Exam 3 Flashcards
(80 cards)
1
Q
Name the three factors in making a differential diagnosis of an oral lesion
A
- Lesion site
- Lesion morphological characterists
- Color of lesion
2
Q
Name of morphological categories of oral lesions
A
Elevated
Depressed
Flat
3
Q
Define elevated lesions
A
surface above the normal mucosa plane
4
Q
Define coalescing
A
Clustered/Clumped/blend into one another
5
Q
Define blisterform lesions
A
translucent
soft rebounding
6
Q
Three types of blisterform lesions
A
vesicle
pustules
bulla
7
Q
Define vesicles
A
> 5mm lesion
Clear fluid
8
Q
Define pustule
A
greater or less than 5mm
yellowish color
9
Q
Define bulla
A
lesion >5mm
may contain serum mucin or extavaasated blood
pink red or blue
10
Q
Define nonblisterform lesion
A
firm and solid
contain NO fluid
opaque in appearance
11
Q
Four types of nonblisterform lesions
A
papule
nodule
tumor
plaque
12
Q
Define papule
size
A
Tissue
13
Q
Define nodule
size
A
Tissue>5mm
14
Q
Define tumor
term
size
A
tumescence (swelling)
>2cm
15
Q
Define plaque
shape
size
A
slightly raised lesion with a broad flat toppasted or stuck on appearance
>5mm
16
Q
Define Sessile nonblisterform lesion
A
papule nodule or tumor whose attachment to the normal mucosa is the greatest diameter of the lesion
17
Q
Define Pedunculated nonblisterform lesion
A
papule nodule or tumor whose attachment to the normal mucosa is smaller than the greatest diameter of the lesion itself
18
Q
Name of the four characteristics to describe depressed lesions
A
Outline-Oh
Margin-My
Depth-Double
Diameter- D’s
19
Q
Define ulcer
definition
center
periphery
A
loss in the continuity of the oral epithelium
yellow
red
20
Q
The normal viewing distance to determine the outline of lesions
A
30-40cm
21
Q
Describe the depth of a superficial and deep depressed lesions
A
3mm
22
Q
Define flat lesions
A
located on the same plane as normal oral mucosa
23
Q
How are flat lesions detected
A
change in color
24
Q
Define macule
A
a flat lesion of abnormal color
25
Why is the loss of a papillae on the tongue considered a flat lesion
Loss of papillae results in what looks like a depressed lesion however since it doesn't involve the mucosal surface it is a flat lesion. Because it doesn't involve an abnormality in color it is not considered a macule
26
Name the three most prominent colors of oral soft tissue lesions
Red
Pink
White
27
Name the four primary endogenous pigments of normal tissue
Oxyhemoglobin
Reduced hemoglobin
Melanin
Carotene
28
Define oxyhemoglobin
define
color
more oxygen
| bright red
29
Define reduced hemoglobin
define
color
less oxygenated
| bluish
30
Define melanin
define
color
formed by malanocytes, pigment particles transferred to malpighian cells of epithelium
brown
31
Define carotene
location
color
cornified superficial layer of the epithelium, sebaceous glands and blood plasma
yellow
32
Soft tissue lesions are rarely seen as single colors. The predominant color involves the greatest surface area first
Soft tissue lesions are rarely seen as single colors. The predominant color involves the greatest surface area first
33
Predominant color of the oral mucosa
pink
34
Location of Red mucosa
vermillion border, alveolar mucosa, soft palate, pharynx
35
Location of Melanin
buccal mucosa, attached gingiva, hard palate
36
Pink lesions
characteristic
normally appear as
types-4 and describe
normally elevated
nonblisterform (papules,nodules, tumors)
1. hyperplasia-increased quantity of normal connective or bone tissue
2. neoplasia-abnormal growth of tissue or cellular infiltrate
3. fluid accumulation-edema, Mucin- localized lesion (the more superficial the fluid accumulation the more translucent it will appear)
4. cyst- fluid filled epithelial lined cavities that are well localized
37
Red lesins
| formed by-2 types
increased quantity of blood to an area via erythema
| Intravascular changes and extravascular changes
38
Define intravascular changes
result from dilation of blood vessels or proliferation of new vessels via hyperemia
use diascopic examination to determine (blanching=positive indication)
39
Define extravascular changes
due to the escape of RBC's into the surrounding tissue via extravasation leading to discoloration of skin known as purpura
40
Three types of extravascular changes and their definitions
1. petechiae-small red macule 1-5mm sharply outlined
2. Ecchymosis-macule larger and slightly deeper than petechiae
3. hematoma- lesion involving large area casing tumescence
41
what is the most common condition resulting in abnormal redness
inflammation resulting from trauma or infection
42
White lesions
result from
Four types and define
alteration of the epithelium and connective tissue
1. hyperkeratinization- thickening of the outer surface of the epithelium via chronic irritation
2. acanthosis- increased thickening via hyperplasia of prickle cell layer
3. necrosis- death of cells in a localized area resulting in epithelial sloughing
4. Fluid accumulation- intra or extracellular edema appearing pale white
43
Red and White Lesions
commonly include
morphology
inflammation
| large ulcers and depressed lesions
44
Gray Lesions
caused by
morphology
```
foreign matter (metals)
associated with macules
```
45
Blue Lesions
caused by
Morphology
reduced hemoglobin
| bullae
46
Purple Lesions
morphology
caused by
bullae, nodules or hematomas
| vascular lesion breakdown products
47
Brown Lesions
caused by
morphology
characteristic
melanin and hemosiderin
macules
crusting and drying of ulcerated lesions (scabs)
48
Black Lesions
| caused by-4
foreign body deposition, altered blood pigments, necrosis/gangrene or melanin
49
Yellow Lesions
caused by-6
morphology
1.carotene via puss, 2.lymphoid tissue, 3.serum exudate, 4.breakdown of blood pigments, 5.lipids, 6.neoplasms
ulcers of pustules
50
Rough white lesion cause
mechanical friction (frictional keratosis)
51
Corrugated white lesion cause
long term tobacco use
52
Irregular, shaggy, sloughing or desquamating lesion cause-4
collapsed bullae, chemical burns, candidiasis, allergies
53
TMD definition
problems involving the masticatory musculature, temporomandibular joint or both
54
Synovial joint definition
synovial membrane that exudes synovial fluid to provide lubrication, and nutrients
55
Complex joint definition
has an articular disk that separates the join into a superior and inferior compartment and has articular disk
56
Articular disc definition
dense fibrous connective tissue that is saddle shaped containing a thick anterior band, thicker posterior band and a central zone that is non-innervated and avascular
57
Fibers of lateral pterygoid muscles attach to
anterior portion of articular eminence, retrodiscal tissue (vascular and innervated) and posterior aspect of the articular disc behind the condylar head
58
```
Primary function of muscles
masseter-
medial pterygoid-
lateral pterygoid-
temporalis-
```
elevation of mandible
elevation of mandible
protrusion and lateral excursion of the mandible
elevation of mandible
59
Masticatory muscles
masseter
medial pterygoid
lateral pterygoid
temporalis
60
Define internal derangement
the location of the articular disc is displaced from its normal seated position on the condylar head
61
```
Define disc displacement WITH reduction
type
most common
painful?
click?
mouth opening
mandible deviation
```
```
internal derangement
anteromedial
very painful
reciprocal click during closing and opening
within normal limits
towards the affected side
```
62
```
Define disc displacement WITHOUT reduction
type
most common
painful?
click?
mouth opening
mandible deviation
```
```
internal derangement
anteromedial
very painful in acute phase
no joint noise
limited mouth opening called "closed lock"
towards the affected side
```
63
Define Open Lock
hyper translation of the disc-condyle complex past the peak of the articular eminence with simultaneous contraction of the elevator muscles
64
Define Retrodiscitis/Capsulitis
inflammation of the vascular bed of the retrodiscal tissue and inflammation of the capsular tissue/synovial membrane resulting in edema that can "throw off" the normal bite of the patient
65
Define Osteoarthritis
| 3 characterists
inflammatory degenerative process of the articular surface of the condyle and articular eminence
1. roughened articular surface
2.pain
crepitus (crunchy) joint noise
66
Define Myalgia
local muscle soreness via overuse
67
Define odontalgia
referred false tooth pain
68
Define Obstructive Sleep Apnea (OSA)
repetitive episodes of complete (apnea) or partial (hypopnea) upper airway obstruction via the soft palate or tongue
69
Prevalence of hypertension
25%
70
True or False:
| "Data Suggests that a person with high blood pressure yields poorer results in dentistry"
False-the disease itself does not pose a risk to treatment rather the systemic cardiovascular, renal, near, and retinal cause increased risk during treatment.
71
Medicines used to treat hypertension cause-5
1. orthostatic hypotension
2. labial blood pressure during general anesthesia
3. gingival hyperplasia
4. xerostomia
72
what % of hypertension is known?
*5%- caused by catecholamine secreting tumors and kidney disease
95% considered essential hypertension
73
at what age should the diagnosis of hypertension be based solely on systemic blood pressure?
age 50
74
When should blood pressure be checked?
prior to giving a local anesthetic
75
What is white coat hypertension
a raise in blood pressure due to fear of medical practitioners including dentists
76
Define One MET
3.5ml of O2/Kg/min (ability of patient to perform physical work)
77
1-4 MET
eating, dressing, walking around, washing dishes
78
4-10 MET
climbing stairs, short run, game of golf
79
> or = 10 MET
swimming, long distance running, singles tennis, football, Friday dental basketball=12
80
Sedation does what to BP
lowers it
