Oral Anatomy & Histology (Review: Outcome 13) Flashcards
(39 cards)
1
Q
Oral pathology
A
The study of diseases in the oral cavity
- Many systemic diseases as well as infectious diseases have oral signs/symptoms
- Only a dentist or physician may diagnose pathological (disease) conditions
2
Q
The Making of a Diagnosis
A
- Historical
- Clinical
- Radiographic
- Microscopic
- Laboratory
- Therapeutic
- Surgical
- Differential
3
Q
Oral Lesions
A
Lesions is a broad term for abnormal tissues in the oral cavity
- can be a wound, a sore, or any other tissue damage caused by injury or disease
- Classified as to whether they are:
i. extend below or extend above the mucosal surface
ii. lie flat or even with the mucosal surface
4
Q
Lesions extending below mucosal surface
A
1) Ulcer
- a defect or break in continuity of the mucosa that results in a punched-out area similar to a crater
2) Erosion of the soft tissue
- a shallow defect in the mucosa caused by mechanical trauma
3) Abcess
- a localized collection of pus in a circumscribed area
4) Cyst
- a closed sac or pouch that is lined with epithelium and contains fluid or semisolid material
5
Q
Lesions extending above mucosal surface
A
1) Blisters
- also known as vesicles; filled with a watery fluid
- Bulla (blister greater than an inch)
2) Pustule
- similar in appearance to a blister but containing pus
3) Hematoma
- Also similar to a blister but containing blood
4) Plaque
- any patch or flat area that is slightly raised from the surface
6
Q
Lesions even with mucosal surface
A
Lie flat or even with the surface of the oral mucosa and are well-defined areas of discoloration
1) Purpura
- red or purple spots that occur on the skin or mucosa caused by localized bleeding
- pinpoint size called petechiae
2) Ecchymosis
- medical term for bruising
3) Macule
- flat pigmented spot on the skin, lips or inside mucosa (mole/freckle)
4) Patch
- an area on the skin that is a different colour
7
Q
Raised or flat lesions
A
- Nodules, which may appear below the surface or may be slightly elevated, are small, round, solid lesions
(when palpated, a nodule feels like a pea beneath the surface) - Granuloma = often used to describe a nodule that contains granulation tissue
- Tumors, also known as neoplasms (benign or malignant)
8
Q
Causes and Mechanisms
A
- Intrinsic (Nature)
- Extrinsic (Nurture)
9
Q
Acute and Chronic Inflammation
A
Inflammation = body’s protective response to irritation or injury
- Acute inflammation occurs if injury to tissue is minimal and short-lasting and the tissue begins to repair quickly
- Chronic inflammation occurs when injury or irritation to tissue continues
10
Q
Common symptoms of inflammation
A
- Redness (erythema)
- Heat
- Pain
- Swelling
11
Q
Cellulitis
A
- Inflammation spreads through the soft tissue or organ
- Swelling develops rapidly, accompanied by a high fever
- Skin becomes very red, severe throbbing pain as the inflammation localizes
- Cellulitis associated with oral infections is potentially dangerous because it can travel quickly to sensitive tissues such as the eye or brain
11
Q
Cellulitis
A
- Inflammation spreads through the soft tissue or organ
- Swelling develops rapidly, accompanied by a high fever
- Skin becomes very red, severe throbbing pain as the inflammation localizes
- Cellulitis associated with oral infections is potentially dangerous because it can travel quickly to sensitive tissues such as the eye or brain
12
Q
Leukoplakia
A
- Means white patch
- Lesions vary in appearance and texture from a fine white transparency to a heavy, thick, warty plaque
- Cause is unknown, but is commonly linked to chronic irritation or trauma
- Very often precedes the development of a malignant tumor
13
Q
Sialolith
A
- Salivary stones of calcium deposits
- May cause obstruction of involved gland
- Extra oral swellings
- Painful (antibiotics/surgery)
14
Q
Mucocele
A
- Blocked/broken minor salivary duct
- Swelling of lower lip
- Kids, biting lips
- Surgery or regress on own
15
Q
Amalgam Tattoo
A
- Amalgam particles become trapped in the tissue
- Gingival tissue in the area appears blue-gray (looks like a tattoo)
16
Q
Ranula
A
- Usually caused by a sialolith or local trauma to the duct
- Saliva escapes into the connective tissue of the floor of the mouth
17
Q
Tonsil tissue
A
- Lymphoid tissue
- Enlarge in infections
- Mistaken for tumors
18
Q
Linea Alba
A
- Raised, wavy line
- Level of collusion on buccal mucosa
- Hyperkeratotic
- Cheek biting
19
Q
Aspirin Burn
A
- Aspirin is placed in the area of a toothache
- Acid in the aspirin causes a tissue burn
- Necrotic white tissue that may slough off resulting in a large painful ulceration
- Should heal within 7-14 days after aspiring use is discontinued
20
Q
Glossitis
A
- General term used to describe inflammation and changes in the topography of the tongue
- There is atrophy of the papilla to creating a smooth erythematous tongue
- Causes:
i. allergic reactions
ii. irritations from foods
iii. nutritional deficiencies
21
Q
Black Hairy Tongue
A
- The filiform papillae are so greatly elongated that they resemble hairs
- These elongated papillae become stained by food tobacco and chromogenic bacteria, hence the name
- May be caused by an imbalance of oral flora after the administration of antibiotics or the use of mouthrinses
22
Q
Fissured Tongue
A
- A variant of normal; its cause is unknown
- Theories about its cause include vitamin deficiency and chronic trauma over a long period
- Dorsal surface (top) of the tongue is marked by having deep fissures or grooves, which become irritated if food debris collects in them
- Patient with a fissured tongue is advised to brush the tongue gently with a soft toothbrush to keep the fissures clean of debris and irritants
23
Q
Bifid Tongue
A
- Rare
- Partial fusion of the tongue during development
- No treatment required
24
Ankyloglossia
- Tongue tie
- Lingual frenum is attached near the tip of the tongue
- Short lingual frenum can also attached the top of the tongue to the floor of the mouth
- Limits movement of tongue (speech disruption)
- Treatment: frenectomy (surgical removal of part of the lingual frenum)
25
Clinical Considerations of numerous diseases that manifest themselves by causing alterations in the oral tissues
- Oral mucosa is a good indicator of health or disease
- Many disease or conditions manifest in some way on oral tissue
- Dental team plays an important role in early detection of these diseases
26
DA's role in clinical consideration
- Describe what you see
- Identify possibilities
- Understand causes
- Consider clinical implications: patient comfort, IPC, treatment options
27
Pernicious Anemia
- A condition in which the body does not absorb vitamin B12
- People with this condition show signs of anemia, weakness, pallor, and fatigue on exertion
- Other signs: nausea, diarrhea, abdominal pain and loss of appetite
- Oral manifestations: angular cheilitis (ulceration and redness at the corners of the lips), mucosal ulceration, loss of papillae on the tongue, and painful burning sensation of tongue
28
HIV and AIDS
- Oral lesions are prominent features
- Oral lesion develop because of the breakdown of immune system that occurs when T-helper cells become depleted as a result of the disease
29
AIDS
- Because the patient's immune system is severely damaged, death is usually caused by an opportunistic infection
- Opportunistic infection: one that normally would be controlled by the immune system but cannot be controlled because the immune system is not functioning properly
- Some lesions that look like HIV and AIDS related infection may also be caused by other disorders
30
HIV Gingivitis
- Often a bright red line along the border of the free gingival margin
- Also known as atypical gingivitis (ATYP)
- Some cases, may be progression of the bright red line from the free gingival margin over the attached gingival and alveolar mucosa
31
HIV Periodontitis
- Resembles acute necrotizing ulcerative gingivitis superimposed on rapidly progressive periodontitis
- Other symptoms include:
- interproximal necrosis and cratering
- marked swelling
- intense erythema over the free and attached gingiva
- intense pain
- spontaneous bleeding and bad breath
32
Candidiasis
- Often the initial oral sign of progression from HIV-positive status to AIDS
- Patient with compromised immune system, candidiasis can be very debilitating and serious disorder
33
Cervical Lymphadenopathy
- Enlargement of the cervical (neck) nodes
- Frequently seen in association with AIDS
34
Lymphoma
- General term used to describe malignant disorders of the lymphoid tissue
- In immunocompromised individual, may occur as a solitary lump or nodule, a swelling, or non-healing ulcer that occurs anywhere in the oral cavity
- Swelling may be ulcerated or may be covered with intact, normal-appearing mucosa
- usually painful, lesion grows rapidly and may be first evidence of lymphoma
35
Hairy Leukoplakia
- Can be important early manifestation of AIDS status
- Filamentous white plaque usually found unilaterally or bilaterally on the lateral borders (sides) on the anterior portion of the tongue
- may spread to cover the entire dorsal surface of the tongue
- Can also appear on the buccal mucosa, where it generally has a flat appearance
36
Kaposi Sarcoma
- One of the opportunistic infections that occurs in patients with HIV infection
- Lesions may appear as multiple bluish, blackish, or reddish blotches that are usually flat in the early stages
- One of the intraoral lesions that is used to diagnose AIDS
37
Herpes Simplex
- Lesions usually occur on the lip
- In immunocompromised patients, lesions may occur throughout the mouth
- An ulcer caused by the herpes virus that persists for longer than 1 month may be an indicator of AIDS
- Patients who do not have HIV or AIDS may also suffer from herpes
38
Human Papillomavirus
- Appears most commonly in immunocompromised individuals
- Diagnosis is made on the basis of history, clinical appearance, and biopsy findings
- Lesions are a common finding in patients with early HIV infection
- These warts appear spiky and some have a raised cauliflower-like appearance
