Describe the layers of microscopic organization of the epithelial layer: 1. Stratum corneum 2. Stratum granulosum 3. Stratum spinous 4. Stratum basal (stratum germinativum)

1. Keratin layer 2. Granular cell layer 3. Spinous layer 4. Basal cell layer

Oral Mucous Membranes (Exam III) Flashcards by Annabella Moody

The main functions of mucous membranes:

Absorption
Excretion
Protection

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What are the classifications of oral mucous membranes?

Masticatory mucosa (nonkeratinized)
Lining mucosa (nonkeratinized)
Specialized mucosa (contains taste buds)

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Masticatory mucosa is _____ mucosa

Keratinized

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Where would you find masticatory mucosa?

Gingiva & Hard palate

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Lining mucosa is _____ mucosa

Nonkeratinized

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Where would you find lining mucosa?

Alveolar mucosa
Buccal mucosa
Floor of mouth
Ventral surface of tongue
Soft palate

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Specialized mucosa contains:

Taste buds

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Where would you find specialized mucosa?

Dorsal surface of tongue

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Classify the mucous membranes present in the image:

What does the blue line represent?

Masticatory mucosa
Lining mucosa

Blue line= mucogingival junction

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Classify the mucous membrane present in this image:

Specialized mucosa

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List the microscopic organization of oral mucous membranes:

Epithelium
Lamina propria
Submucosa
Periosteum

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A periosteum with a mucosal surface, i.e., close approximation of mucous membrane (epithelium and lamina propria) with the periosteum of bone to form an apparent single layer

Mucoperiosteum

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Which component of the microscopic organization of oral mucosa membranes may or may not be present:

Submucosa

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List the tissues layers (top to bottom)

Blue: Epithelium
Green: Lamina propria
Orange: Periosteum
White: Bone

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List the tissue layers (top to bottom)

Green: Lamina propria
Orange: Periosteum
White: Bone

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What is this image displaying?

Submucosa of the palate

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Name the following zones of submucosa of the palate:

A) Gingival zone
B) Fatty Zone
C) Glandular zone

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List the microscopic organization of the epithelial layer:

Stratum corneum
Stratum granulosum
Stratum spinosum
Stratum basale (Stratum germinativum)

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Describe the layers of microscopic organization of the epithelial layer:

Stratum corneum
Stratum granulosum
Stratum spinous
Stratum basal (stratum germinativum)

Keratin layer
Granular cell layer
Spinous layer
Basal cell layer

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List what the arrows are pointing to in the image of microscopic organization of the epithelial layer:

What is this collectively referred to as:

Green: keratin layer
Blue: granular cell layer
White: spinous cell layer
Yellow: basal cell layer

Collectively= cell strata

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List what the arrows are pointing to in the image of microscopic organization of the epithelial layer:

Green: Connective tissue papilla
Yellow: Epithelial rete pegs

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What is the function of both the epithelial retention pegs and connective tissue papilla in oral mucous membranes?

Both aid in attachment

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What layer of the oral mucous are the epithelial retention pegs and connective tissue papilla located in?

Epithelial layer

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The epithelial layer of the oral mucous membrane are organized into:

Cell strata

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The epithelium of the oral mucous membrane rests on a ______

Basement membrane

The epithelium of the oral mucous membrane exhibits one or more specialized ____________

Intercellular attachements

What are two examples of the specialized intercellular attachments present in the epithelium of the oral mucous membrane?

Desmosomes Tonofilaments

Describe the vascularity of the epithelial layer of the oral mucous membrane:

Avascular

Because the epithelial layer of oral mucous membrane is avascular, it gets all of its nutrients from the:

Dermis

The epithelium of the oral mucous membrane exhibits a high degree of ______ & a relatively low volume of ______

Cellularity ECM

The epithelium of the oral mucous membranes may exhibit:

Cell polarity

List the types borders the epithelial cells of the oral mucous membranes may exhibit:

Can exhibit apical, basal & lateral borders

In regards to the epithelium of oral mucous membranes- Polarity is expressed in the:

Distribution of cytoplasmic organelles

Which layer of the oral mucous membrane do the following terms describe? - Orthokeratosis - Parakeratosis - Hyperkeratosis - Dyskeratosis a

Stratum Corneum

Refers to normal keratin formation with clinically normal presentation within the stratum corneum

Orthokeratosis

Retention of pyknotic nuclei in the stratum corneum:

Parakeratosis

Abnormal thickening of the stratum corneum; may exhibit aberrant patterns of keratinization:

Hyperkeratosis

Abormal keratinization below the level of the stratum corneum, i.e, keratinization within the stratum granulosium and/or stratum spinosum

Dyskeratosis

Refers to hyperplasia of the epithelial layer (i.e., increase in the number of cells)

Acanthosis

Loss of intercellular attachments between epithelial cells (keratinocytes)

Acantholysis

A reversible change in which one adult cell type is replaced by another

Metaplasia

Transition of columnar squamous epithelium in the respiratory tract as a response to smoking is an example of:

Metaplasia

Refers to the disorderly but non-neoplastic growth of tissue including the epithelial layer; characterized by pleomorphism, hyperchomatism, & loss of normal spatial orientation:

Dysplasia

Key word for metaplasia: Key word for dysplasia:

Reversible Non-neoplastic

How might the following masticatory mucosa be described as?

Gingival orthokeratosis

What condition is seen in this image of masticatory mucosa?

Gingival parakeratosis

What condition is seen in this image of masticatory mucosa?

Gingiva hyperkeratosis

What conditions are seen in this image of buccal lining mucosa

Ancathosis & Parakeratosis

Describe what is seen in the following image of the buccal lining mucosa:

Hyperkeratosis & parakeratosis

What disease state is represented by the following images?

Gingival dyskeratosis of the masticatory mucosa (squamous cell carcinoma)

Describe what is seen in the following image:

Gingival dyskeratosis of the masticatory mucosa (squamous cell carcinoma)

List the nonkeratinocytes in the oral epithelium of the oral mucous membranes:

1. Melanocytes 2. Langerhans cell 3. Merkel's cell 4. Lymphocytes

Describe the morphology of a melanocyte:

Dendritic morphology (long processes)

Where is a melanocyte located within the oral epithelium?

Basal cell layer

What is the function of a melanocyte?

Synthesis of melanin pigment granules (melanosomes)

Melanin pigment granule

Melanosomes

What is represented by the following images?

Melanocytes

Describe what cells are seen in the following image:

Langerhans cells

Describe the type of cells seen in the following image

Lymphocytes

What type of cells are seen in the following image

Merkel’s cells

Describe the morphology of a langerhan’s cell

Dendritic morphology

Where are langerhan’s cells located within the oral epithelium?

Stratum spinosum

What does the characteristic langerhan’s granule look like?

Tennis racquet

Langerhan cells function as a _______ in the epithelium and transfers _____ information to ______

Antigen trap Antigen information CD4 Lymphocytes

Describe the morphology of a Merkel’s Cell:

Rounded in morphology

Where are Merkel’s cells located within the oral epithelium?

Basal cell layer

Merkel’s cells contain characteristic ______ granules

Dense core

What is the possible function of Merkel’s cells?

Tactile sensory functions

Describe the morphology of a lymphocyte in the oral epithelium:

Rounded morphology

Where are lymphocytes located within the oral epithelium?

Found in basal & spinous cell layers

What are lymphocytes within the oral epithelium associated with? (3)

1. Immune surveillance 2. Antigen message processing 3. Inflammation (both cellular response & humoral)

What does the yellow arrow point to?

The basement membrane

What two layers is the basement membrane comprised of?

Basal lamina + Lamina reticularis

The basal lamina portion of the basement membrane can be further broken down into:

Lamina Lucida + Lamina Densa

What is represented by A, B & C?

A) Lucida B) Densa C) Reticularis

What is represented by the arrows A, B & C?

A) Lucida B) Densa C) Reticularis

The Lamina Lucida is part of the ________

Basal lamina

What are two main components the lamina Lucida is comprised of?

1. Bullous pemphigoid antigen 2. Type VII Collagen

What is the function of the type VII collagen in the Lamina Lucida component of the basal lamina?

Anchoring fibrils

The Lamina Densa is a component of the ________

Basal lamina

What are two key components of the lamina densa portion of the basal lamina?

1. Type IV collagen 2. Type VII collagen

What is the function of the type VII collagen within the Lamina Densa portion of the basal lamina?

Anchoring fibrils

The Lamina Reticularis is a part of the _____

Basal lamina

What four components make up the lamina reticularis portion of the basal lamina?

1. Reticulin 2. Type I collagen 3. Type III collagen 4. Elastin connective tissue

What are the two connective tissue components of the lamina reticularis?

Reticulin Elastin

What are the three layers of the basal lamina?

1. Lamina Lucida 2. Lamina Densa 3. Lamina Reticularis

What are the intermediate filaments in the cytoplasm of the cell?

Tonofilaments

Tonofilaments are made of what types of keratin?

5 &14

The intermediate filaments (Tonofilaments) of the cytoplasm of the cell include (4):

1. Actin 2. Myosin 3. Talin 4. Vinculin

The hemidesmosome components of the cell include:

1. Bullous Pemphigoid antigen 1&2 (BPAG1 & BPAG2) 2. Cadherins

What connects the cytoplasm of the cell & all of its intermediate filaments to the lamina Lucida?

Hemidesmosomes

Types of collagen found in each of the layers of the basal lamina: Lucida: Densa: Reticularis:

Lucida= Type VII Densa= Type IV & VII Reticularis= Type I & III

The following components belong to which layer of the basal lamina- - BPAG1 & BPAG2 - Basement membrane glycoprotein (BMG-1) - Classical laminin (Laminin-1) - Kalinin & K-laminin (Laminin-5 & 6) - Entactin - Type VII collagen - Epiligrin

Lamina lucida

The following components belong to which layer of the basal lamina- - Classical laminin (Laminin-1) - Type IV Collagen - Type VII Collagen - Basement membrane glycoprotein (BMG-1) - Fibronectin - Integrins

Lamina Densa

The following components belong to which layer of the basal lamina- - Type I collagen - Type III collagen - Reticulin - Elastin

Lamina reticularis of the lamina propria

What are the five specialized cell attachments present in oral mucous membranes?

1. Desmosomes 2. Hemidesmosomes 3. Intermediate junctions 4. Tight junctions 5. Gap junctions

Desmosomes in the oral mucous membranes are also called:

Macula adherens

Intermediate junctions of the oral mucous membranes are also referred to as:

Zonula adherens

The tight junctions of the oral mucous membranes are also called:

Zonula or macula adherens

What are the gap junctions of the oral mucous membranes called?

Communication junction

What type of specialized cell attachment is present in the image below:

Desmosomes

What are the two main protein components of desmosomes?

1. E-cadherin (Desmoglein) 2. P-cadherin (Desmocolin)

What occurs to the specialized cellular attachments in the oral mucous membranes in the presence of inflammation?

Loss of cellular attachments

What is occurring in each of the images of the specialized cell attachments below?

Left: Normal RIght: Inflammation

FIbroblasts Monocytes Basophils Plasma Cells Endothelial Cells Neutrophils Lymphocytes These cells belong to the:

Lamina Propria

List the permanent/resident cell populations of the lamina propria:

Fibroblast Monocyte Basophil Plasma cell Endothelial cell

Describe the path of development the monocytes of the lamina propria take:

Monocyte —> Histiocyte —> Macrophage

What do the basophils of the lamina propria develop into?

Mast cells

List the transient cell populations of the lamina propria:

Neutrophils & lymphocytes

Secretes collagen & elastin within the lamina propria:

FIbroblast

Resident precursor of functional macrophage within the lamina propria:

Histiocyte

Blood-borne precursor of functional macrophage within the lamina propria:

Monocyte

Phagocytic cell capable of antigen processing within the lamina propria:

Macrophage

Secretes inflammatory mediators, e.g., histamine & heparin within the lamina propria:

Mast cell

Synthesis of immunoglobulins (antibodies) within the lamina propria:

Plasma cell

Phagocytic cell capable of neutralizing antigens & killing bacteria within the lamina propria:

Neutrophil

Functions in the humoral & cell-mediated immune response & located within the lamina propria:

Lymphocyte

Functions to line the blood & lymphatic vessels within the lamina propria:

Endothelial cell

What are two inflammatory mediators that may be secreted by mast cells:

Histamine & Heparin

What is the yellow arrow indicated in the following image?

Free gingival groove

What is represented by the arrows in the following image?

Blue= sulcular epithelium Maroon= junctional epithelium

What diseased state can be observed in the following images?

Inflammatory periodontal disease

What can be observed in the following images?

Gingival pigmentation

What can be observed in the following images?

Gingival pigmentation

What do each of the arrows represent in the following image?

Green- gingival papillae (keratinized) Blue- attached gingiva (attached & keratinized) Yellow- Mucogingival junction Orange- alveolar mucosa

What is represented in the following images?

Lip

- Papillae that are “hair-like” - Most numerous - Highly keratinized - Found over the dorsal surface of the tongue

Filiform papillae

- “fungus-like” papillae - small, round, red surface projections - may contain tastebuds - Commonly found on the tip of the tongue

Fungiform papillae

Where are Filiform papillae commonly found?

Over the entire dorsal surface of the tongue

Where are Fungiform papillae commonly found?

Commonly found at the tip of the tongue

- "leaf-like" papillae - May contain tastebuds - Contain lymphoid nodules with germinal centers - Forms part of Waldeyer's ring - located on the posterior lateral margins of the tongue

Folliate papillae

Foliate papillae contains:

Lymphoid nodules with germinal centers

Foliate papillae forms part of:

Waldeyer's ring

Where are foliate papillae commonly found?

Posterior lateral margins the tongue

- "Walled" papillae - Generally 6-8 in number - lightly keratinized - located just anterior to the sulcus terminalis on the posterior dorsal tongue surface

Circumvallate papillae

How many circumvallate papillae are typically found

6-8

Are cirumvallate papillae keratinized?

Lightly

Location of circumvallate papillae:

Anterior to sulcus terminalis on posterior dorsal tongue surface

The papillae sulcus is cleared of taste stimuli by:

Serous salivary glands of von Ebner

The different papillae response to all types of taste stimuli but display bias in:

Their sensitivity

_____ tend to be more sensitive to bitter compounds

Circumvallate

_____ respond best to salt & sweet stimuli

Fungiform papillae

____ shows a bias for sweet

Foliate papillae

Taste cells are specialized:

Epithelial cells

Give an example of a taste cell:

Neuroepithelial cells

Nerve supply for taste: 1. anterior 2/3 of tongue 2. posterior 1/3 of tongue 3. Soft palate 4. Walls of pharynx & epiglottis

1. facial nerve (CN7) via chordae tympani branch 2. glossopharyngeal (CN9) 3. facial nerve (CN7) via greater petrosal branch 4. Vagus nerve (CN10)

Taste fibers from all three nerves (facial, glossopharyngeal & vagus) all converge in the:

Tractus solitarius of the brain stem

Unknown etiology, but T-lymphocyte infiltrates with Langerhans cell hyperplasia are characteristic of:

Lichen planus

Cell-mediated immune injury to basal cells is a consequence of:

Lichen planus

Thickening of the stratum corneum, often with aberrant keratinization:

Hyperkeratosis

A white plaque of the oral mucous membranes that CANNOT be removed by scraping and CANNOT be classified histologically as another disease entitiy

Leukoplakia

Until proven otherwise, leukoplakia should be considered:

Pre-cancerous

Oral cancer that account for about 3% of all cancers

Squamous cell carcinoma (SCCA)

The highest incidence of SCCA is in:

middle aged African American males

The overall male-to-female gender ratio of occurrence is:

3:1

The most common site for SCCA is the:

Posterior lateral border of the tongue

What are two common sites for SCCA not including the posterior lateral border of the tongue:

1. Ventral tongue surface 2. Floor of mouth

Tobacco, alcohol, phenol exposure, oncogenic viruses (HPV), Immunosuppression (AIDS), Oncogenes & tumor suppressor genes all have a strong relationship with:

SCCA

In SCCA the lesion arises from ____ & features alterations in size, shape & organization of the cellular components, including nuclear polymorphism

Dysplastic surface epithelium

SCCA lesions exhibit _____ and cords of malignant squamous epithelial cells:

Invasive islands

In SCCA there is often a strong _____ or ____ response to the invading epithelium and focal areas of ____ may be present

Inflammatory or immune cell response; necrosis

In SCCA, abnormal production of ____ in the form of _____ is a frequent finding

Keratin; keratin pearls

Round focus of concentrically layered keratinized cells

Keratin pearls

Other names for mucosal pemphigoid include: (3)

1. Benign mucous membrane pemphigoid 2. BMMP 3. Cicatricial pemphigoid

Mucosal pemphigoid is classified as a ____ disease

Autoimmune

What is the antigen found in mucosal pemphigoid? Where is it found?

Adhesin protein epiligrin found in the lamina Lucida

Characterized by the linear accumulations of IgG and C3 along the basement membrane:

Mucosal pemphigoid

Mucosal pemphigoid is characterized by linear accumulations of ____ & ___ along the ____

IgG & C3; Basement membrane

Mucosal pemphigoid tends to affect what age range and what is the ratio of affected females to males:

older adults 50-60 range 2:1 (female to male)

BMMP involvement of the ____ of the eye results in scarring (symblepharon)

Conjunctiva

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

Ectodermal dysplasia

Peripheral ossifying fibroma is considered to be _____ rather than ____ in nature:

Reactive; neoplastic

In peripheral ossifying fibroma, the lesion is thought to represent the maturation of:

Pyogenic granuloma

Peripheral ossifying fibroma occurs exclusively on the:

Gingiva

Peripheral ossifying fibroma is predominantly a lesion of ____ & ____ with peak prevalence between the ages of:

teenagers & young adults 10-19 years

60-65% cases of Peripheral ossifying fibroma occur in:

Females

Peripheral ossifying fibroma histologically reveals a gingival mass with islands of _____ derived from ____

calcified material periosteum

What is the recommended treatment of Peripheral ossifying fibroma?

Surgical excision

Peripheral ossifying fibroma lesions are likely to reoccur if:

Excision is not extensive and complete

Oral Mucous Membranes (Exam III) Flashcards

(179 cards)