Oral Mucous Membranes Flashcards

1
Q

What are the main functions of mucous membranes?

A

-absorption
-excretion
-protection

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2
Q

Where is masticatory mucosa located?

A

gingiva and hard palate

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3
Q

Where is lining mucosa located?

A

-alveolar mucosa
-buccal mucosa
-floor of the mouth
-ventral surface of the tongue
-soft palate

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4
Q

Where is specialized mucosa located?

A

on the dorsal surface of the tongue

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5
Q

Which type of oral mucosa is keratinized?

A

masticatory

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6
Q

Where are taste buds located?

A

in specialized mucosa

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7
Q

What is mucoperiosteum?

A

a periosteum with a mucosal surface (close proximity of mucous membrane) with the periosteum of bone to form an apparent thin layer

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8
Q

What are the two microscopic organizations of oral mucous membranes?

A

1: epithelium
lamina propria
submucosa
periosteum
2: epithelium
lamina propria
periosteum

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9
Q

What are the layers of cells in the epithelial cell layer?

A

-stratum corneum (keratin layer)
-stratum granulosum (granular cell layer)
-stratum spinosim (spinous cell layer)
-stratum basale (basal cell layer)

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10
Q

What are some characteristics of stratum corneum?

A

-no nucleus
-high levels of keratin

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11
Q

What are the epithelial rete pegs?

A

projections of epithelial tissue that insert into the connective tissue to lock the epithelium into place

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12
Q

What are connective tissue papillae?

A

projections of connective tissue that interlock with the epithelial rete pegs

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13
Q

What are characteristics of the epithelium of oral membrane mucosa?

A

-rests on basement membrane
-exhibit one of more specialized intercellular attachments
-avascular
-exhibit a high degree of cellularity and relatively low volume of extracellular matrix
-may exhibit cellular polarity

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14
Q

What does cellular polarity do?

A

-allows cells to exhibit apical, basal, and lateral borders
-expressed in the distribution of cytoplasmic organelles

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15
Q

What is orthokeratosis?

A

refers to normal keratin formation with clinically normal presentation

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16
Q

What is parakeratosis?

A

retention ofpyknotic nuclei in the stratum corneum

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17
Q

What is hyperkeratosis?

A

abnormal thickening of stratum corneum
-may exhibit aberrant patterns of keratinization

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18
Q

What is dyskeratosis?

A

abnormal keratinization below the level of the stratum corneum
-keratinization within the stratum granulosum and/or stratum spinosum

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19
Q

What is acanthosis?

A

refers to hyperplasia of the epithelial layers
(increase in number of cells)

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20
Q

What is acantholysis?

A

loss of intercellular attachments between epithelial cells
-loss of desmosomes

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21
Q

What is metaplasia?

A

reversible change in which one adult cell type of replaced by another
-transitions of columnar to squamous epithelium in the respiratory tract due to smoking

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22
Q

What is dysplasia?

A

disorderly by non-neoplastic growth of tissue including the epithelial layer
-pleomorphism, hyper chromatism, and loss of normal spatial orientation
-could be a sign of precancerous conditions

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23
Q

What type of keratinized cell is present?

A

gingival parakeratosis (nucleus retained in the stratum corneum)

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24
Q

What type of keratinized cell is present?

A

gingival hyperkeratinization (very thick stratum corneum)

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25
Q

What is occuring in this histological slide of buccal lining mucosa?

A

acanthosis and parakeratosis
(nuclei retained all the way at the top and there is a lack of cellular attachment seen with lack of epithelium rete pegs)

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26
Q

What is seen in this histological slide of buccal lining mucosa

A

parakeratosis and hyperkeratosis
(nuclei retained at the top and the layer is signicantly thickened)

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27
Q

what is seen in these histological slides?

A

gingival dyskeratosis
-abnormal keratinization below the level of the stratum corneum
-can be an indicator of squamous cell carcinoma

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28
Q

What is seen in this histological slide?

A

gingival orthokeratosis

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29
Q

What do melanocytes look like?

A

have dendritic morphology
-long processes

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30
Q

Where are melanocytes at?

A

basal cell layer

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31
Q

What occurs in melanocytes?

A

synthesis of melanin pigment granules
(melanosomes)

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32
Q

What do langerhans cells look like?

A

have dendritic morphology
-look like tennis rackets

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33
Q

Where are langerhans cells located?

A

in the stratum spinosum

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34
Q

What is the function of langerhans cells?

A

antigen traps in epithelium that transfer antigen information to CD4 lymphocytes

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35
Q

What do merkel cells look like?

A

round

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36
Q

What type of cells are these>

A

melanocytes

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37
Q

What type of cells are these?

A

langerhans cells

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38
Q

What type of cells are these?

A

merkel cells

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39
Q

Where are merkel cells located?

A

basal cell layer

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40
Q

What is a possible function of merkel cells?

A

tactile sensory function

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41
Q

What do lymphocytes look like?

A

round

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42
Q

Where are lymphocytes located?

A

basal and spinous cell layers

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43
Q

What are lymphocytes associated with?

A

-immune surveillance and antigen message processing
-inflammation- both humoral and cellular response

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44
Q

what type of cells are these?

A

lymphocytes

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45
Q

What are the layers of the basement membrane?

A

-basal lamina + lamina reticularis
-lamina lucida
-lamina densa

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46
Q

What are the components of the lamina lucida?

A

-bullous pemphigoid antigen
-type VII collagen
-BMG-1
-classic laminin
-kalinin
-k-laminin
-entactin
-epiligrin

47
Q

What are the components of lamina densa?

A

-type IV collagen
-type VII collagen
-classic laminin
-BMG-1
-fibronectin
-integrins

48
Q

What are the components of lamina reticularis ?

A

-reticulin connective tissue
-type I collagen
-type III collagen
-elastin CT

49
Q

What help to create connections in the basal lamina>

A

-cadherin proteins

50
Q

What are proteins that aid in creation of hemidesmosomes in basal lamina?

A

-bullous pemphigoid antigen 1 and 2
-cadherin

51
Q

What protein is important in the lamina lucida layer?

A

type VII collagen

52
Q

What proteins are important in lamina densa layer?

A

-type IV and VII collagen

53
Q

What proteins are important in lamina retiucularis of lamina propria?

A

type I and III collagen

54
Q

What are the specialized cell attachments of the oral mucosa membrane?

A

-desmosome (macula adherens)
-hemidesmosome
-intermediate junction (zonula adherens)
-tight junction (zonula or macula adherens)
-gap functions (communication junction)

55
Q

What are the protein components of desmosomes?

A

-E- cadherin
-P-cadherin
-desmoplakin 1 and 2
-evoplakin
-periplakin
-plakoglobin

56
Q

What cells types are permanent or resident cell population of lamina propria?

A

-fibroblast
-monocyte -> histiocyte -> macrophage
-basophil -> mast cell
-plasma cell
-endothelial cell

57
Q

What are the transient of labile cell populations in lamina propria?

A

-neutrophils
-lymphocytes

58
Q

What are fibroblasts?

A

cells the secrete collagen and elastin

59
Q

What are histiocytes?

A

cells that are resident precursors of functional macrophages

60
Q

What are monocytes?

A

blood-borne precursors of functional macrophages

61
Q

What are macrophages?

A

phagocytic cell capable of antigen processing

62
Q

What are mast cells?

A

cells that secrete inflammatory mediators (histamine and heparin)

63
Q

What are plasma cells?

A

cells that make immunoglobins (antibodies)

64
Q

What are neutrophils?

A

phagocytic cells capable of neutralizing antigens or killing bacteria

65
Q

What are lymphocytes?

A

humoral and cell mediated immune response cells

66
Q

What is the endothelial?

A

cells that are lining blood and lymphatic vessels

67
Q

What is the sulcular epithelium?

A

epithelial cells located in the sulcus

68
Q

What is junctional epithelium?

A

epithelium attached to the tooth
-remanent of inner enamel epithelium

69
Q

what causes the attachment loss seen in periodontal disease?

A

the moving of the junctional epithelium moving apically
-create a larger sulcus

70
Q

Does everyone have the same amount of alveolar and attached gingiva?

A

no, there is a lot of anatomical variation that can occur with different amounts of alevolar and attached gingiva

71
Q

What are filiform papillae?

A

hair like papillae
-most numerous
-highly keratinized
-found over the entire dorsal surface of the tongue

72
Q

What are fungiform papillae?

A

-fungus like papillae
-small round, red surface projections
-may contain taste buds
-commonly found at the tip of the tongue and

73
Q

What is this?

A

filiform papillae

74
Q

What is this?

A

fungiform papillae

75
Q

What are foliate papillae?

A

-leaf like papillae
-may contain taste buds
-contain lymphoid nodules with germinal centers
-forms part of waldeyer’s ring
-located on posterior lateral margin of tongue

76
Q

What is this?

A

foliate papillae

77
Q

What are circumvallate papillae?

A

-walled papillae
-generally 6-8 in number
-lightly keratinized
-located just anterior to the sulcus terminalis on the posterior of tongue
-papillae sulcus is cleared of taste stimuli by serous salivary glands of von Ebner

78
Q

What taste stimuli are circumvallate most sensitive to ?

A

bitter compounds

79
Q

What taste stimuli are fungiform papillae most sensitive to?

A

salty and sweet

80
Q

What taste stimuli are foliate papillae most sensitive to?

A

sweet

81
Q

What are taste cells?

A

specialized epithelial cells (neuroepithelial)

82
Q

What nerve supplies taste to the anterior 2/3s of the tongue?

A

facial nerve via the chorda tympani

83
Q

What nerve supplies taste to the posterior 1/3 of the tongue?

A

glossopharyngeal nerve

84
Q

What nerve supplies taste to the soft palate?

A

facial nerve via the greater petrosal branch

85
Q

What nerve supplies taste to the walls of pharnyx and epiglottis?

A

vagus nerve

86
Q

Where do taste fibers of all three nerves converge in?

A

in the tractus solitarius in the brain stem

87
Q

wat is this?

A

drug induced lichenoid reaction

88
Q

what is lichen planus?

A

unknown etiology
-T-lymphocyte infiltrates with Langerhans cell hyperplasia are charactertistic
-cell mediated immune injury to basal cell is suspected

89
Q

What is this?

A

lichen planus

90
Q

What is this?

A

candidiasis

91
Q

What is this?

A

atrophic candidiasis

92
Q

What is this?

A

fissured tongue and possible focal epithelial hyperplasia

93
Q

What is this?

A

hairy tongue

94
Q

What is this?

A

geographic tongue

95
Q

What is hyperkeratosis?

A

thickening of the stratum corneum, often with aberrant keratinization

96
Q

What is leukoplakia?

A

white plaque of the oral mucosa membranes that cannot be removed by scraping and cannot be classified histologically as another disease entity

97
Q

What should leukoplakia be considered?

A

precancerous until proven otherwise

98
Q

what percent of all cancers is oral cancer?

A

3%

99
Q

What group of people have the highest incidence of squamous cell carcinoma?

A

middle-aged african american males

100
Q

What is the overall male-to-female gender ratio of occurrence of SCAA?

A

3:1

101
Q

What is the most common site for oral SCCA?

A

posterior lateral border of the tongue
-floor of mouth and ventral tongue surface are also common sites

102
Q

What have strong relationships with SCAA?

A

-tobacco smoking
-chewing tobacco
-alcohol consumption
-phenol exposure
-oncogenic viruses (HPV)
-immunosuppresion (HIV)
-oncogenes and tumor suppressor genes

103
Q

what are common histopathology of SCCA?

A

-lesion from dysplastic surface that have nuclear pleomorphism
-invasive islands and cords of malignant squamous epithelial cells
-often strong inflammatory or immune cell responses (necrosis may be present)
-abnormal production of keratin (keratin pearls)

104
Q

What is Mucosal pemphigoid?

A

-autoimmune disease
-epiligrin in lamina lucida
-linear accumulation of IgG and C3 along basement membrane

105
Q

Who does mucosal pemphigoid affect most commonly?

A

older adults in the 50-60 year old range
-females more often affected than males 2:1

106
Q

What can be seen in the eyes of patients with mucosal pemphigoid?

A

scarring in the conjuctiva
(cicatricial)

107
Q

What is ectodermal dysplasia?

A

syndrome involving abnormal or lack of development of ectodermal structures such as hair, eyebrows, eyelashes, and teeth

108
Q

What is peripheral ossifiying fibroma?

A

lesion that represents the maturation of pyogenic granuloma

109
Q

where does peripheral ossifying fibroma mostly occur?

A

exclusively occurs on the gingiva

110
Q

Who is mostly affected by peripheral ossifying fibroma?

A

teenagers and young adults with peak prevalance between ages of 10-19 years olf
-60-65% occurs in females

111
Q

What does histology of peripheral ossifying fibroma appear like?

A

-islands of calcified material (from periosteum)

112
Q

What is the recommended treatment of peripheral ossifying fibroma?

A

surgical excision
-lesion can occur again if excision is not extensive and complete

113
Q

what is seen?

A

peripheral ossifying fibroma