Last God exam questions Flashcards
(157 cards)
1
Q
How would you chart bitewing findings?
A
- Specific location (start with alveolar bone)
- Radio-opaque or radiolucent
- Extent
2
Q
What is a material risk? How do we manage it?
A
A material risk is a significant risk that occurs regardless of frequency of the procedure. Such risk could be exposing patients to radiation who are pregnant
3
Q
What are the steps to radio-graph assessment?
A
- Exposure
- Detector orientation
- Horizontal detector positioning
- Vertical detector positioning
- Horizontal beam angulation
- Vertical beam angulation
- Central beam position
- Colimator rotation
- Sharpness
- Overall diagnostic value
4
Q
What are the steps to gingival assessment?
A
C - colour
C - contour
C - consistency
T - texture
E - exudate
5
Q
What is the difference between sign and symptom?
A
Symptom - are reported by the patients
Signs - are detected by the physician
6
Q
What are the steps to ILA?
A
- Patient
- CC
- MHx
- SHx
- DHx
- Exam
7
Q
What is empathy?
A
It is the ability to understand and share other people’s emotions.
8
Q
What is the cultural iceberg?
A
It is a visualisation diagram that allows us to understand the concepts of deep and surface culture.
Surface culture could include: Language, holiays and festival and literature
Deeps culture includes: gender norms, understanding of self and allowed autonomy
9
Q
What is TRIM?
A
TRIM is an acronomy for:
Timing
Relevance
Involvment
Method
10
Q
What is differential diagnosis?
A
It is a process where a physician is able to assign probability of one illness in comparison to others accounting for patients sympotms.
11
Q
What is a white spot lesion?
A
A white spot lesion is an incipient caries lesion, it has a dull opaque chalky appearance and occurs due to demineralisation of enamel caused by cariogenic bacteria
12
Q
What is the pathogenesis of caries?
A
- Cariogenic bacteria requires simple sugars for anaerobic respiration
- Glucose is processed through glycolysis in the cariogenic bacteria
- Glucose is converted into 2 pyruvate
- In order to than convert NADH electron carrier into NAD+, pyruvate is converted into lactic acid
- Lactic acid accumulates in the cariogenic bacteria and is released into the oral environemnt
- Lactic acid has pH of about 2.35 which is slower than the critical pH of hydroxyapatite which means Lactic acids is able to cause dissociation of hydroxyal groups in hydroxyapatite which leads to demineralisation of the enamel
13
Q
How can we remineralise a tooth?
A
In presence of Calcium, Phopshate and/or Fluoride in the biofilm or in salivary pool, if pH of above 4.5 is restored the tooth would be immediatley remineralised
14
Q
What is the significance of dental pelicle?
A
It is able to provide some protection to the enamel. It also allows for binding of bacteria to the surface of the tooth
15
Q
What is the significance of biofilm in demineralisation?
A
Biofilm and calculus are able to create a more closed system where buffering agents from saliva are unable to penetrate, this may cause more demineralisation as lactic acid produced by carcinogenic bacteria is not buffered
16
Q
Why is brushing so good for caries prevention?
A
Brushing:
- removes biofilm
- introduces more fluoride for remin
17
Q
Why is fluoride so effective?
A
- It is able to stop cariogenic bacteria metabolism
- Drive remin
- Create fluoride salivary pool
18
Q
Why are incipient carious lesion look so much opaque?
A
Due to increased porosity. Increased posicity of enamel traps water which has a different refractive index which makes it look more dull
19
Q
Why is calcium still needed for fluoride incorpiration?
A
Fluoroapatite still needs calcium and phosphate
20
Q
How would you describe WSL
A
L - location
C - colour
T - texture
C - contour
21
Q
What is stephan’s curve?
A
It is a graph that shows what happens with oral pH after sugar consumption
22
Q
What would your brushing instruction would be for a person between ages of 0-1.5
A
No fluoride
23
Q
What would be your recommendation for an individual 1.5-6 years old for brushing?
A
- Low fluoride tooth paste to minimise fluorosis
- peasize
- Supervised
- Spit not rinse
24
Q
What would your recommendation for an individual 6+ years old?
A
- Standard dose fluoride
- Peasize
- Spit not rinse
- Supervise if needed
25
How is calculus formed?
1. Acid attack occurs
2. Statherin releases Ca
3. Excess calcium is able to percipitate on the biofilm as it can be used as an epitatic agent
26
What are the steps to rubber dam application?
1. Tooth assessment and tooth prep
2. Clamp selection and preparation
3. Dam preperation
4. Clamp placement
5. Clamp and dam placement
6. Anchorage
7. Dam Frame
8. Inversion
9. Finishing
10. Removal
27
What are the steps of rubber dam applicaition and removal?
1. Prepare rubber dam equipment
2. Assess tooth to be clamped
3. Prepare the rubber dam
4. Floos up the clamp
5. Try clamp onto tooth
6. Apply rubber dam and the clamp
7. Put the frame on
8. Invert the dam
9. Cut the inteproximal spaces
10. Remove the dam and clamp
11. Floss the rubber in the interproximal areas
28
What are the steps of rubber dam critique?
1. Dam preperation (hole positionin, punching)
2. Clamp selection (choice, gingival trauma, retention)
3. Clamp placement (gingival trauma)
4. Dam placement (alignment of dam)
5. Frame placement (positioning of frame)
6. Dam finish (isolation of appropriate teeht, moistture control)
7. Dam removal
29
What are some of the other methods of moisture control?
1. Retraction
2. Cotton rolls
3. Triplex
30
What is an ecological niche?
It is space where some organisms are able to thrive in, such are present in oral environment on tooth surfaces, calculus
31
What is utilitarianism?
It is basically - greatest happiness for the greatest number. Most benefit = the best route
32
What are the four classic biomedical principles?
1. Non-maleficence
2. Beneficence
3. Autonomy
4. Justice
33
What is non-maleficence?
Cause no harm. Donwside: harm could be unavoitable and uncotrolled
34
What is justice?
Justice is giving another their due/what they are owed.
35
What is pubic health?
It is response of society to protect and promote health and to prevent illness
36
What is lifestyle approach?
It essentially based on the idea that healthy behaviours are shaped by social environment
37
How do we achieve haemosatasis in 4 steps?
1. Vascular spasm/local vasocontriction - the cut vessels immediately contrict to slow blood flow and minimise blood loss
2. Formation of a platelet plug via adhesion, activation & aggregation of platelets:
a. von Willebrand factor adheres to the exposed endoepethilial collagen, creating sites which allow platelets to bind forming a platelet plug - than platelets release factors that aggregate other platelets
b. Thromboxane A2 - major component produced by platelets - involved in platelet aggregation adn vasocontriction
c. ADP is also produced by platelets - it stimulates release of prostocyclin and nitric oxide which can limit platelet aggregation - platelets plug size control
3. Blood coagulation = transformation of blood from liquid to solid gel
a. Platelets are stimulated to relase prothrombin activator which converts the plasma protein prothrombin into the enzyme, thrombin
b. Thrombin converts the plasma protein fibrinogen into threads of the protein fibrin which wind around the platelet plug to form a framework of fibres - this holds the plug and other blood cells in the blood vessel
c. Platelets in the clot begin to shrink - tightening the clot
4. Clot dissolution occurs via:
a. TPA, a protein on endothelial cells activates the conversion of plasminogen to plasmin
b. Plasmin breaks down clots by breaking down the fibrin netwrok
c. Macrophages & phagocytic WBCs then phagocytose the debris
38
What is the pathogenesis of erosion?
1. Intrinsic acids from gastroesophageal reflux or extrinsic acids from diet, medication or other sources enter the oral cavity.
2. Acids wash away dental biofilm and the dental pellicle and land directly on the tooth surface.
3. Acids reduce the pH of the oral environment below the critical pH of HA (5.5) or FA (4.5) and cause demineralisation of enamel to form Ca & PO4 ions. Enamel rods are permanently shortened
4. As erosion occurs in an open system (as there is no biofilm to trap mineralisation products), mineralisation products are washed away or swallowed and there is no future potential for remineralisation.
39
What are the steps of CD4+ cell activation process?
1. Foreign antigen phagocytes, killed & processed by the APC
2. ACP presents processed fragment
3. This is done via MHC II molecule (epitode) on the membrane surface of the APC
4. Epitode binds with TCR on naive CD4+ T lymphocyte
5. This causes activation of the naive CD4+ T lymphocyte and creates a T helper cell
6. T helper is able to bind with a B lymphocyte and cause it to transform into either B memory cell or plasma cell
41
What are the steps of Type I hypersentivity?
1. Antigen is processed as usual and Plasma cells are created with a speicifc IgE antibody
2. IgE antibody binds with a mast cells and act as a receptor
3. If the antigen apprearce again and binds with IgE receptor on the mast cell it will cause degranulation
42
What are the 5 steps of inspiration?
1. Diaphragm and external intercostal muscles contract
2. Thoracic cage expands up and out
3. Lungs expand
4. This causes a drop in intrapulmonary pressure
5. This cause a drop in intra-alveolar pressure thus movement of air from the atmosphere to the alveoli
43
What are the 6 steps of expiration?
1. Diaphragm and external intercostal muscles relax
2. Thoracic cage moves in and down
3. Lung’s recoil toward pre-inspiratory size
4. Air in lungs compressed
5. Pressure rises above atmospheric
6. Air flows out of the lungs down the pressure gradient
44
What is surface tension?
Surface tension is a force that make it hard for the alveoli to expand. Basically there are water molecules on the epithelium lining of the alveoli which create the “air-water interface”, but those water molecules are more strongly attracted to each other than the air thus are able to resist the pulling apart while the alveoli expand.
45
How can we overcome the surface tension?
Through use of a surfactant released by type 2 alveolar cells. Surfactant can be released through tubular myeline. It reduces the attraction between the hydrogen bonds of the water molecules thus reducing their resistance to separation while the alveoli expand resulting in an increase in pulmonary compliance.
46
What is compliance?
Compliance is the effort required to expand the lungs. Some factors may reduce compliance thus making is hard to breathe. Some things, such as elastic connective tissue that facilitate alveolar recoil, increases elastic compliance.
49
What are the 4 steps of buccal stage?
1. Compression of the bolus against hard palate
2. Retraction of the tongue forces bolus into the oropharynx
3. Elevation of the soft palate seals off the oropharynx
4. Once bolus enters the oropharynx, reflex response are initiated and the bolus is moved towards the stomach
50
What are the 4 steps of pharyngeal stage?
1. Tactile receptors on palatal arches & uvula are stimulated
2. Pattern of muscle contraction in the pharyngeal muscles is triggered by th swallowing center in the medulla
3. Elevation of the larynx & folding of the epiglottis results from contractions of the pharyngeal muscles
4. Pharyngeal constrictors then force the bolus thru the pharynx, past closed glottis and into oesophagus
51
What are the 6 steps of orhostatic hypotension?
1. Blood is evenly distrivuted through the body when lying flat
2. On standing blood pools in the legs due to contraction of skeletal muscles and squeezing of veins
3. Pooling blood cuases reduction in venous return, this causes the reduction in cardiac output, reducing blood pressure
4. The body is unable to appropritley regulate it due to multiple factors
5. Reduced pressure to the brain causes the brain to shut down due to lack of oxygen
6. Person falls
52
What are the steps to fissure selant placement and what are their reasons?
1. Moisture isolation – salivary contamination and easier access
2. Clean the surface of plaque/debris – if the debris is there fissure sealant won’t bond
3. Rense the tooth and dry – remove debris and tooth needs to be dry
4. Etch – phosphoric acid remove pellicle, remove old enamel surface, increases surface area by creation of porosities thus creating micromechanical bonding
5. Rinse tooth – stop etching process and remove enamel products
6. Dry tooth – remove debris and tooth needs to be dry for bonding
7. Apply the fissure sealant to the etched surface
8. Probe the entire surface in order to check for potential imperfection – make sure the fissure sealant does not create niches for bacteria to accumulate
53
How can we calculate the GFR?
By using substances that can be freely filtered and not at all resorbed. SUch substance is creatinine - a bi-product of muscle metabolism.
54
What s the formula for GFR?
GFR = (urine concentraion x urine flow)/plasma concentration
55
What are podocytes?
They are cells that cover basal lamina of the bowman's capsule
57
How can podocytes function?
The movement of actin like filaments allows them to increase their size, constrict the area of filtration thus reduce GFR
58
What is a tubular maximum reabsorption?
It is a theoretic process in which active transport mechansism can reabsorbed substances at max. Beyond tubular maximum reabsorbtion rate can not increase and surplus of materials is lost in urine.
59
How does diabetes mellitus relate to maximum tubular reabsorbtion?
Diabetes mellitus is a condition where there is a large amount of glucose in blood.
Upon filtration in the glomerulus it is released in the tubular system.
Due to high amounts the glucose excides the maximum tubular reabsorption rate thus is excreted in urine.
This cause a shift in osmotic pressure against reabsorption thus increasing the urine volume.
Thus the thirst is increased.
60
Outline once again the cosntant and variable Na+ reabsorptions in the tubular system of the nephron.
Constant:
1. Proximal tubule 65%
2. Ascending loop of henle 25%
Variable:
1. Ditant convoluted tubule and collecting 0-10%
61
What is the importance of sodium in relation to water?
High sodium load = increased water reabsorption
62
WHat are the three mechanisms of rening release?
1. Baroreceptor like - granular cells can act as baroreceptors
2. Stimulation from macula densa cells that detect changes in salt in the distal tubule
3. SNS signalling
63
What is the mechanism of renin?
Renin works via RAAS system to increase Na+ reabsorption
64
What is the mechanism of work of aldosterone?
Aldosterone is part of the RAAS and increase the reabsorption of Na+ by kidneys.
This changes the osmotic pressure to hold more water.
Thus increasing blood volume.
Increasing blood pressure.
65
What is the mechanism of work of angiotensin II?
Angiotensin II triggeres the relaaese of vasopressin by the posterior putunitary gland.
Vasopressin is able to increase the water reabsobtion in kidney tubules by binding to type 2 vasopressin receptor and increasing the work of aquapourins 2 and increasing there number in the collecting duct.
66
How do ACE inhibitors help with regulation of hypertension?
ACE is a hormone that converts Angiotensin 1 into Angiotensin 2 trigeering aldosterone releae and vasocontriction.
IF ACE is blocked, angiotensin 1 can not be converted into angiotensin 2 thus it is undable to cause vasocontriction and increase sodium retention.
67
How does the mechanism of vasopressin release occur?
1. Hypothelamus receptors detect the hgih salt concentrtions
2. Receptors send a signal to the posterior pituitary gland via neurosecretory cells
3. Vasopressin is released
68
How can baroreceptros stimulate the release of vasopressin?
1. Baroreceptors on the aortic arch detect low blood pressure and via SNS signal the posterior pituitary gland
2. Vasopressin is released
69
How can vasopressin act as a vasoconstrictor?
Vasopressin is able to binf to V1 receptor on the smooth muscle and cause the contriction of the muscle
70
What intercellular events are triggered by vasopressin?
1. Vasopressin in blood is able to bind to the basolateral membrane of a distal or collecting tubule cell
2. This binding activates cyclic AMP
3. AMP promotes the insertion of the water channels in the opposite membrane that faces the tubule, which is impermiable to water without aquapourins
4. Water is able to enter the tubular cell and exit into the peritubular fluid and into the capillary
71
What happens with urine when there is no vasopressin present?
1. It becomes diluted
2. Volume increases
72
What happens to urine when vasopressin is present?
1. Urine reduces in volume
2. Urine is more concentrated
3. Blood pressure increases
73
Where is Atrial Natriuretic peptide released?
It is released from the atria of the heart
74
Where is Brain Natriuretic Peptide released?
It is released from the ventricles of the heart
75
What stimulates the release of ANP and BNP?
High plasma volume detected by the baroreceptors
76
Describe the aldosterone triggered process in the cellular wall of the distal tubule in 5 steps.
1. Aldosterone binds with cytoplasmic receptor
2. Initiation of transcription
3. Synthesis of new protein channels
4. Modulation of existing channels
5. Modified and new channels are able to reabsorb more Na+ and secrete K+
77
What is the objective of ANP and BNP release and how do the peptides achive it?
Main objective: Reduction of blood pressure in nephron.
Methods:
1. Inhibition kidney Na+ reabsorbtion
2. Inhibitng the effect of RAAS
3. DIlation of afferent arterioles in glomerulus
Also inhibition of Sympathetic drive thus decrease in cardiac output
78
How does bone remodeling occur?
Bone remodeling occurs according to Wolf's Law. It states that the bone will adapt to the stresses placed on it.
79
Why is new eruptly tooth more likely to suffer from caries?
Permanent enamel (and possibly primary enamel) undergoes post-eruptive maturation, accumulating fluoride, becoming harder, less porous and less caries-prone.
80
81
What are the four classic biomedical principles?
1. Non-maleficence
2. Beneficence
3. Autonomy
4. Justice
82
What is non-maleficence?
Cause no harm. Donwside: harm could be unavoitable and uncotrolled
83
What is justice?
Justice is giving another their due/what they are owed.
84
What do you know about neutrophils?
They are a cell with a many shaped nuclei - respond by chemotaxis from chemokine release and use diapedesis to get to the site of tissue injury - release granules - have an antimicrobial effect.
85
What do you know about macrophages?
Macrophages are a form of a monocyte - used for phagocytosis and antigen presentsation - Use PRR receptors
86
What do you know about eosinophils?
They are a type of granulocyte - kill large parasites - contain large number of enzymes
87
What are mast cells?
They are cells that contain potent substances - cells that induce chemotaxis - one of the most important signaling cells in inflamation
88
What are dendritic cells?
They are cells that have similar function to macrophages and actually have similar origin - act as messengers and antigen presenters
89
What are natural killer cells?
They are a non-T and a non-B lymphocyte - they recognise infected or transformed cells through the MCT II recpetor - f a cell does not have an MHC receptor it must be killed
95
What are the steps of CD4+ cell activation process?
1. Foreign antigen phagocytes, killed & processed by the APC
2. ACP presents processed fragment
3. This is done via MHC II molecule (epitode) on the membrane surface of the APC
4. Epitode binds with TCR on naive CD4+ T lymphocyte
5. This causes activation of the naive CD4+ T lymphocyte and creates a T helper cell
6. T helper is able to bind with a B lymphocyte and cause it to transform into either B memory cell or plasma cell
97
What are the three goals of inflamation?
1. Isolate, detsroy or inactivate
2. Remove debris
3. Prepare for healing
98
What are the 4 cardinal signs of inflamation?
Redness, Swelling, Heat, Pain
99
What causes the redness in inflamation?
It is caused by increased blood flow tp the area - which increases the number of red blood cells - red blood cells are red because of albumin
100
What causes swelling in inflamation?
It is caused by increased leakage of protein rich fluid om the tissue are due to increased capillary permeability as a result of vasodialation.
101
What causes heat in inflamation?
Heat is caused by increased blood flow to the area - this increase in heat increases the metabolic rate of cells
103
How do vaccines work?
Vaccines are able to present the antigens in weakened form in order go through the acquired immunity response to create sophisticated Plasma Cells that can produce specifc antibodies for the antigen, in order to eliminate the antigen faster when it is presented in the system next time.
104
What are the 5 principles of NHMRC?
1. Patients are entitled to make own decisions abotu treatment and given adequate information
2. Information provided in form and manner which help patient understand
3. Doctors should give advice that patient is free to accept or reject with no coercion
4. Patients should be encouraged to make their own decisions
5. Patients should be frank and honest in giving info about health
105
What is the needle stick inury protocol in dental emergencies?
1. Stop
2. Place needle/sharp aside
3. Take off gloves
4. Wash hands with soap and water
5. Dry and cover with non-stick dressing
6. Apply pressure if bleeding
7. Let tutor know
8. Contact SADS registered nurse for risk assessment
9. Write up incident report - SLS
106
What to do if a patient faints?
1. DRSABCD - Danger, Response, Send for help, Airway, Breathing, CPR, Defibrillator
2. Lay victim flat
3. Raise legs
4. Place on side (if pregnants)
107
Why do we use antiseptic fluid and paper towels to wipe table and benches?
1. Antiseptic solutions reduce the bacterial and viral load BUT TO NOT FULLY REMOVE IT
2. Paper towels are available, cheap and easy to despose
108
What are the standard precautions?
1. Personal hygiene pracitce
2. Use of PPE
3. Appropriate handling of and safe disposal of sharps
4. Appropriate sterulisation of reusable equipment and instruments
109
What is origin and insertion of masseter muscles?
Origin: Zygomatic arch
Insertion: Mandible angle and mandible ramus
111
What is the origin and insertion of the temporalis muscles?
Origin: Temporal fossa
Insertion: Mandible coronoid process
112
What is the action of the masseter muscles?
Elevate the mandible
113
What is the origin and insertion of medial pterygoid muscles?
Origin: Maxillary tuberosity
Insertion: Medial surface of mandible angle
115
What is the origin and insertion of the lateral pterygoid muscles?
Origin: Infratemporl crest of greater wing of sphenoid bone
Insertion: Pterygoid fovea on Mandible condyle anterior neck
116
What is the action of the temporalis?
1. Elevate the mandible
2. Retrude mandible
118
What is the action of the medial pterygoid muscles?
1. Elevate the mandible
2. Retrude the mandible
120
What is the action of the lateral pterygoid muscle?
Depression of the mandible
121
What does informed consent include?
1. Alternatives and all options for treatment
2. Information surrouding the nature and what the treatment involves
3. Risks of treatment
4. Pros and Cons of treatment and No intervention
5. Cost of treatment
122
In general terms, what are the function of glucagon and insulin?
1. Glucagon – is a hormone secreted by pancreatic islets alpha cells that is able to induce glycogenolysis, gluconeogenesis and ketogenesis in order to increase blood glucose concentration or provide similar type molecule that can be used as source of fuel for cells. Secreted when blood glucose levels are low.
2. Insulin – is a hormone secreted by pancreatic islets beta cells that is able to induce glucose oxidation, glycogen synthesis, fat synthesis and protein synthesis. Secreted when blood glucose levels are high.
123
Describe the physiology of insulin on cellular level.
1. Insulin is released and it binds on the surface receptor of cells.
2. This triggers the transduction cascade
3. Glucose channels are synthetized and are transferred to cell surface through exocytosis
4. Glucose is able to enter the cell through the glucose channels
124
Which glucose transporter is regulated by insulin?
The GLUT-4
125
Describe the cascade that follows the starvation state?
1. Plasma glucose decreases
2. Insulin secretion by pancreatic cells is reduced
3. Glucagon secretion increases
4. Glycogenolysis and gluconeogenesis is induced
5. \* In case of prolonged hypoglycemia – ketones can be synthesized
126
What are 3 main thing insulin promoting?
1. Glycogen synthesis
2. Protein synthesis
3. Fat synthesis
127
Does fructose rely on insulin for uptake into liver and muscle cells?
NO – consumption of fructose is not dependent & does not illicit insulin secretion.
128
What does the mandibular movement exam include?
1. TMJ exam
2. Opening closing paths
3. Maximal Mandibular opening
4. Maximum mandibular lateral movement
129
What does the static occlusal relationship exam include?
1. Notation and morphology
2. Arch Shape
3. Crowding, spacing, rotations
4. Axial incilation
5. Occlusal curvatures and opposing contacts
6. Angle's molar classification + canin classification
7. Overjet (mm)
8. Overbite (%)
9. Crossbite
10. Mediolateral relationships
130
What are the two factors thatcombine to define the resistance of flow in a tube?
1. Radius and length o the tube
2. Fluid viscocity
131
How does antihistaine work?
Antihistamin can block H1 and H2 receptors on cells, thus histamine can not bind and alergic reacton is stopped
132
What is the role of elastin in the aorta?
Elastin allows for recoil.
As aorta expands and holds a large amount of blood post systole and is able to push the rest of the blod uring diastole
133
What are 3 other roles of respiratory system besides gas exchange?
1. Olfaction
2. Defence
3. Phonation
134
Compare endocrine capilaries and bone capillaries
1. Endocrine capillaries - fenestretated
2. Bone - continous
135
What is the role of thrombin and collagen in haemostasis?
Thrombin - involved with blood coagulation - used to convert fibrinogen into fibrin meshwork to trap cells
Collagen - involved in platelet aggregation - used by von Wellibrand factor to create sights for where platelets can attach and aggregate (become sticky)
136
How do the respiratory and skeletal muscle pumps assist with maintanance of BP?
1. Skeletal muscle pump - uses contraction of skeletal muscles to move the blood in veins agains gravity in the lower extremeties and towards the heart - helps with maintanace of venus return
2. Respiratory muscle pump - uses expansion of thoracic cavity to increase pre-load - as thoraci cavity expands the throracic pressure drops which iwhich decreases atrial pressure forcing more blood in venus return through suction
137
Describe the process of how filtrate is formed in the glomerulus?
Filtrae is the substances that travel from the fenestrated capillaries toward the glomerulus through the endothelial fenestration, basement membrane and the bowman capsule podocytes
138
What factors control the rate at which gas can diffuse across memebrane?
1. Cncentrations (or partial pressures)
2. Surface area
3. Thickness of the barrier
139
What is the fdifference between the immune function of the spleen and a lymphatic nodule?
Spleen is used to filter blood and fighting germs in the blood
Lymph nodules are used to concentrate antigen and immune cells
140
What is the mode of action of CPP-ACP
1. Casein phospho peptides can stanilise amorphouc calcium pjopshate as casei proteins can bind calcium and phosphate and release these mineralisations during acid attacks
2. Product can penetrate down the laminar pores of enamel and remin the depth of the lesion
3. Caclcium based products can also result in a release of calcium & phosphate which is required for remin
141
What is the mode of action of acidulate phosphate fluoride?
1. It contains a small amount of acid which triggers demin
2. The demineralised Ca2+ from the tooth can be used to form fluroapetite
3. Better for xerostomia as it uses calcium from the tooth
142
How is subsurface lesion formed?
1. Acids are able to benetrate the lamina pores of the enamel and damage the enamel rods
2. As acids progress down to the subsurface enamel, the mineralse travel upwards and reminerlise the surfae enamel
3. This cuases the trapping of water due to increased porocity of the enamel
4 result dull opaque calky appearance
143
What are the 5 stages of caries?
1. Demineralisation of surface enamel
2. Triangular demineralisation of enamel upto DEJ - appears triangular due to direction of enamel rods
3. Ballooning - path of least resistance along the DEJ - porosities increase in size and bacteria can enter
4. Dentine is infected
5. Cavity develops - due to loss of dentine thus decrease in ability to bear tensile load
144
What muscle elevate the mandible?
1. Masseter
2. Temporlis
3. Medial pterygoid
145
What muscle depresses the mandible?
1. Lateral pterygoid
2. Digastric
146
What muscles retracts the mandible?
Temporalis
147
What happens when lateral pterygoid muscle contract uniletrally?
The mandible moves to the other side
148
What is the sequence of event during inflamation?
1. Brief vasocontriction
2. Vasodialation - mediated by mast cells
3. Increased vasuclar permeability - to small proteins not cells (cause of edema is due to release of water due to colloid osmotic prssure)
4. Transmigration - chemotaxis and increased cell wall permeability allw=ows for extravasion and leukocyte migration
5. Phagocytosis
6. Healing
149
What is the post cough reflex steps?
1. Receptors in the osesophagus, stomach or other
2. afferent pathway
3. Cough center
4. Efferent
5. Expiratory muscle contraction as wel as smooth muscles of the trachea
150
What is hypomineralisation?
It is a disruption of enamel inorganic matrix laying
151
What is hypoplasia?
It is the disruption of amelogenin matrix (organic matrix)
152
What is the function of CCK?
1. Contraction of gall bladder
2. Secretion of digesive enzymes from the pancrease
153
What is the function of gastrin?
Increase parietal cell secretion
154
What is the function of secretin?
1. Secretion of bicarbonate solution by pacnrease
2. Release of bile from the liver
155
Why does your body produce more ketones during diabetes?
Because insulin loses it's ability to increase glucose rebasorbtion, the body will try and produce ketones for your brain
156
What happens during amino acid metabolism?
Nitrogen is removed and carbon skeleton can be used for production of glucose, ketone and lipids
157
What are the three types of mucosa in the oral cavity?
1. Masticatory mucosa
2. Lining mucosa
3. Specialised mucosa
158
What type of epithelium is the masticatory mucosa?
Parakeratinised stratified squamous epithelium
159
What are the areas of the lip?
1. Thin skin (thin layer)
2. Vermilion border
3. Labial mucosa and salivary glands
160
What is the epithelium on the dorsal surface of the tongue?
Non-keratinised stratified squamous epithelium
161
What epithelium is on the dorsal surface of the tongue?
Keratinised stratified squamous epithelium
162
What does the masticatory epithelium not have?
Submucousa
163
What are the 3 modes of exocrine secretion?
1. Merocrine - granules
2. Apocrine - apical portion of the cells
3. Holocrine - whole cell
164
What are the 3 major salivary glands?
1. Parotids
2. Submandibular
3. Sublingual
165
Is primary saliva isotonic or hypotonic?
It is isotonic
166
Is secondary saliva isotonic or hypotonic?
It is hypotonic
167
What type of saliva is the stimulated saliva?
It is hypertonic
168
By which method of bone growth does the mandible grow?
Intramembranous ossification primarily
169
What are the two types of bone present in the mandible?
1. Trabecular bone
2. Compact bone
170
What are the 3 types of CT?
1. Loose CT
2. Dense irregular
3. Dense regular
171
What does PICO stand for?
Patient
Intervention
Comparison
Outcome
172
What are the three functions of commensal bacteria?
1. Release amonia which makes the oral environment more alkaline
2. Immune response
3. Break down of molecules
4. Protection from pathogenic bacteria
