Chapter 25: The Head and Neck - Oral Cavity

Question 1

Vesicles often found on lips/oral mucosa that rupture and form shallow, painful ulcers that form as a result of “ballooning degeneration” of epithelial cells contain
______ within squamous cells seen on biopsy. This description is associated with what infection?

Answer 1

1) intranuclear viral inclusions

2) Herpes simplex virus type 1

Question 2

Where does HSV1 remain dormant? What reactivates the virus?

Answer 2

1) trigeminal ganglion

2) stress (trauma, allergy, menstruation, pregnancy, UV light exposure, other viral infections etc)

Question 3

Name 2 other names for Candidiasis. Where does it inhabit? Who is commonly infected? What do candidal lesions look like?

Answer 3

1) thrush or moniliasis
2) oral cavity, GI tract, vagina
3) immunocompromised (especially those w/AIDS) and diabetics
4) white, slightly elevated soft patches w/fungal hyphae

Question 4

Ludwig angina is a rapidly spreading ______ due to __aerobic?anaerobic?__ bacteria most commonly the result of ________.

Answer 4

1) cellulitis
2) both aerobic and anaerobic!
3) dental extraction or trauma to the floor of the mouth

Question 5

What’s a fancy name for canker sores? How would you describe the lesions? Do they heal?

Answer 5

1) Aphthous stomatitis
2) Painful, recurrent small ulcers of the oral mucosa; ulcers covered by fibropurulent exudate
3) They heal spontaneously without scar formation

Question 6

______ results from persistent cystic dilatation of thyroglossal duct midline in the neck that causes sore throat and awareness of a mass. Most common location is at the foramen cecum of the tongue.

Answer 6

Thyroglossal duct cyst

Question 7

The term used to describe an acute necrotizing ulcerative gingivitis caused by two symbolic organisms is ________. When it’s severe it’s called _______ and causes rapid gangrene of oral and facial tissue, leaving the bone exposed

Answer 7

1) fusospirochetosis

2) Noma (cancrum oris)

Question 8

Describe the lesions involved with a Borrelia vincentii infection. Who is at risk?

Answer 8

1) Lesions are punched-out erosions of inter-dental papillae that spread to involve all gingival margins which become covered by a necrotic pseudomembrane
2) People with inadequate nutrition, immunodeficiency or poor oral hygiene

Question 9

Name the several factors that are responsible for the formation of dental caries

Answer 9

1) Bacteria such as Streptococcus mutans (form dental plaques)
2) Saliva (or lack thereof, causing xerostomia)
3) Dietary Factors (soft and refined foods stick to teeth/require less chewing)
4) Fluoride (forms fluorapatite on the enamel which protects teeth from acid)

Question 10

_______ begin with disintegration of enamel prisms after decalcification of the interprismatic substance, leading to accumulation of debris and microorganisms.

Answer 10

Dental caries

Question 11

What happens to dentin when someone presents with dental caries?

Answer 11

Debris/microorganisms penetrates dentin along dentinal tubules and forms a substantial cavity in the dentin with a narrow orifice. Dentin is then decalcified.

Question 12

_______ describes an acute or chronic disorder of the soft tissues around the teeth which can lead to loss of supporting bone. Chronic type causes loss of more teeth in adults than does any other disease. Who is prone to this disease?

Answer 12

1) Periodontal disease
2) Both those with poor oral hygiene and people w/impeccable habits but with a strong family history of periodontal disease

Question 13

Name of the most common tumor of epithelial odontogenic origin. Are they fast or slow growing? What is characteristic on radiographic appearance?

Answer 13

1) Ameloblastoma
2) Slow growing
3) On x-ray, show a “soap bubble” appearance

Question 14

Describe the histological appearance of an Ameloblastoma

Answer 14

They resemble the enamel organ in its various stages of differentiation; commonly seen as islands of odontogenic epithelium with central stellate reticulum-like area and basal cells with a “picket fence” appearance.

Question 15

________ describes asymptomatic white lesions on the surface of mucous membranes which cannot be scraped away with a tongue depressor. Name some risk factors. Are these premalignant?

Answer 15

1) Leukoplakia
2) Tobacco use, alcoholism and local irritation
3) Not necessarily, though 10-12% are at risk for squamous cell carcinoma

Question 16

What is another name for a pyogenic granuloma? Why is the name a misnomer (ie, what do pyogenic granulomas actually look like?)

Answer 16

1) Lobular capillary hemangioma
2) Misnomer b/c it’s neither infectious nor granulomatous. Looks like soft elevated red/purple smooth ulcerated surfaces in the oral cavity, with lots of vascular proliferation arranged in lobules.