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Oral Pathology > Ch 1 > Flashcards

Ch 1 Flashcards

1
Q

Define Pathology

A

Pathology is a branch of natural science which is concerned with the search for the cause and mechanism of disease.

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2
Q

Define Disease

A
  • The alteration of the state of the human body or some of its organs which interrupt the performance of the organs or parts of the body.
  • A disease will have a group of symptoms peculiar to it which will set it apart from all other diseases as an abnormal entity.
  • Causes of disease can be because of a malformation or an organ or structure, or because of the presence of microorganisms, physical or thermal injury, or lack of oxygen.
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3
Q

Define Etiology

A

-The study of the cause of a disease. The cause may be endogenous (an injury within the cell, such as genetic problems) or its may be exogenous (caused by an agent outside the cell, such as a chemical, trauma, lack of oxygen, nutrition, or bacteria).

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4
Q

4 Parts of Etiology

A

Hereditary – genetic defect

Congenital – present at birth, not necessarily hereditary

Idiopathic – don’t know why the disease occurred

Iatrogenic – cause by a clinician (intentionally or unintentionally)

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5
Q

Pathogenisis

A

Origination and development of disease

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6
Q

Diagnosis

A

The term denoting the name of the disease a person is believed to have. This is valuable in order to provide a basis for treatment and the prognosis.

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7
Q

Signs

A

-The objective evidence or manifestation of an illness or dysfunction in the body detected by someone other than the individual affected by the disease. -Usually they are definite and obvious.

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8
Q

Symptoms

A

-Any perceptible change in the body or its functions that indicates disease. -This phenomenon is experienced by the individual affected by the disease. -Frequently, they are considered subjective in nature, while signs are objective.

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9
Q

Prognosis

A

Outcome of disease

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10
Q

Differential Diagnosis

A

Diagnosis based on a comparison of two or more similar diseases to determine which the patient is suffering from.

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11
Q

Oral Pathology

A

Deals with diseases affecting the oral areas, teeth, adjacent tissues, oral mucosa, and contiguous parts.

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12
Q

Descriptive Terminology

A

Clinical appearance

Consistency

Color

Size

Surface texture

Radiographic terms (if applicable)

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13
Q

Bulla

A

A circumscribed elevated lesion that is more than 5mm in diameter. Usually contains serous fluid, and looks like a blister. Circumscribed means confined to a limited area.

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14
Q

Lobule

A
  • A segment or lobe that is part of a whole
  • Lobules can appear fused together
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15
Q

Macule

A
  • An area that is usually distinguished by a color different from that of the surrounding tissue.
  • It is flat and does not protrude above the surface of the normal tissue.

•A freckle or birthmark are examples of a macule.

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16
Q

Papule

A
  • A small, circumscribed lesion usually less than 1cm in diameter.
  • It is elevated or protrudes above the surface of normal surrounding tissue
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17
Q

Vesicle

A

•A small, elevated lesion less than 1cm in diameter that contains serous fluid.

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18
Q

Pedunculated

A

•Attached by a stem-like or stalk-like base similar to that of a mushroom.

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19
Q

Sessile

A

•Describing the base of a lesion that is flat or broad instead of stem-like.

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20
Q

Nodule

A
  • A palpable, solid lesion up to 1cm in diameter found in soft tissue.
  • Can occur above, level with, or beneath the skin surface.
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21
Q

Palpable

A
  • The evaluation of a lesion by feeling it with the fingers to determine the texture of the area.
  • Descriptive terms for palpation are soft, firm, sei-firm, and fluid filled.
  • These terms also describe the consistency of a lesion.
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22
Q

Erythema

A

Abnormal redness of muscoa or gingiva

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23
Q

Pallor

A

Paleness of skin or mucosal tissues

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24
Q

Erythroplakia

A
  • A clinical term used to describe an oral lesion that appears as a smooth, red patch or granular, red and velvety patch.
  • Less common than leukoplakia.
  • 90% of erythroplakias demonstrate epithelial dysplasia or squamous cell carcinoma.
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25
Q

Leukoplakia

A

•A clinical term for a white, plaque-like lesion on the oral mucosa that cannot be rubbed off or diagnosed as a specific disease.

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26
Q

6 Surface Texture Descriptions

A
  • Corrugated – winkled
  • Fissured – a cleft or groove, normal or otherwise, showing prominent depth.
  • Papillary – resembling small, nipple-shaped projections or elevations found in clusters.
  • Smooth
  • Rough
  • Folded
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27
Q

Coalescence

A

•The process by which parts of a whole join together, or fuse, to make one.

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28
Q

Diffuse

A
  • Describes a lesion with borders that are not well defined, making it impossible to detect the exact parameters of the lesion.
  • Can make treatment more difficult and, depending on the biopsy results, more radical.
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29
Q

Multilocular

A
  • Describes a lesion that extends beyond the confines of one distinct area.
  • Defined as many lobes or parts that are somewhat fused together.
  • A multilocular radiolucency is sometimes described as resembling soap bubbles.
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30
Q

Well curcumscribed

A

•Used to describe a lesion with borders that are specifically defined and in which one can clearly see the exact margins and extent.

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31
Q

Clinical Exam

A

Use of the practioners expertise based on a physical exam

This information may be in the form of lab tests (blood and urine samples, examination of cells)

32
Q

Biopsy

A

A tissue sample taken from the diseased area. Various types of biopsies are:

a. Needle biopsy
b. Incisional biopsy – small area of tissue is taken.
c. Excisional biopsy – the entire abnormality or area is removed.

33
Q

Clinical Diagnosis Steps (2)

A

1.) How does the lesion present? Looking:

color, shape, texture, locaiton

2.)Touching (palpating)

34
Q

Historical Diagnosis

A

Coupled with clinical apperance

a. personal and family history
b. History of drug ingestions, for example, tetracycline staining on teeth related to tetracycline ingestion.
c. Past and present medical and dental histories.
d. History of the presenting disease or lesion.

35
Q

Labratory Diagnosis

A

involves clinic or radiographic appearance with laboratory tests like blood chemistries, urinalysis, and cultures.

36
Q

Microscopic Diagnosis

A

Examination of specific cells, appearance of tissue, biopsy.

a. Often the main component of the definitive diagnosis.
b. Adequate tissue sample is necessary.
c. Brush tests can be used to obtain information from oral mucosal epithelium and the results may help determine whether a scalpel biopsy is needed to establish a definitive diagnosis.
d. A white lesion cannot be diagnosed on the basis of clinical appearance alone.

37
Q

Surgical Diagnosis

A

Surgically exposing something identified on a radiograph, or because of another findings, for example, from lab results.

Ex: Traumatic bone cyst

38
Q

Therapeutic Diagnosis

A

Seeing a disorder, without knowing its etiology you treat the symptoms and look for results.

a.Nutritional deficiencies are common conditions to be diagnosed by therapeutic means.

39
Q

Differential Diagnosis

A

A point in the diagnostic process when the practitioner decides which test or procedure is required to rule out the conditions originally suspected and to establish the definitive or final diagnosis.

  • Collect data:
  • Patient’s medical and dental health histories
  • History of lesion
  • Clinical description and evaluation
  • Biopsy and microscopy reports
40
Q

Lysosomes

A

•Lysosomes contain enzymes called lysozymes that are capable of breaking down proteins, carbohydrates, nucleic acids, and function to destroy worn cell parts.

*** Lysozymes are also significant in periodontal destruction.

41
Q

Hypoxia/Anoxia

A

Reduced or lack of oxygen availability

Lack of O2 results in cessation of product

Cell dies

42
Q

Toxic Injury of cell

A

Heavy metals

Drugs/drug overdose

43
Q

cellular injury - microbial pathogens

A
  • Bacteria often produce toxins, which may inhibit various cell functions such as respiration or protein synthesis.
  • Viruses can invade cells and kill from within by disturbing various cellular processes or disrupting the integrity of the nucleus and/or plasma membrane.
  • Viruses can encode the production of foreign proteins and elicit an immune response that kills the cell.
44
Q

cellular injury - mediators of inflammatory and immune rxns

A
  • Mediators such as lymphokines and cytokines or complement proteins, may injure cells in several ways.
  • They are produced to eliminate the infectious agents, but end up killing the body’s own cells too, like we see in periodontal disease.
45
Q

cellular injury - genetic / metabolic

A
  • Many genetic inborn errors of metabolism cause disturbances of intermediate metabolism and subsequent accumulation of toxic metabolites in the cells.
  • Adult metabolic disturbances such as diabetes mellitus cause changes in blood vessels that lead to tissue ischemia (blood supply restriction causing oxygen shortages).
46
Q

cellular adaptation (5)

A
  • Atrophy
  • Hypertrophy
  • Hyperplasia
  • Metaplasia
  • Dysplasia
47
Q

cellular adaptation - Atrophy

A

Decrease in size of cell, tissue, organ in body

48
Q

cellular adaptation - hypertrophy

A

Increase in size of tissues or organs to an enlargement of cells

49
Q

cellular adpatation - hyperplasia

A

Increase in numbers of tissue cells

50
Q

ceullar adpatation - Metaplasia

A

Change from one cell type to another

Ex: smoking

51
Q

cellular adaptation - Dysplasia

A
  • Characterized by a disorderly arrangement of cells and nuclear atypia.
  • Dysplasia may progress to neoplasia.
  • Neoplasm – new and uncontrolled cellular growth.

ex: Cancer

52
Q

cellular degeneration - 3 types

A
  • Cellular Swelling
  • Hydropic or Vacuolar Degeneration
  • Fatty Change
53
Q

cell degeneration - cellular swelling

A

•This type of degeneration used to be known as cloudy (albuminous degeneration). It occurs when water is retained within the cell.

  • Fluid in the cell is not pumped out fast enough
54
Q

cell degeneration - hydropic / vacuolar

A
  • This type of degeneration is more serious.
  • So much water accumulates in a cell that vacuoles (or bubbles) of water are found in the cell when examined under a microscope.
  • This is found with certain kinds of kidney diseases, for example.
  • The endoplasmic reticulum within the cells will appear enlarged or vacuolar.
55
Q

cell degeneration - fatty (lipid) change

A
  • ***This is the most severe form of cellular degeneration.
  • It is reversible, but it implies injury severe enough to lead to cell death.
  • It is the accumulation of fat vacuoles within cells. If there is enough accumulation of fat, the cell may expand and rupture.
  • Fatty bacteria change occurs in cells that are involved with the metabolism of fat or the use of fat for energy, such as the liver, heart, and kidney.
  • The organ (upon autopsy) will have a soft, greasy, yellow appearance. Large accumulations of fat within the cell impairs the function of the cell. If it is severe, the cell alcohol membrane will actually burst.
56
Q

cell necrosis

A

•the injury to a cell is so severe that it can no longer adapt. Necrosis is the morphological changes in tissue caused by cell death. Enzymes cause the necrosis on the dead cell.

57
Q

first part of cell necrosis…

A

•The first occurrence when a cell dies is the destruction and disappearance of the nucleus.

58
Q

4 patterns of cell necrosis

A
  • Coagulative
  • Liquefactive
  • Caseous
  • Enzymatic Fat Necrosis
59
Q

cell necrosis - coagulation

A

•This is the type of necrosis found when there is a lack of oxygen to a cell or tissue (hypoxia) which occurs because of a lack of blood being delivered to the tissue (ischemia).

* Most common pattern of necrosis seen

* Typically involved in solid organs

*Gangrene is a form of necrosis caused by hypoxia and bacterial infection

60
Q

cell necrosis - Liquefaction

A
  • It is the self destruction of a cell by enzymes within the cell (autolysis), the dissolution of tissues occur, and characteristically a bacterial infection was involved in some way.
  • Proteolytic enzymes liquefy the dead cells. There will usually be an accumulation of white blood cells (leukocytes and neutrophils) and an abscess is created. The material found in the abscess is purulent exudate or pus.
  • Liquefaction is found in the nervous system (most commonly the brain). Brain cells lose their contours and are liquefied and become soft and fluid-filled.
61
Q

cell necrosis - Caseous

A
  • This type is a distinct form of necrosis which is typical of a tuberculosis infection. The reaction of cells is known as a granulomatous reaction.
  • The necrotic material would look white, dry, and cheesy (like cream cheese).
  • May possible be found in fungal infections such as histoplasmosis.
62
Q

cell necrosis - Somatic death

A

Death of entire cell

63
Q

Fordyce Granules

A

Clusters of ectopic sebaceous glands.

  • Appear as yellow lobules in clusters.
  • Commonly observed on vermilion border of lips and buccal mucosa.
  • No treatment necessary.
64
Q

Torus Palatinus

A

An exophytic growth of normal compact bone.

  • Observed clinically in the midline of the hard palate.
  • Inherited, gradual formation.
  • Occurs more commonly in women.
  • May take on various shapes and sizes, may be lobulated, and is covered by normal soft tissue.
  • No treatment unless they interfere with speech, swallowing, or a prosthetic appliance.
65
Q

Mandibular Tori

A

Outgrowths of dense bone found on the lingual aspect of the mandible in the area of the premolars above the mylohyoid ridge.

  • Usually bilateral.
  • Often lobulated or nodular.
  • Can appear fused together.
  • Has no predilection for either gender.
  • No treatment necessary unless they interfere with fabrication and placement of a prosthetic appliance.
66
Q

Melanin Pigmentation

A

The pigment that gives color to skin, eyes, hair, mucosa, and gingiva.

•Most commonly observed in darker-skinned individuals.

67
Q

Retrocuspid Papilla

A

A sessile nodule on the gingival margin of the lingual aspect of the mandibular cuspids

68
Q

Lingual Varicosities

A
  • Clinical appearance: red-to-purple enlarged vessels or clusters.
  • Usually observed on the ventral and lateral surfaces of the tongue.
  • Most commonly observed in individuals older than 60 years of age.
  • No treatment required.
69
Q

Leukoedema

A
  • A generalized opalescence on the buccal mucosa.
  • Mostly commonly observed in African Americans.
  • If the mucosa is stretched, the opalescence becomes less prominent.
  • No treatment required.
70
Q

Lingual Thyroid Nodule

A
  • Undescended, trapped remnants of thyroid tissue.
  • Clinical appearance:
  • A mass in the midline of the dorsal surface of the tongue posterior to the circumvallate papillae in the area of the foramen cecum.
  • Usually has a sessile base and is 2cm to 3cm in width.
  • Predilection:
  • Females
  • Linked to hormonal changes
  • Treatment:
  • Evaluation of the patient to determine whether the thyroid gland is present in its normal location.
71
Q

Median Rhomboid Glossitus

A
  • Clinical Appearance:
  • Flat or slightly raised oval or rectangular erythematous area in the center of the tongue.
  • Devoid of filiform papillae (smooth).
  • May be associated with a chronic infection with Candida albicans.
  • No treatment necessary, but antifungal treatment may be used.
72
Q

Geographic Tongue

A
  • Clinical Appearance:
  • Erythematous patches surrounded by a white or yellow border.
  • Diffuse areas devoid of filiform papillae.
  • Distinct presence of fungiform papillae.
  • There appear to be remission and changes in the depapillated areas.
73
Q

Ectopic Geographic Tongue

A

•Term used to describe “geographic tongue” found on mucosal surfaces other than the tongue.

74
Q

Fissured Tongue

A
  • Clinical appearance:
  • The dorsal surface of the tongue appears to have deep fissures or grooves.
  • Cause:
  • Unknown.
  • Probably involves genetic factors.
  • Seen in about 5% of the population.
  • Home care:
  • Patient to brush the tongue gently with a toothbrush.
  • No treatment necessary.
75
Q

White Hairy Tongue

A
  • Clinical Appearance:
  • Elongated filiform papillae are white.
  • Result of either an increase in keratin production or a decrease in normal desquamation.
  • Home care:
  • Patient to brush the tongue gently with a toothbrush to remove debris.
76
Q

Black Hairy Tongue

A
  • Clinical Appearance:
  • Papillae are brown-to-black because of chromogenic bacteria.
  • Contributing Factors:
  • Tobacco
  • Foods
  • Hydrogen peroxide
  • Alcohol
  • Chemical rinses
  • Home care:
  • Patient to brush the tongue gently with a toothbrush to remove debris.

Oral Pathology (1 decks)

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