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D1 BS1 + II/ FSI + II > bsi mod 3 > Flashcards

bsi mod 3 Flashcards

1
Q

compound vs simple gland

A
  • compound gland: salivary. Simple is sebaceous with 1 duct
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2
Q

dense irregular connective tissue

A
  • mesoderm but some neural crest
  • structure, exchange, defense and fat storage
  • MUCOSA
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3
Q

strat spinosum

A
  • become spinous cells, larger than basal
  • less nc ratio
  • no prolif!
  • integrin profile changes from a6b4 to a3b1. also keratin profile changes
  • no organells, chromatin condense
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4
Q

cytokeratins

A

made by all epi cells
- int fila
- type 9-20 are type 1 and acidic
- KRT 1-8 are basic
- found in pairs

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5
Q

top layer in skin is called what in oral cavity, skin? characteristics

A

stratum superficiale is called superficial layer in mucosa and oral cavity, stratum corneum in skin
- this is no organelles, flat and varied width
- water resistant and barrier

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6
Q

hemidesmosome structure

A

cytokeratin molecules in cytoplasm are connected to integrin a6b4 via bullous pemphigoid 230 and 180 and plectin
- then integrin crosses plasma mem to bind laminin 5 (laminin 332)

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7
Q

desmosome structure

A

thick part: desmoplakin and plakogoblin
desmoglein and desmocollin are zipper in intercell space

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8
Q

where to find parakeratin

A

hard palate, dorsum of tongue and attached gingiva
- retained nuc

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9
Q

where to find orthokeratin

A

in skin!!

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10
Q

melanocytes

A
  • neural crest derived
  • live in basal skin and mucosa
  • communicate to keratinocytes via dendrites
  • melanin does uv rad protection
  • cells take up this melanin (umbrella style)
  • same number of melanocytes in everyone! pigment depends on number and size of MELANOSOMES, dispersion in skin
  • sometimes even on attached gingiva
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11
Q

langerhans cells

A
  • dendritic from bone marrow
  • in strat spinosum
  • found in all layers of epi and papillary derm
  • granulated birbeck stuff thats black
  • immune macrophages (1st cells)
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12
Q

merkel cells

A
  • proprioception sensory cells
  • from epi progenitor cells
  • in basal layer
  • from keratinocytes
  • fingers, feet, hard palate, lips
  • touch stuff. communicate with sensory nerves DIRECTLY
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13
Q

white sponge nevus

A

mutations in cytokeratin 4 or 13
- white tongue

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14
Q

pachyonychia congenita

A

mutations in cytokeratin 6,16, or 17
- happens in the accral skin (palms and soles)
- fingernails
- thickened keratin

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15
Q

epidermolysis bullosa (general)

A

mutations in cytokeratin 5 and 14
- the mitten hand one
- blisters, ulceration
- hereogneous

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16
Q

pemphigus vulgaris

A

desmoglein 3 is bad
desmosome
- red burning thing
- SUPRABASAL CLEAVAGE IN SPINOUS LAYER!!!

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17
Q

pemphigus foliaceus

A

desmoglein 1 bad
desmosome

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18
Q

mucous membrane pemphigoid

A

bp 230 and 180
- mucous problem ONLY
- blindness thing
- antibodies attach proteins that are sub-basilar (under basement mem)
- THIS IS HEMIDESMOSOMES

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19
Q

bullous pemphigoid

A

bp 230 and 180
- skin problem ONLY

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20
Q

lamina lucida

A
  • made by basal epi
  • unique to epi
  • anchored by laminin 332 and collagen 17 (bp 180!)
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21
Q

lamina densa

A
  • made by basal epi
  • unique to epi
  • collagen 4, nidogens nad perlecan
  • anchored by collagen 7!!!!
  • binds to 4 and laminin 332 above
  • binds to collagen 1 and 3 below
    “clothespin”
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22
Q

lamina reticularis

A
  • made by fibroblasts
  • NO part of basal lamina
  • collagen 1 and 3, elastic fibers, fibronectin
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23
Q

epidermolysis bullosa simplex

A

cytokeratin 5 and 14 or plectin
- separation above basement mem
- all over the body

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24
Q

junctional epidermolysis bullosa

A

collagen 17, integrin a6b4 or laminin 332
- most severe
- can dev amelogenesis imperfecta, tooth loss and caries
- separation in lamina lucida layer of basement mem

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25
Q

dystrophic epidermolysis bullosa

A

collagen 7
- risk for skin and oral cancer!!
- separation under basement mem

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26
Q

fixed cells

A

fibroblasts (mesenchyme), myofibroblast (mesenchyme), adipocytes (mesenchyme), pericytes, mast (bone marroq) and macrophage (bone marrow)

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27
Q

transient cells

A
  • from bone marrow!!!!
  • NEB, monocytes, macrophages, lymphocytes, plasma cells
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28
Q

fibroblasts

A
  • make collagen, reticular (type 3), elastic
  • trichrome, VVG and reticulin stain
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29
Q

collagen types

A

1 is found in skin and mucosa. most abundant
- type 2 in cartilage
- type 3 in blood vessels, support for hollow organs
- type 4 in basement mem (NON-FIBRILAR)
- type 5 needed for fibrillation of type 1 and 3

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30
Q

type 1 collagen

A
  • found in almost all organs of the body including tendons, bones, ligaments
  • found in dermis layer
  • triple helix structure that decreases with age

3 proteins, 2 a1 chains and 1 a2 chain
- c terminal does triple helix in rough er, then procollagen in cyto, tropocollagen, fibril and fiber

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31
Q

type 3 collagen

A
  • young skin tissue, blood vessels, lungs and internal organs
  • papillary dermis
  • 3 helix that is thin and shorter than type 1
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32
Q

scurvy

A
  • gingiva and perio inflam
  • loss of teeth
  • bleeding
  • impaired wound healing
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33
Q

ehlers danlos syndrome

A
  • heterogenous
  • bad collagen or NOT ENOUGH of 1,3,5
  • if 3 then blood vessels integrity bad, bruising, hemorrage
  • mess up the helix
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34
Q

elastic fiber

A

elastin and microfirbils (made of fibrilin)
- elastic in, fibrilin out

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35
Q

cutis laxa

A

sagging, non stretch skin
- wrinkeld
- elastin defect

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36
Q

marfan syndrome

A
  • tall with long everything
  • flexible joints
  • high arched palate
  • aortic rupture
  • fibrilin defect
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37
Q

papillary lamina propria and reticular components + location

A
  • papillary is loose tissue that is closer to basal mem, reticular is more collagenous and deeper
  • contains; vasculature, fibroblast, collagen, elastin, nerves (PNS), meissner corpuscles ONLY FOUND IN PAP
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38
Q

submucosa

A
  • under reticular lamina propria
  • contains fibrocollagenous tissue, nerves, adipose, minor salivary glands, skeletal muscle
  • varies by site!
  • attached gingiva and hard palate don’t have submucosa (since bound directly to bone as MUCOPERIOSTEUM)
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39
Q

masticatory mucosa

A
  • found on hard palate
  • everywhere where skin touches food
  • attached gingiva, tongue
  • ## parakeratinezed
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40
Q

specialized mucosa

A
  • dorsal tongue only
  • parakeratin and non
  • masticatory but also flexible and sensory
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41
Q

lining mucosa

A
  • non keratin
  • found everywehre else in mucosa
  • thicker than masticatory and flex
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42
Q

tongue

A
  • posterior 3 from branchail arches 3 and 4
  • base of tongue contains lymphoid tissue
  • entrance to oropharnyx!!!!
  • anterior 2/3 from 1st arch
  • has v shape terminal sulcus with foramen cecum at tip (remnant of thryoid gland!!)
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43
Q

filiform papillae

A
  • cover anterior 2/3 tongue
  • hair like
  • point towards orophanyx (back)
  • thick keratin
  • non keratinized between papillae
  • no taste buds!
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44
Q

fungiform papillae

A
  • anterior 2/3
  • scattered and mushroom like
  • no keratin
  • vascular
  • taste buds!!
  • the pink spots on tongue
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45
Q

foliate papillae

A
  • at the lateral posterior surface
  • 4-11 parallel ridges
  • taste buds within the ridges
  • no kerain
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46
Q

circumvallate papillae

A
  • form the v shape at the terminal sulcus? converge at the foramen cecum
  • keratin on top
  • lateral walls are not keratin
  • deep circular groove that opens to minor salivary glands
  • SEROUS GLANDS OF VON EBNER!! only place
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47
Q

where to find taste buds

A
  • fungiform, foliate, circumvallate, soft palate, pharynx
    NOT IN FILIFORM
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48
Q

taste bud

A
  • barrel shaped
  • 30-80 spindle cells
  • can taste in all cells
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49
Q

umami foods are rich in

A

l glutamate, inosine monophosphate and guanosine monophosphate

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50
Q

waldeyers ring

A
  • ring of lymphoid tissue
  • back is pharyngeal tonsil, then tubal tonsil, palatine tonsil, lingual tonsil, palatine tonsil, tubal tonsil
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51
Q

fordyce granules

A
  • ectopic sebaceous glands in lamina propria
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52
Q

ORAL mucosa dev at 26 days

A

fusion of stomatodeum with foregut

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53
Q

ORAL mucosa dev at 5-6 weeks

A

stratification of epi

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54
Q

ORAL mucosa dec at 7 weeks

A
  • tongue epi shows specialization
  • circumvalate, foliate, and fungiform papillae
  • taste buds form
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55
Q

ORAL mucosa dec at 8-12 weeks

A
  • mouth begins to become defined, palatal shelves elevate and close
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56
Q

ORAL mucosa dec at 10-12 weeks

A

specific keratinization patterns become apparent, filiform papillae on anterior 2/3 tongue

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57
Q

ORAL mucosa dec at 13-20 weeks

A
  • oral epithelia thicks, parakeratinization
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58
Q

internal lip contains

A
  • labial mucosa, beginning of oral mucosa and minor salivary glands
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59
Q

attached gingiva

A
  • pale pink, stipled (like an orange), keratin, no submucosa!!, collagen attaches to periosteum of bone
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60
Q

alveolar mucosa

A
  • reddish, thicker epithelial layer, non keratin, submucosa, flexible
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61
Q

free gingiva

A
  • keratinized on outside, non keratinized on segment facing tooth
  • can be broken down by plaque!!
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62
Q

dentinogingival junction

A
  • where oral mucosa meets tooth structure
  • point of weakness, may be damaged by bac
  • seal btw oral cavity and underlying tissues
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63
Q

dgj oral epi

A

this is the outer ridge part of the free and attached gingiva
- keratin

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64
Q

dgj sulcar epithelium

A
  • these cells extend from edge of junctional epi to gingival margin
  • no keratin
  • depth of 0.5 to 3 mm (3- 3.5 is normal)
  • sulcular epi contains fluid!
  • thin sulcular epi
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65
Q

hair tongue and geographic tongue

A
  • hairy is filifrom overgrowth (NOT NORMAL)
  • geographic is changing atrophy of filiform
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66
Q

leukoedema

A

grey translucent mucosal coloration
- disappears when mucosa stretched
- marked intracell edema

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67
Q

juntional epi dgj

A
  • no keratin, especially thin!!
  • physically attached to enamel epi of tooth germ @ base of sulcus
  • VERY REGENERATIVE
  • derived from tooth germ!!!
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68
Q

pharyngeal arches

A
  • 5 swellings
  • ectoderm from neural crest
  • numbered 1,2,3,4,6
  • first arch has 2 prominences (max and mand)
  • each arch has: cart from neural crest, specific skeletal muscles, CN, aortic arch artery
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69
Q

pharyngeal arch 1

A

incus malleas, sphenomand ligament
- max and mand bone
- first arch muscle moves the mand and max
- trigem innervation 5 of mand and max, plus two tensors (tympani and veli palatini - ear and soft palate)

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70
Q

pharyngeal arch 2

A

stapes, styoid process for muscles, stylohyoid ligament, upper hyoid (floor of mouth?)
- hyoid bone
- these muscle leave hyoid and go to face!!!
- facial nerve 7 also innervates stapedius (amp sound)

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71
Q

pharyngeal arch 3

A

lower half and greater horns of hyoid
- hyoid bone
- only 1 muscle stylopharyngeus but leaves hyoid for swallowing
- cn 9 glossopharyngeal

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72
Q

pharyngeal arch 4

A

thyroid and epiglottic cart of larynx
- larynx muscle
- cn 10 innervates all palate except veli palatini (arch 1) and all pharynx except for stylopharyngeus (arch 3)

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73
Q

4th aortic arch

A

gives rise to arch of aorta and r subclavian

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74
Q

6th aortic arch

A

pulmonary arteries and ductus arteriosus

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75
Q

3rd aortic arch

A

gives rise to common and internal carotid arteries

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76
Q

1st aortic arch

A

gives rise to max artery

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77
Q

pharyngeal arch 6

A

cricoid of larynx
- cn 10
- all larynx except for cricothyroid
- pumonary arteries and ductus arteriosu

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78
Q

preotic somitomeres

A
  • cn 3,4,6 that innervate eyes
  • not mixed!
  • ONLY MOTOR FUNCTION off of arch 1
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79
Q

postotic somites

A

tongue, cn x
- skeletal by 11 and 12!! motor only

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80
Q

facial primordia formation

A

5 of them formed by neural crest, max and mand prominence dev in arch 1
- frontonasal process, 2 max process, 2 mand
- max prominence outgrowths fuse to form palatine shelves
- primary palate is the v at the front
- incisive foramen marks fusion pt of two palates
- cleft lip is bad fusion btw max prominences

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81
Q

pharyngeal pouch 1

A
  • 4 from the pharynx!!!
  • pouch 1 forms auditory tube touching the ONLY reminant of pharyngeal groove 1 (xternal aud meatus). barrier is tympanic membrane
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82
Q

pharyngeal groove

A
  • groove 1 remains (the only one that remains outside) as external auditory meatus
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83
Q

pharyngeal pouch 2

A

palatine tonsil
- oropharynx

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84
Q

pharyngeal pouch 3

A

parathyroid gland inferior and thymus
- migrate down following the thymus

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85
Q

pharyngeal pouch 4

A

parathyroid gland sup and parafollicular cells thing that migrates into thyroid gland

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86
Q

tympanic mem mucous and skin profile

A

mucosa is pharyngeal endo and skin is ectoderm

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87
Q

nasal cavity + oral cavity profile

A

ectoderm
- mostly branch 1 and 2 of V skin and mucosa innervation

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88
Q

tongue profile

A

front 2/3 is ecto, back is endo
- back is part of oropharynx: contains lingueal tonsil, palatine tonsil, pharyngeal tongue
- foramen cecum is site where thyroglossal duct descended
- sulcus terminalis is boundary btw oral and pharyngeal tongue- - cn 12 innervation since not in pharyngeal pouch
- MUCOSA innervation is diff: anterior 2/3 is cn 5 (not taste, pain, touch temp) and 7 (taste)
- posterior is cn 9 from arch 3

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89
Q

naso, oro, laryngo and esophagus profile

A

endoderm but not closed!
- rememnant of pouch 1, auditory tube is in naso
- palatine tonsil in tonsil fossa from pouch 2
- cn glossopharyngeal in oropharynx then cn 10 below

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90
Q

thyroid gland profile

A
  • midline endoderm from 1/3 posterior tongue
  • starts as diverticulum in part of tongue, then goes down midline to trachea via thyroglossal duct meaning its actually BELOW thryoid cart
  • diverticulum forms from between 1 and 2 pharynngeal pouch
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91
Q

digeorge sequence

A

defect in pouch 3 and 4
- bad t cells, calcitonin leading to hypocalcemia, heart problems, ears

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92
Q

what innervates skin/mucosa of pharyngeal apparatus

A
  • trigeminal only pretty much
  • cn 7,9,10 do the pinna and external auditory meatus (ear)
93
Q

vit d synth in skin

A

from 7 dehydrocholesterol to vit d3 using UV B!

94
Q

skin development

A

WNT signal blocks fibroblast growth factor activity on neuroectoderm. these cells express k8 and 18 initially (multipotent)
- leads to expression of BMP that inhibits neural fate and diff to epidermis. now p63 active so induce k5 and 14 expression
- loss of p63 is lethal!!

95
Q

dorsal dermis comes from

A

dermomyotome

96
Q

ventral dermis comes from

A

lateral plate mesoderm

97
Q

head dermis comes from

A
  • neural crest
98
Q

strat corneum epi

A
  • cross linked proteins and lipids
  • keratin
  • ded
99
Q

strat granulosum epi

A
  • profilaggrin induces keratin aggregation in keratohyalin granules!
  • cells are most flat
  • contain keratin 1 and 10
  • filagrrin and loricrin proteins
100
Q

spinous layer epi

A
  • committed to terminal diff
  • k 1 and 10 (now all above cells have it too)
101
Q

basal layer epi

A

dividing cells, k 5 and 14

102
Q

palm skin layer

A

has thick corneum and granulosum, prominent rete ridges

103
Q

eyelid skin

A

thin corneum and granulosum, not prominent rete ridges

104
Q

hair development

A

found in dermis?
- starts with formation of placode (embryo thickening area)
- then regulated by wnt/ b catenin pathway
- first anagen (growth phase of hair) then catagen where hair detaches from nourishment supply then telogen (hair falls out)
- alopecia, hirsutism (some hair) and hypertrichosis (werewolf)

105
Q

nails

A
  • made of keratin
  • eponychium is viable skin (bottom of nail)
  • cuticle is layer of dead cells attached to nail plate
  • lichen planus (scratchy nails = dystrophic)
  • plummer vinson syndrome leads to koilonychia spoon nails
106
Q

sebaceuous gland

A
  • grease. located at top of hair follicle
  • sebum lubricates and waterproofs hair. holocrine sec where cells die
107
Q

eccrine sweat glands

A
  • found eveywhere
  • merocrine secretion (vesicles)
  • most of glands are this
  • put secretion right onto surface of skin
108
Q

apocrine sweat glands

A
  • only found with hair, apocrine secretion where it buds off to form blebs
  • body odor
  • influenced by bac!
109
Q

skin microbiome

A
  • bac, fungi, virus
  • protection against invading path
  • immune surveillance
  • breakdown of natural products
110
Q

aged vs young skin

A
  • epi is thinner, dryer, impair wound healing and increased cancer
  • dermis is thinner, less collagen and elastin
111
Q

ectodermal displasia x linked hypohidroticc ED

A
  • heterogenous
  • EDA gene that is most common. no sweat
  • there is no hair made (hypotrichosis), weird nails and hypohidrosis,
  • hypodontia (less teeth) and oligodontia (like 2-5 teeth only)
  • p63 leads to cleft palate phenotype
112
Q

skin problems

A
  • warts and herpes (cold sore stuff)
    -basal cell carcinoma, squam cell carcinoma
113
Q

melanin production

A
  • sunlight stim
  • a MSH activates melanocortin 1 receptor (MC1R)
  • comes from acth pituitary then cleaved
  • made of two pigments: eumelanin and pheomelanin
  • l tyrosine to l dopa then l dopaquinone then melanin
  • done using tyrosinase, in MELANOSOME
114
Q

melanosomes

A
  • melanin is packaged into melanosomes (granules)
  • transported through dendrites to adjacent keratinocytes in basal and spinous layer
  • keratinocytes engulft melanosomes and arrange pigment over nuclei
115
Q

epidermal melanin unit

A
  • epidermal melanin unit is function unit of 1 melanocyte to 36 keratinocytes
116
Q

MC1R genetic variation

A

polymorphism is freckles. from point mutation no AA change
- sun darkens them

mutation: autosomal recessive is red hair, white skin
- decreased eumelanin synth and sensitive to uv light

117
Q

oral melanotic macule

A
  • not related to sun
  • increased melanin NOT melanocytes
  • mole on mucosa
118
Q

nevus (mole)

A
  • less than 5 mm in diameter
  • prepubertal
  • risk is sun exposure and geneticcs
  • benign
119
Q

melanoma

A
  • 3rd most common skin cancer
  • family history
  • dysplastic nevi
  • high number of nevi
  • sunburns
120
Q

ABCDE melanoma

A
  • assymetry, border irregular, color, diameter over 6 mm, enlargement and elevation
121
Q

melasma

A
  • irregular symmetric sigmentation on sun area of face
  • more common in women and dark skin ppl
  • multifactoral causes
122
Q

vitiligo

A

autoimmune loss of melanin
- white patch thing

123
Q

albinism

A
  • genetic inability to produce melanin
  • tyrosinase
124
Q

adrenocortical insufficiency (addison disease)

A

adrenal gland dysfunction
- so too much ACTH then overstim of pit, weird pigmentation

125
Q

mast cells

A

bone marrow. inflam and sensitivity reactions, heparin histamine. first response to injury
- stain with toluidine blue
- NOT in CNS!
- CT proper are around blood vessels!!

126
Q

macrophages

A
  • bone marrow. enter as monocytes then mature in CT
  • phagocytes and APC
  • kupfer in liver, langerhans in skin
  • microglia in brain
127
Q

adipocytes

A
  • full diff. white adipose is big droplet brown is many small in babies
128
Q

myofibroblast

A
  • contractile, derivative of fibroblast (mods), wound healing, can have many origins!
129
Q

pericytes

A

endothelial cells of cap for contraction

130
Q

specialized CT

A

reticular, bone, cart, ligament, fat, blood

131
Q

langerhans cell histiocytosis

A
  • abnormal clonal prolif of langerhans cells
  • unifocal, multifocal unifocal(many lesions on 1 organ) and multifocal multisystem (many lesions)
  • braf mutations result in RAS tyrosine kinase activation so cancer
132
Q

merkel cell carcinoma

A
  • highly aggressive skin cancer
  • associated with polyomavirus
133
Q

solar radiation bad stuff

A
  • # 1 cause of skin cacner, lip, and precancerous lip and skin lesions, premature aging, catacts, immune suppression
134
Q

uva

A

wavelength is 3125 to 400 nm
- 95% of radiation that hits earth BUT not absorbed by glass/clouds
- activates melanin, penetrates lamina propria dermis so skin becomes less elastic and wrinkly
- penetrates eye lens and increases INDIRECT cell ox damage
- NOT THE DIMER AND PHOTOPRODUCT MECH

135
Q

uv b

A

wavelength is 290 to 315
- can be blocked but absorbs everywhere
- penetrates to epidermis
- causes sunburn not tan
- new melanin that is LONGER lasting than tan
- direct dna damage
- keratin cells stim to divide and prolif
- decreases langerhans cells
- absorbed by cornea
- cancer, sunscreen works

136
Q

solar elastosis

A
  • accumulation of abnormal elastin
  • chronic sun damage
  • pathoneumonic!!!!
137
Q

melanosis

A
  • melanin produced
  • chronic sun damage
138
Q

hyperkeratosis

A
  • thickened strat superficiale
  • sun damage
139
Q

acanthosis

A
  • thickened stratum spinosum
  • sun damage
140
Q

dna damage from UV

A
  • modifies nuc (thymine dniculeotide is fused to make a CYCLOBUTANE PYRIMIDINE dimer DIRECT and then 6-4 photoproduct that triggers indirect damage)
  • ONLY FROM UVB
  • first single strand breaks then second one. free radicals induce ox stress
141
Q

dna damage response

A
  • ionized rad is always 2 strand break
  • activates chckpoint, dna repair, growth arrest (senescence) and apoptosis
  • nucleotide excision repair (NER) is primary mechanism used by keratinocytes for repair of UV dna products
142
Q

xeroderma pigmentosum

A
  • extreme uv sensitivity, skin and lip cancer, eye problems
  • heterogenous
  • messes up NER
143
Q

sun on lips

A
  • no vermilion border, actinic chelitis, cancer, herpes cold sores
144
Q

sun on skin

A

sunburn, solar lentigo (pigment spots), aging, actinic keratosis, cancer (basal, squam, melanoma)

145
Q

oral mucosa layers

A
  • below basement
  • papillary lamina propria
  • reticular lamina propria
  • submucosa
146
Q

skin layers

A

epidermis (come lets get sun burnt)
- then dermis (papillary and reticular) then fat

147
Q

loose CT

A

contains: fixed cells, collagen, elastin, ground substance, fluid, nerves, blood vessels
- ground is filled with mucopolysac

148
Q

minor salivary glands

A
  • produce mostly mucous but circumvalate makes serous also. (papilla base)
  • all over mouth even esophagus and oropharynx
  • develop from ectoderm, except for von ebner (endo) at 8-12 wks
  • NOT FOUND in gingiva, anterior hard palate, anterior dorsum tongue
  • unencapsulated
  • ducts open directly onto mucosal surface
  • von ebner’s glands ARE SEROUS
  • secrete igA
149
Q

parotid

A

ectoderm, in 4-6 weeks
- largest gland, mostly serous
- long branching intercalated ducts
- many striated ducts
- mostly digestive enzymes
- stensen’s duct opens into mouth
- also has fat and lymph tissue!!
- cn 9, but cn 7 passes through

150
Q

submandibular

A

6 weeks, endoderm
- second largest
- medium length intercalated ducts, many striated
- wharton’s duct opens into sublingual caruncle
- serous-mucous
- produces distinct MUCINS!!
- cn 7. has fat

151
Q

sublingual

A

8-12 weeks, endodermal
- smallest
- short bad intercalated and striated ducts
- bartholins duct opens into SUBLINGUAL CARUNCLE
- ducts of rivinus open along SUBLINGUAL FOLD
- mucous serous
- cn 7. has fat.

152
Q

salivary gland development

A
  • epithelial cells proliferate in stomatodeum then form a tree thing that branches to form lumen in the middle.
  • cytodiff: inner cells become secretory
  • outer cells become myoepithelial
  • maturation of glands continues till birth and increase in sice after
153
Q

sublingual caruncle contains

A
  • wharton’s duct from submand and bartholin duct from sublingual!!!
154
Q

salivary gland structure

A
  • acini (secretory endpiece) that are spherical/tubular buds at end. this is site of fluid and protein secretion
  • ductal network is small ducts connected to acini, merge to form larger ducts then one main duct
  • connective tissue surrounds glandular epi separated by septae (connective tissue) that divides into lobes called capsules
  • has blood vessels and nerves
155
Q

serous cells

A
  • protein rich secretory granules
  • pyramid that contains all protein to make saliva
156
Q

mucous cells

A

mucin rich secretory granules

157
Q

mixed acini

A

mucous cells in the center, then serous cells form cresent around the edge
- tubular shaped
- secrete into common lumen

158
Q

Myoepi cells

A
  • found in acini btw basal mem of secretory cells and basement mem
  • also found along ducts
  • functionally and structurally like smooth muscle that contract to force saliva out
159
Q

intercalated ducts

A
  • first duct from acini, small dia, cuboidal cells that are lined by myoepi cells
160
Q

striated ducts

A
  • main intralobular duct that is mostly in parotid, submand, unique to salivary glands
  • simple columnar cells, larger dia then acini, larger luman then intercalated ducts, basal mem highly folded and filled with mito, small blood vessels surround ducts
161
Q

excretory ducts

A
  • large, interlobular ducts
  • surrounded by ct, pseudostrat columnar epi, ducts merge to form single main duct
162
Q

order of ducts

A

secretory portion, intercalated duct, interlobular duct (aka striated duct), then excretory duct

163
Q

saliva components

A
  • 600-1000 mL is normal
  • major glands have levels based on circadian rhythm, but minor is continuous
  • 99% water and organic is 1%
  • ph is slighyly acidic 6.2-7.6
  • binds bac, helps in taste, wound healing, tooth remin
164
Q

pelicle formation

A

composed of saliva proteins, crevicular fluid( from sulcus) , oral mucosa and microbes
- on enamel surface (cervical tooth where it meets gingiva) for protection and remin

165
Q

stim and unstim saliva

A
  • unstim is basal secretion without exogenous stim (sleep, more mucous since its mostly submandibular gland)
  • stim is in response to something and usually watery since mostly parotid!
  • stim can be taste, smell, thinking, chewing via cn 7,9,10
  • inhibition is sleep, fear, dehydration
166
Q

parasymp saliva secretion

A
  • high volume, watery, rich in electrolytes and enzymes, parotid (cn 9) and submand (cn 7). inhibition leads to atrophy
167
Q

symp saliva secretion

A
  • low vol, viscous saliva, rich in mucus
  • all fibers originate in superior cervical ganglion
  • inhibition does not cause change
168
Q

salivary secretion process

A
  • begins as isotonic then cl and na added by acinar cells (Active) then water is pulled in through aqp5 and tight junctions (passive). na and cl reabsorbed by ductal cells then k and hco3- is added to saliva by ductal cells (BUT NO WATER FOLLOWS)
  • adding and removing ions as it goes like cl, k out, h in
  • BUT less hypotonic as flow rate increases!!
  • ions stop at striated ducts

in the duct, transporters reabsorb na and cl to make it hypotonic
- ends up as hypotonic and acidic

169
Q

sodium in saliva

A

higher in plasma, then gets higher when stim

170
Q

potassium in saliva

A
  • low in plasma, higher in basal then not much change with stim
171
Q

calcium in saliva

A

stays the same

172
Q

magnesium in saliva

A

higher in plasma, then same in basal and stim

173
Q

chloride in saliva

A

higher in plasma, then higher in stim

174
Q

bicarbonate in saliva

A
  • higher in plasma, then gets higher with stim
175
Q

what’s in saliva

A

salivary proteins, digestive enzymes, carbonic anhydrase, growth factors, proline rich proteins, glucocort, sex hormones, glucose!!!, AA, statherin and haptocorrin

176
Q

saliva protein secretion

A
  • exocytosis merocrine through acini cells. hormone stim
  • DNA and rna is in there too!
177
Q

salivary proteins

A
  • mucins made by acini (esp 7 and 5b are imp!!!), secretory igA from plasma, histatins for digestion, lysozyme, lactogerrin
178
Q

digestive enzymes in saliva

A

a amylase, lipase, peroxidase
- mostly from parotid

179
Q

carbonic anhydrase saliva

A

for co2 exchange

180
Q

growth factors in saliva

A

epidermal growth factor

181
Q

slatherin in saliva

A

works in enamel min with hydroxyapetite

182
Q

haptocorrin saliac

A

binds v b12

183
Q

mucin functions

A
  • bind bac and pelicle formation
  • esp muc7 and 5b
  • lubrication
  • made by submand and sublingual glands!!!
184
Q

von ebner glands

A
  • von ebner’s glands ARE SEROUS
  • secrete histacin and lingual lipase
  • base of tongue in circumvallate papilla
    (endo) at 8-12 wks
185
Q

xerostomia treatment

A

sugarless gum, oral hygeine stuff like biotene, parasymp agonist drugs, fluoride or chlorhexidine rinses

186
Q

primary shogen syndrome

A
  • sicca syndrome
  • xerostomia, xeropthalmia (dry eyes!)
  • autoimmune
  • 9:1 female ratio!! gland enlargement
  • rampant caries
187
Q

secondary shogen

A

sicca syndrome coupled with dry mouth, eyes and other maniffestations like arthritics and stuff
- 9:1 female ratio!! gland enlargement
- caries

188
Q

sialorrhea

A
  • xs salivation
  • from lots of places like local anesthetic, new denture, rabies,
189
Q

salivary gland agenesis, atresia or hypoplasia

A
  • mandibulofacial dystosis (treacher collins syndrome)
  • impacts rRNA production so basically no parotid and very dry mouth
190
Q

mucocele

A
  • rupture of salivary duct
  • most common in lower lip. can also happen in ventral tongue, floor of mouth
  • trauma!
191
Q

sialolithiasis

A
  • stone
  • usually submand since complex thing
  • radiopaque (white) mass
  • block salivary flow, so lead to bac build up and need to remove stone
192
Q

acute bacterial sialadenitis

A
  • retrograde infx due to block of saliva
  • pain, inflam, heat etc, swelling
  • abscess in ducts and acini
  • need antibiotics then drain
193
Q

mumps

A
  • paramyxovirus
  • infect saliva, pee, breast, ovary, testes (long term = infertility)
  • mainly bilateral parotid enlargement
  • pain
194
Q

pleomorphic adenoma

A
  • benign salivary gland tumor most common
195
Q

mucoepidermoid carcinoma

A

most common malignant salivary gland tumor
- parotid common or minor glands

196
Q

order of diagnosis

A

cc, HPI (old carts), medical, social and family history, complete clinical examination (ROS), differential diagnosis, working diagnosis, tests, final diagnosis and treatment

197
Q

clinical examination part

A

review of systems before examining sus stuff
- inspect, palpate, percuss and auscultate
- check both sides for symmetry
- refer patient for NOT oral stuff

198
Q

signs and stuff of lesions

A
  • size, color, consistency, mobility, tenderness, temp, function
  • shape and outline
  • arrangement of lesions
  • distribution: diffuse is big lesion spread out or local
  • multilocal is lesions on same part but diff area
199
Q

macule

A
  • discoloured flat spot not elevated
200
Q

pustule

A
  • visi8ble collection of pus beneath skin
  • don’t picck this unless can see pus coming out
201
Q

vescicle/bulla

A

vescicle is less than 5mm (fluid filled)
bulla is more than 5 mm
- ulcer after it pops

202
Q

ulcer

A
  • loss of surface epi
  • for this, biopsy not only the ulcer but also the epi. usually disease is of the epi so want to see it all (since ulcer tissue won’t have it!)
203
Q

papule/ plaque

A
  • papule is small, solid elevation of skin less than 1 cm
  • plaque is more rough and larger than 1 dm
204
Q

nodule vs mass

A
  • nodule is small bump
  • mass is non specific description of mass (nodule = mass but not all mass = nodule)
  • sessile is attached to a base, pedunculated is attached by stalk (can move it)
  • exophytic is out, endo is in
  • ALL peduncle is exophytic while sessile can be either
205
Q

differential diagnosis process to final

A
  • a list of things it could be
  • then narrow it down to 3 when doing working diagnosis. #1 is working diagnosis
  • determine tests and do them. This solidifies the working diagnosis
  • final diagnosis = definitive usually done by pathologist.
  • forms basis of development of treatment plan
206
Q

what tests to order

A
  • if u can see it, feel it then usually a biopsy!
207
Q

mast cells mucosal

A

in Di and respiratory
- rich in chondrotin sulfate

208
Q

alveolar ridges

A

mand and max divide teeth into oral cavity proper and oral vestibules (outer portion)

209
Q

lip corner

A

commissure

210
Q

frenum and frenulum

A

buccal and labial mucosa to alveolar mucosa

211
Q

fold in inner lip

A

vestibule/mucobuccal fold

212
Q

pad thing in corner of mouth

A

retromolar trigone

213
Q

order of mucosa on teeth maxilla

A

Top is alveolar mucosa, then mucogingival junction then attached gingiva then free gingival groove then free gingiva (festooning)

214
Q

enamel epi thing

A

oral epi is outside, then sulcular then junctional

215
Q

inside the mouth palate parts

A

Rugae and incisive papilla
Raphe is line

216
Q

pillar in back of mouth

A

soft palate then uvula
First fold is palatoglossal
Then gap is palatine tonsils
Then palatopharyngeal folds
Then oropharyngeal wall

217
Q

bottom of mouth anatomy

A

lingual frenulum with sublingual caruncle on it
Under tongue tissue attached to frenulum is sublingual fold

218
Q

which taste buds have keratin and which don’t

A

Filiform: keratin on top
Fungiform has no keratin but its vascular
Foliate is no keratin
Circumvallate is 100% keratin

219
Q

migratory tongue

A

erythema migrans

220
Q

what does foliate papillae look like

A
  • non keratin so very thick at the top
  • very branchy finger things
221
Q

circumvallate papillae look like

A

thick top since keratin but thin sides
- deep grooves for the ebner glands

222
Q

fungiform papillae look like

A

very round and budded
- thick all over since no keratin

223
Q

parotid gland looks like

A

hella granules

224
Q

submandibular gland looks like

A

lots of demilunes since white and pink mixed

225
Q

sublingual looks like

A

very white since mucousy

226
Q

melanocytes look like

A

little brown/red spots in basal mem layer (rugae)

227
Q

langerhans cells look like

A

very dark brown all over the pegs

228
Q

alveolar mucosa looks like

A

very thick top part since no keratin

229
Q

gingiva looks like

A

very thin with a keratin layer

D1 BS1 + II/ FSI + II (12 decks)

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