Test 1 Flashcards
1
Q
What is pathology?
A
Study of tissues under abnormal conditions, the nature of a disease and its causes, development and consequences.
2
Q
Pathology addresses what 4 components of disease?
A
Cause/etiology
Mechanisms of development
Structural alterations of cells
Consequences of changes
3
Q
What is a site of structural and functional change in body tissues that is produced by disease or injury?
A
Lesion
4
Q
What is a manisfestation?
A
A symptom or sign of an ailment/disease
5
Q
What is the study of the development of disease?
A
Pathogenesis
6
Q
What is the study of changes of normal mechanical, physiological, and biomechanical functions, either caused by a disease or resulting from an abnormal sundrome?
A
Pathopysiology
7
Q
What is oral pathology?
A
Specificly abnormalaities in the oral cavity
8
Q
What is a traumatic ulcer?
A
Trauma to an area
9
Q
What is a butterfly rash of the bridge of the nose?
A
Lupus (autoimmune disease)
10
Q
Why must DH study oral pathology?
A
Legal
Professional
Ethical
11
Q
What is the role of the dental hygienist in regards to oral pathology?
A
Identifying
Interpreting
Reporting
12
Q
Accurate descriptions of oral pathology abnormalities must include:
A
Location
Distribution
Physical characteristics
13
Q
What is the most important part of the oral pathology abnormality description?
A
Location
14
Q
How should the location of an abnormality be recorded?
A
Precise anatomical location related to a head/neck and oral landmarks
15
Q
What is distribution in relation to an abnormality description?
A
Number of present (single vs multiple, generalized or localized, unilateral or bilateral)
16
Q
What must be included in the physical characteristics of an oral pathology abnormality?
A
Category/classification
Size
Colour
Surface texture
Consistency
Attachment to the surface
17
Q
What category/classification is a solid, raised lesion that is less than 5mm in diameter? (Solid raised bump)
A
Papule
18
Q
What is category/classification is a solid, raised lesion that is greater than 5mm in diameter (solid elevated, circumscribed lesion greater than 5mm)
A
Nodule
19
Q
Category/classification: What is a deep and solid elevation 1-2cm wide or greater?
A
Tumor
20
Q
Category/classification: What is a lesion that is slightly elevated, a flat raised area greater than 1cm in diameter?
A
Plaque
21
Q
Category/classification: What is a blister filled with purulent exudate, circumscribed blister filled with a collection of pus ranging from 0.1 to 2cm?
A
Pustule
22
Q
Category/classification: What is a superficial blister, 5mm or less in diameter, usually filled with clear fluid?
A
Vesicle
23
Q
Category/classification: What is a large fluid filled blister over 5mm?
A
Bulla/Bullae
24
Q
Category/classification: What is a closed sac lined by the epithelium located in the dermis, subcutaneous tissue, or bone?
A
Cyst
25
Category/classification: What is a serum filled papule or plaque?
Wheal (hives)
26
Category/classification: What is a lesion characterized by the surface epithelium and frequently some of the underlying connective tissue? Often appears depressed or excavated.
Ulcer
27
Category/classification: What is a superficial lesion, often raisin secondary to rupture of a vesicle or bulla, that is characterized by partial or total loss of the surface epithelium?
Erosion
28
Category/classification: What is a shallow linear crack in the epidermis often associated with hypersalivation, xerostomia, and dehydration?
Fissure
29
Category/classification: What is the thinning of tissue layers, decrease in size of cells/loss of tissue?
Atrophy
30
Category/classification: What is a permanent mark from wound healing?
Scar
31
Category/classification: What is a flat, circumscribed, discoloured area 5mm to 1cm?
Macule
32
Category/classification: What is a larger flat, discoloured area?
Patch
33
Category/classification: What is dried blood area approximate to the edge of the area?
Crust/scab
34
Category/classification: What are red spots, pinpoint to area of hemorrhage, broken blood vessels?
Petechiae
35
Category/classification: What is a non elevated area of hemorrhage, larger than a petechia?
Ecchymosis
36
Surface texture: What is a central depression?
Crater
37
Surface texture: What is a hard covering, composed of dried serum, pus, blood, or combination?
Crust
38
Surface texture: What is hardness of tissue from increased number of surrounding epithelial cells?
Induration
39
Surface texture: Having rough surface containing small nodulations or elevated projections?
Papillary
40
Surface texture: What is loose membranous surface layer of exudate containing microorganisms formed during inflammatory reaction?
Pseudomembrane
41
Surface texture: What is a deep lesion that pushes up and stretches surface tissue?
Smooth
42
Surface texture: What is having rough, wart like surface with multiple irregular folds?
Verrucous
43
Lesion consistency: What is adipose tissue, loose connective tissue, or glandular tissue that is composed mainly of cells without much intervening fibrous connective tissue?
Soft
44
Lesion consistency: What is harder than the adjacent softer oral mucosa or skin, indicating presence of increased fibrous connective tissue comparable to cartilage?
Firm
45
Lesion consistency: What contains bone or other calcified material?
Hard
46
What type of tissue attachment is this?
Sessile
47
What type of tissue attachment is this?
Pedunculated
48
What category/classification is this?
Papule
49
What category/classification is this?
Nodule
50
What category/classification is this?
Tumor
51
What category/classification is this?
Plaque
52
What category/classification is this?
Pustule
53
What category/classification is this?
Vesicle
54
What category/classification is this?
Bulla/Bullae
55
What category/classification is this?
Cyst
56
What category/classification is this?
Wheal (hives)
57
What category/classification is this?
Ulcer
58
What category/classification is this?
Erosion
59
What category/classification is this?
Erosion
60
What category/classification is this?
Fissure
61
What category/classification is this?
Atrophy
62
What category/classification is this?
Atrophy
63
What category/classification is this?
Scar
64
What category/classification is this?
Macule
65
What category/classification is this?
Patch
66
What category/classification is this?
Crust/scab
67
What category/classification is this?
Petechiae
68
What category/classification is this?
Ecchymosis
69
What is the surface texture?
Smooth
70
What is the surface texture?
Papillary
71
What is the surface texture?
Fissured
72
What is the surface texture?
Verrucous
73
What is the surface texture?
Cratered
74
What is the surface texture?
Pseudomembranous
75
What is the surface texture?
Indurated
76
Describe the lesion
Coricated and uni-locular
77
Describe the lesion
Multi-locular
78
Describe the lesion
Focal opacity
79
Describe the lesion
Ground glass
80
What is tissue reflectance for?
To locate abnormal cells
81
How does tissue reflectance work?
Light provides a blue white illumination and abnormal cells reflect the light appearing bright white after a client has rinsed with flavoured acetic acid
82
What’s an example of a tissue reflectance system?
Micorlux
83
What is autofluorescence for?
To detect abnormal cells
84
How does autofluoresence work?
Hand held unit emits a cone of blue light under which healthy tissues appear pale green and abnormal lesions appear dark green/black
85
What is an example of an autofluorescence system?
VELScope
86
What is toluidine blue stain for?
To detect abnormal tissue
87
How does toluidine blue stain work?
Topical application to suspected site will allow the blue dye to define the margins needed for biopsy
88
What is the drawback of toluidine blue stain?
Inflammatory cells will also pick up stain
89
What is the dental hygienist’s role in oral cancer screening?
Interpreting the findings - creating a list of possible manifestation or lesions or diseases that fit the data/information
90
What does MIND stand for?
Metabolic
Inflammatory
Neoplasm
Developmental
91
What subcategories are under metabolic?
Compromised organ system
Hormonal
Nutritional
92
What subcategories are under inflammatory?
Trauma
Reactive
Infection
Immunologic
93
What subcategories are under neoplasms?
Benign
Premalignant
Malignant
94
What subcategories are under developmental?
Genetic
Acquired
95
What are the 12 questions for the client with oral lesions?
1. How long?
2. Has it happened before?
3. Anywhere else in the mouth?
4. Painful?
5. Getting worse?
6. Treatments you’ve tried?
7. Constant or changing?
8. Injury?
9. Anywhere else outside the mouth?
10. Anyone else in your family have it?
11. How’s your general health?
12. Taking any meds?
96
What is derived from clinical appearance and palpation of the lesion?
Diagnosis
97
Radiographs provide sufficient information to establish the
Diagnosis
98
How can laboratory diagnosis be accomplished?
With lab tests including blood chemistries and urinalysis.
99
What is surgical diagnosis?
Surgical intervention providing conclusive evidence of the diagnosis when the lesion is opened.
100
What is therapeutic diagnosis?
Prescribing therapeutic drugs and observing the results based on clinical and historical information.
101
What is microscopic diagnosis?
Microscopic evaluation of a biopsy specimen taken from the lesion which is often the main component of the definitive diagnosis.
102
What are the reasons for a biopsy?
Highly reliable and accurate
Provides a microscopic examination
Rules out or confirms malignancy
Allows for a definitive diagnosis
103
What is the complete removal biopsy of a small lesion (less than 1 cm)?
Excision biopsy
104
What is removed during an excision biopsy?
The entire lesion plus a rim of surrounding normal tissue with a scalpel
105
What is the extra normal tissue surrounding a lesion that is removed in an excision biopsy referred to as?
Safety margin
106
What type of biopsy is the removal of only a small portion of the whole lesion plus a small section/rim of surrounding tissue with a scalpel?
Incision biopsy
107
During an incision biopsy, which is preferred, a narrow and deep incision or a broad and shallow?
Narrow and deep is preferrable
108
What is a needle biopsy?
A need aspiration of tissue from a needle inserted into the tumor
109
What is a punch biopsy?
Basically a hole punch for tissue
110
What is an exfoliatative cytology sample?
Pre-biopsy tool that involves the scraping of the surface of a soft tissue lesion which is then examined under a microscope
111
What needs to be done if an exfoliatative cytology samples comes back as abnormal?
A biopsy
112
Why is an exfoliatative cytology sample not ideal?
It only evaluated superficial cells
113
What is a transepithelial cytology sample?
A pre-biopsy tool that is a brush painlessly collecting cells from full thickness (penetrates to the basement membrane)
114
What should be done if a positive result comes from a transepithelial cytology?
Biopsy
115
What must the DH do in regards to reporting lesions?
Make appropriate referrals to other health care professionals
116
How to care for a client with a lesion?
Inform the client of the lesion
Create a written record
Take intra oral photos
Provide referral and written instructions for client
Follow up with client after referral
117
What information is required in a client referral?
Client details (name, address, contact info, birthday)
Medical history (including meds, allergies)
Social history (tobacco use etc)
Detailed description of lesion (MCATSS)
Differential or working diagnosis
Referring clinician details (name, title, address, contact info)
118
What is microdontia?
Tiny teeth
119
What is macrodontia?
Giant teeth
120
What is adontonia?
Congenital absence of all teeth
121
What is hypodontia?
Genetically missing some teeth
122
Where is partial anodontia most common?
3rd molars max more often than mand
123
What is the 2nd most common area for partial anodontia?
Max laterals
124
What is the third most common area for partial anodontia?
Mandibular 2nd premolars
125
What teeth are the least likely to be congenitally missing?
Canines
126
90% of supernumerary teeth occur in
The maxilla
127
What are the most common areas for supernumerary teeth?
Max laterals or max third molars
128
What is a tooth erupting between the max centrals?
Mesiodens
129
Which teeth have the most variable crown shape?
Maxillary 3rd molars followed by mandiabular 3rd molars
130
What is a paramolar?
A supernumerary premolar
131
What is the most commonly seen anomally with the max laterals?
Peg laterals
132
What is a small supernumerary molar found distal to the 8’s?
Distomolar
133
What are dwarfed roots?
What it sounds like. Stumpy roots
134
What is a dilaceration root?
Abnormal curve in the root
135
What is root gemination?
Single tooth germ attempts to divide. 1 root, two crowns
136
What is root fusion?
Union of two adjoining tooth buds that looks like one large tooth. 2 roots, one crown
137
What is excessive cementum on the roots of the teeth?
Hypercementosis
138
What is abnormal development of the enamel?
Enamel dysplasia
139
What is incomplete or defective formation of enamel from environmental factors, nutrition, infections, chemical ingestion, trauma, or hereditary factors?
Enamel hypoplasia
140
What is an inherited defect in enamel formation?
Amelogenesis
141
What is ankylosis?
Teeth in which bone had fused to cementum/dentin
142
What are supernumerary roots?
Extra roots
143
What is the loss of tooth surface from excessive acid?
Erosion
144
What is the loss of tooth surface from wear?
Abrasion
145
What is internal resorption?
Inside the root resorbing. Inflammatory response in the pulp that destroys dentin due to trauma, injury, inflammatory, hormonal, infection, etc.
146
What is external resorption?
Top of the root resorbing from pressure on the tooth (ortho)
147
What is complete cleft lip?
Involves the roof of the mouth into the sinus/nose
148
What is incomplete cleft lip?
Doesn’t reach all the way up into the nose/root of mouth.
149
Is cleft lip more common in males or females?
Males
150
___% of cleft lips are unilateral and ___% are bilateral.
85%
15%
151
True or False: Midline clefts are common
False. Midline clefts are rare.
152
What are paramedian lip pits?
Congenital bilateral (usually) depressions in the lips
153
When do paramedian lip pits develop?
6 weeks in utero
154
Is there treatment for paramedian lip pits?
No
155
What are commissural (lip) pits?
Indentation of the corner of the lips (little dimples I have)
156
What causes commissural pits?
Failure of fusion of the mand and max
157
What is the pendulous fold of excess labial mucosa/tissue on the inner aspect of the lip?
Double lip
158
What causes double lip?
Developmental or trauma
159
What is a maxillary frenum mucosal tag?
Small, pink, tissue tag on the frenum
160
What causes maxillary frenum mucosal tags?
Developmental or trauma
161
What is microglossia?
Tiny tongue
162
What is macroglossia?
Giant tongue
163
What is ankyloglossia?
Tongue tie
164
What is a cleft tongue (bifid)?
Snake tongue. Groove or split running lengthwise along the tip of the tongue
165
What causes cleft tongue?
Incomplete fusion of the distal tongue buds
166
What else has been reported to be associated with cleft tongue?
Maternal diabetes
167
What causes hairy tongue?
Smoking, antibiotics, extended hydrogen peroxide rinsing
168
What is geographic tongue?
Benign migratory glossitis - loss of fill form papilla in one or multiple areas
169
What are lingual varicostities?
Dark blue/purple like veins under the tongue. Result of venous dilation which is a part of aging
170
What is lingual thyroid nodule?
Thyroid tissue becomes trapped in tongue tissues and doesn’t migrate anterior to trachea
171
What is white sponge nevus/nevi?
Defect in the maturation and exfoliation of the mucosa epithelium
172
What does white sponge nevi look like?
White, folded, spongey plaques
173
What are ectopic sebaceous glands that may or may not contain the hair follicle that have become trapped during the fusion of the max and mand processes?
Fordyce granules
174
What is leukoedema?
Spongosis (fluid accumulation) of the middle cell layer of the epidermis
175
What is hereditary gingival fibromatosis?
Hyperplastic enlargement of the gingiva, overgrowth of connective tissue
176
What are retrocuspid papillae?
Firm, round papule 1-4mm in diameter, pink and smooth under the lingual of the lower cuspids.
177
What is micrognathia?
Tiny jaw
178
What syndromes are associated with micognathia?
Apert
Crouzons
Pierre Robin
Treacher Collins
179
What is macrognathia?
Giant jaw (think chin twins)
180
Syndromes associate with macrognathia?
Cherubism
Fibrous dysplasia
Acromegaly
181
What is cleft palate?
Like cleft lip but only affects the palate
182
What does TMJ involve?
The two joints that attach the mandible to the skull
183
Where do TMD symptoms originate from?
The joint itself or the muscles around the joint
184
Some research suggest that as many as ___% of all adults have at least one sign of TMD.
70%
185
How many adults describe accompanying symptoms with TMD?
25%
186
How many adults seek treatment for TMD?
5%
187
Who are the majority of patients with TMD?
Females between 20-40 years old
188
Some researchers suggest what hormones may have a role in TMD pathogenesis?
Female sex hormones
189
What comorbid conditions are often associate with TMD?
Depression
Rheumatoid arthritis
Chronic fatigue syndrome
Chronic headache
Fibromyalgia
Sleep disturbances
Irritable bowel syndrome
190
What are the bones of the TMJ?
External acoustic meatus
Temporal bone
Articular disc
Zygomatic arch
Articular tubercle
Condyle of mandible
191
What are the ligaments of the TMJ?
Joint capsule
Temporomandibular ligament
Stylomandibular ligament
192
What is a normal TMJ opening?
3 fingers edge to edge (40mm)
193
What are the TMD symptoms?
Pain
Popping, clicking, crepitus, grating sounds
Difficulty opening the mouth
Locking of the joint
Headache
Swelling on one or both sides of the face
194
Causes of TMD
Bruxism
Arthritis
Trauma
Facial bone defects
Misalignment
195
Phase 1: Non surgical treatment for TMD
Pharmacological therapy (drugs) - pain control, muscle relaxants, anti-inflammatory, anti-anxiety meds
Physiotherapy
Corrective dental tx (full mouth reconstruction with crowns)
Biteplate
Night guard
Botox
Chiropractic therapy
196
Phase 2: ortho and adjustment treatments for TMD
Occlusal appliance
Anterior reposition appliance
Stabilizing appliance
197
Phase 3: surgical treatment for TMD
Arthroscopy
Surgical reposition of the condyle
Open joint surgery for disc repositioning
Replacement or excision
Total joint reconstructions using prosthetics or autogenous grafts
198
What is the role of the dental hygienist in TMD client management?
Advise client to eat soft diet, avoid opening wide, suggest relaxation training
Refer
