
Q

When does JE form?

A

Established during tooth eruption

72
Q

How does JE form?

A

REE and oral epithelum fuse utilizing desmosomes–> Forms primary epithelial attachment

PEA is replaced by oral epithelium forming JE and secondary epithelial attachment

73
Q

What kind of epithelium makes up the hard palate? Describe the epithelium

A

Masticatory mucosa

Thick para/orthokeratinized epithelium

Increased rete pegs

74
Q

Describe the subepithelial CT of the hard palate

A

Subepithelial CT has lamina propria with increased CT papilla

Firmly bount to periosteum- part of mucoperiosteum
Submucosal layer present in lateral zones

75
Q

Associated structures of the hard palate

A

Raphe, gingival region, rugae, incisive papilla, fovea, minor slivary glands

76
Q

Vascularization and innervation of hard palate

A

Branches of nasopalatine and palatine arteries and nerves

77
Q

Describe the epithelium that makes up the soft palate

A

Lining mucosa

Thin, nomkeratinized epithelium
Increased rete ridges

78
Q

Describe the subepithelial CT of the soft palate

A

Thick lamina propria
Increased CT papilla w/ elastin layer
Attaches to epimysium
Contains MSG’s

79
Q

Vascularization and innervation of soft palate

A

Lesser palatine artery and nerve

80
Q

Describe the epithelium of the uvula

A

Lining mucosa

Nonkeratinized epithelium
Increased rete pegs

81
Q

Describe the subepithelial CT of the uvula

A

Lamina propria has increased CT papilla

SUbmucosal layer attaches to epimysium of muscle core

82
Q

Describe the epithelium of the nasopharynx/nasal surface of palate

A

Hard and Soft palate: Pseudostratified columnar epithelium

Posterior soft palate: nonkeratinized epithelium

83
Q

Describe the subepithelial CT of the nasopharynx

A

Lamin propria and submucosal layer

Similar to hard/soft palates
Contains MSG’s

84
Q

Describe the epithelium of the body/dorsum of tongue- Anterior 2/3

A

Specialized mucosa

Para, ortho and non keratinized epithelium (mixed)

85
Q

Describe the subepithelial CT of the body/Anterior 2/3 of tongue

A

Lamina propria has increased CT papilla

Submucosal layer attaches to epimysium of muscle core

86
Q

What kind of epithelium make up the lingual papilla? What are the 4 kinds of lingual papilla?

A

Keratinized epithelium

Filiform- abrasive/no taste
Fungiform- taste
Foliate- taste and vin ebner salivary ducts
Circumvallate- taste and von ebner

87
Q

What are the components of taste buds?

A
Taste pore- Opening on the top of taste buds
Taste hair- taste receptors
Taste bud- Origin of taste
Taste cells- produce taste sensation
Supporting cells- support taste cells
88
Q

What vessel provides blood supply to the tongue?

A

Lingual artery

89
Q

What nerves provide general sensory to the tongue?

A

Trigeminal- body

Glossopharyngeal- root

90
Q

What nerves provide special sensory for the tongue?

A

Facial
Glossopharyngeal
Vagus

91
Q

What are the motor nerves of the tongue?

A

Facial
Glossopharyngeal
Hypoglossal

92
Q

Describe the glands of Von Ebner (middle)

A
Pure serous (watery)
Posterior 1/3 of tongue
Open into circumvallate and foliate papilla
93
Q

Describe the glands of Blandin Nuhn (anterior)

A
Mixed gland (serious/mucus)
In tip of tongue 
Open into plica fimbriata on ventral surface
94
Q

Describe posterior mucus gland (posterior)

A

Pure mucus gland (thick)
In posterior 1/3 root of tongue
Open into tonsillar crypts of tongue

95
Q

Describe the epithelium of the posterior 1/3 of the tongue

A

Lining mucosa

Nonkeratinized and decreased rete pegs

96
Q

Describe the subepithelial CT of the posterior 1/3 of tongue

A

Lamina propria has increased CT papilla

Attached to epimysium of muscles

97
Q

Associated structures of posterior 1/3 of tongue

A

Sulcus terminalis- jct of body and root
Foramen cecum- depression posterior to sulcus terminalis (thyroid)
Lingual tonsil- lateral surface
Tonsillar crypts- crevices of lingual tonsils

98
Q

Describe the epithelium of the ventral surface of the tongue

A

Lining mucosa

Thin, nonkeratinized
Decreased rete pegs

99
Q

Describe the subepithelial CT of the ventral surface of the tongue

A

Lamina propria has decreased CT papilla

Submucosal layer is loosely attached to muscle epimysium

Great range of movment

100
Q

Where can hyperkeratinized epithelium occur?

A

On non/para/orthokeratinized epithelium

101
Q

Examples of hyperkeratinized epithelium

A

Linea alba on buccal mucosa from localized trauma
Fibrosis of attached gingiva from advanced perio disease
Nicotine stomatitis on hard palate
In oral vestibules from chewing tobacco

102
Q

What can give rise to squamous cell carcinoma of the oral mucosa?

A

Alcohol use, tobacco use and HPV

Increase risk of oral cancer with these conditions