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Dentistry Year 1 > David Dixon > Flashcards

David Dixon Flashcards

1
Q

What type of muscles are muscles of mastication

A

Skeletal

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2
Q

What are the muscles of mastication

4

A

Masseter
Temporalis
Lateral pterygoid
Medial pterygoid

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3
Q

What are the origin and inserstions of massater

A

Origin
Superficial head- zygomatic process of maxilla, anterior zygomatic arch
Deep head- posterior zygomatic arch

Insertion
Superficial head- angle on lateral surface of mandible
Deep head- upper half of ramus

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4
Q

What is the function of the massater

A

Elevates mandible

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5
Q

Which nerve supplies massater

A

Mandibular branch of trigeminal nerve

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6
Q

Where does temporalis originate and insert

A

Originate at temporal gods and deep surface of temporal fascia

Inserts onto coronoid process

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7
Q

What is the function of temporalis

A

Elevates and retrudes mandible

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8
Q

What nerve innervates temporalis

A

Mandibular branch of trigeminal nerve

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9
Q

What are the origins and insertions of lateral pterygoid muscle

A

Origin
Superior head- greater wing of sphenoid
Inferior head- lateral surface of lateral pterygoid plates

Insertion
Pterygoid fovea of condyle

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10
Q

What is the function of the lateral pterygoid

A

Depress mandible

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11
Q

What innervates lateral pterygoid muscle

A

Mandibular branch of trigeminal nerve

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12
Q

What is the origin and insertion of medial pterygoid

A

Origin
Deep head- medial surface of lateral pterygoid plate
Superficial head- maxillary tuberosity and pyrimidal process

Insertion
Medial surface of ramus and angle of mandible

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13
Q

What is the function of medial pterygoid muscle

A

Elevates mandible
Protrudes mandible
Side to side movement

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14
Q

What innervates medial pterygoid muscle

A

Mandibular branch of trigeminal nerve

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15
Q

What are the four supra hyoid muscles involved in depression of mandible

A

Digastric- depresses mandible
Stylohyoid- elevates hyoid bone
Mylohyoid- forms floor of mouth
Geniohyoid- protracts and elevates hyoid bone or depresses mandible

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16
Q

What’s are the types of oral mucosa

3

A

Lining
Masticatory
Specialised

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17
Q

What are the layers of oral mucosa

A

Oral epithelium
Basement membrane
Lamina propria (papillary and reticular layer)
Submucosa

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18
Q

What are the layers of skin

A

Epidermis
Basement membrane
Dermis (papillary layer and reticular layer)
Hypodermis

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19
Q

What are the zones of oral mucosa epithelium as they differentiate
4

A

Basal layer
Stratum spinosum/prickle layer
Stratum granulosum
Keratinised layer

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20
Q

What shape are the cells of oral mucosa from proliferation to differentiation

A

Cuboidal to squamous

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21
Q

What is the difference between ortho and parakeratinised epithelium

A

Ortho keratinised have complete keratinisation

Parakeratinised are in an intermediate stage of keratinisation

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22
Q

What percentage of mucosa is lining mucosa

A

60%

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23
Q

What percentage of mucosa is masticatory mucosa

A

25%

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24
Q

What are epithelial cytokeratins

How many cytokeratins do each epithelial cell contain

A

Keratin proteins found in the intracytoplasmic cytoskeleton of epithelial tissues

At least 2, one from each family

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25
Q

What substance is used in histopathology to characterise epithelial tissues

A

Pan cytokeratin antibodies

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26
Q

What are desmosomes

A

Inter epithelial cell adhesion sites

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27
Q

What are desmosomes made of

A

Cell adhesion molecules with linking proteins attaching them to cytoskeleton

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28
Q

What are hemidesmosomes

A

Sites connecting basal epithelial cells to basement membrane

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29
Q

Where can keratinised lining mucosa be found

1

A

Vermillion

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30
Q

Where is non keratinised lining mucosa found

6

A 
Soft palate
Ventral tongue 
Floor of mouth
Alveolar mucosa 
Labial mucosa
Buccaneers mucosa
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31
Q

Where is keratinised masticatory mucosa found

2

A

Gingivae

Hard palate

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32
Q

Where is keratinised specialised mucosa found

1

A

Dorsum of tongue

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33
Q

Where can non keratinised specialised mucosa be found

2

A

Junctional epithelium

Saliva duct lining

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34
Q

Name the types of gustatory epithelium

4

A

Circumvalate
Fungiform
Filiform
Foliate

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35
Q

Where are melanocytes found and what is there function

A

Basal layer

Synthesis of melanin and transfer to keratinocytes

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36
Q

Where are langerhans cells located and what is their function

A

Suprabasal layers

Traps and processes antigens

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37
Q

Where are merkel cells located and what is it’s function

A

Basal layer

Tactile sense

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38
Q

Where are lymphocytes found in the epithelial layer and what is it’s function

A

Variable location

Inflammation response

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39
Q

Define acute inflammation

A

The initial response taking place minutes to hours following injuries

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40
Q

Define chronic inflammation

A

Persistent inflammation alongside attempts at healing which can go on months to years

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41
Q

Functions of acute inflammation

3

A

Carries proteins, fluid and cells from local blood vessel to damaged area
Destroys causative agent of inflammation
Removes damaged tissue

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42
Q

What are the cardinal signs of inflammation

5

A 
Heat
Redness
Swelling 
Pain
Loss of function
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43
Q

What are the stages of accuse inflammation

4

A

Tissue damage
Release of inflammatory mediators
Vascular changes
Exudate formation

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44
Q

What vascular changes do inflammatory mediators cause

A

Shorten diameter of endothelial cells creating gaps and cause CAM expression increasing permeability

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45
Q

What do cell adhesion molecules facilitate

A

Margination

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46
Q

After leukocytes migrate out of vessels between endothelial cells how are they attracted to inflammation site

A

Chemotaxis

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47
Q

What cell adhesion molecules are part of the immunoglobulin supergene family and where are they found
3

A

Intercellular adhesion molecule 1-endothelial cells
Intercellular adhesion molecule 2-endothelial cells
Vascular cell adhesion molecule 1- endothelial cells

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48
Q

What cell adhesion molecules are part of the selectin family and where are they found
3

A

E selectin- endothelial cells
P selectin- endothelial cells
L selectin- leukocytes

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49
Q

Which cell adhesion molecules are part of the integrin family and where are they found
1

A

Alpha 2 integrins- leukocytes

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50
Q

What is inflammatory exudate made up of

3

A

Cells
Proteins
Serum

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51
Q

What type of cells are found in inflammatory exudate in acute and chronic inflammation

A

Accute- neutrophils
Chronic- monocytes, macrophages, lymphocytes

Occasionally erythrocytes

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52
Q

Define respiratory burst

A

A rapid release of oxygen species by neutrophils and monocytes on contact with pathogens, to aid degredation of bacteria, fungi and other matter

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53
Q

What serum proteins can be found in inflammatory exudate

4

A

Albumin
Fibrinogen
Immunoglobulin
Complement proteins

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54
Q

What is pus

A

An inflammatory exudate rich in neutrophils, some of which are dying through auto digestion of their own enzymes alongside bacterial debris

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55
Q

What does the left coronary artery divide into

A

Circumflex coronary artery

Left anterior descending coronary artery

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56
Q

Define cardiac output

What is the average cardiac output

A

Total amount of blood pumped from one ventricle per minute

5000ml per min

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57
Q

Define stroke volume

What is the average stroke volume

A

Volume of blood pumped out of one ventricle during one systole
70-80ml per beat

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58
Q

What is the equation for cardiac output

A

CO = SV x HR

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59
Q

Define compliance

A

A description of how easily a chamber of the heart or lumen of blood vessel expands when it is filled with a volume of blood

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60
Q

What is the equation for compliance

A

🔼V (change in vol) / 🔼P (change in pressure)

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61
Q

What is preload

What is afterload

A

Preload is amount of stretch of cardiomyocytes during diastole

Afterload is amount of resistance heart must pump against when ejecting blood during systole

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62
Q

What is the action of the baroreceptor reflex when blood pressure increases

A

Detected by baroreceptors in carotid sinuses and aortic arch, relayed to cardiac centre in medulla oblongata
Increases parasympathetic and decreases sympathetic stimulation to decrease heart rate and stroke volume
Vasomotor center decreases sympathetic stimulation of blood vessel causing vasodilation to decrease peripheral resistance

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63
Q

What is the action of the baroreceptor reflex when blood pressure decreases

A

Detected by baroreceptors in carotid sinuses and arch of aorta and relayed to cardiac center to inhibit baroreceptor reflex
Increase in sympathetic stimulation and decreases parasympathetic stimulation to increase heart rate and stroke volume
Vasomotor centre increases sympathetic stimulation to cause vasoconstriction of blood vessels which increases peripheral resistance

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64
Q

What is chronotrophy

A

Alterations in heart rate

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65
Q

What is ionotrophy

A

Alterations in force of contraction

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66
Q

What happens when B1 adrenoceptors stimulated

Where are they located

A

Increases heart rate via SAN
Increases force of contraction

Found on cardiac muscle

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67
Q

What happens when B2 adrenoceptors stimulated

Where are they located

A

Arteriolar relaxation
Increases blood flow

Found on arterioles of coronary circulation

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68
Q

What happens when a1 receptors stimulated

A

Arteriolar construction

Increased resistance

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69
Q

What happens when M2 mACh receptors stimulated

Where are they located

A

Decrease heart rate via AVN

Found on cardiac muscle

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70
Q

What is starlings law

A

The more the heart fills the stronger the force of contraction based on the length tension relationship of ventricular cardiac muscle as preload is increased so cardiac output is overall increased

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71
Q

What is the length of cardiac cycle in normal adult

A

O.7-0.8 seconds

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72
Q

What does a phonocardiogram show

A

Valves opening and closing

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73
Q

What are the three heart sounds and what causes them

A

S1 = lub: closing of atrioventricular valve

S2 = dub: closing of semilunar valves

S3 = sound of blood flowing into aorta or sloshing back and forth in ventricle

74
Q

How many action potentials are produced by SAN per minute

A

60-100

75
Q

What are the phases of cardiac action potential

4

A

Depolarisation
Plateau
Repolarisation
Resting

76
Q

What occurs during depolarisation of cardiac action potential

A

Voltage gated sodium channels open and some voltage gated calcium channels open

77
Q

What happens during plateau of cardiac action potential

A

Voltage gated sodium channels close and voltage gated calcium channels open

78
Q

What happens during repolarisation of cardiac action potential

A

Voltage gated potassium channels open and voltage gated calcium channels close

79
Q

What happens during resting phase of cardiac action potential

A

Voltage gated sodium channels and voltage gated calcium channels closed and voltage gated potassium channels open

80
Q

What are the stages of electrical conduction in heart

A

SAN generates action potential
Action potential spreads through Atria to AVN
Action potential delayed at AVN allowing atrial contraction and ventricular filling
Impulse from AVN travels down ventricular septum via bundle of his
Impulse dispersed through myocardium via purkinje fibres
Remaining ventricular cells contract due to spread of impulse via cell gap junctions

81
Q

What does the p wave of ECG show

A

Atrial depolarisation and contraction

82
Q

What does PR interval represent

A

Impulse in AVN node spanning from onset of atrial contraction to beginning of ventricular contraction

83
Q

What does QRS complex of ECG show

A

Ventricular depolarisation and contraction

84
Q

What does ST segment of ECG represent

A

Entire ventricle depolarisation

85
Q

What does the Twave of ECG show

A

Ventricular repolarisation and relaxation

86
Q

How much ventricular filling does atrial contraction cause

A

10-30%

87
Q

What is end diastolic volume

A

Volume of blood in ventricles at end of diastole

88
Q

Why does volume of ventricles not change at beginning of ventricular systole

What does isovolumetric mean in relation to this

A

Both atrioventricular and semilunar valves closed

Ventricles contracts with no corresponding volume change

89
Q

What is end systolic volume

A

Blood remaining in ventricle after systole

90
Q

What is an arrhythmia

A

Irregularities of heart beat

91
Q

What causes atrial fibrillation
How common is atrial fibrillation
How does atrial fibrillation preset clinically

A

Electric impulses from SAN overwhelmed by other disorganised electrical impulses
Present in 1% population

Palpitations, fainting, chest pain, thrombus formation

92
Q

What causes ventricular fibrillation and what does this result in

A

Hypoxic myocardium creates irritable myocardial cells that act as additional pacemakers causing muscles to twitch instead of pump

Ventricular contraction uncoordinated so blood pumped inefficiently leading to cardiac arrest

93
Q

What are the pressures in the heart chambers

A 
Vena cava - 13/8
RA- 13/8
RV- 30/8
Pulmonary artery- 30/17
Pulmonary vein- 18/12
LA- 17/12
LV- 120/10
Aorta - 120/70
94
Q

What is a ligand

A

A molecule that binds onto a receptor to transmit signal within or between cells

95
Q

Define phosphorylation

A

Addition of phosphate group to switch mechanisms on or off

96
Q

What is kinase

A

An enzyme that catalysed phosphorylation

97
Q

What is a cytokine

A

Any cell signaling molecule of the immune system

98
Q

What are autocrine hormones

A

Hormones that have effect on the cell by which it is secreted

99
Q

What are paracrine hormones

A

Hormones that only effect cells nearby to the gland secreting it

100
Q

What are the domains of receptors called

3

A

Extra cellular/ligand binding domain
Trans membrane spanning domain
Intercellular domain

101
Q

What is the intercellular signalling cascade

A

The sequential activation of proteins inside cell until message reaches its final destination leading to response

102
Q

What are the 4receptor families

A

Ion channel
G protein coupled receptors
Enzyme linked receptors
Intracellular receptors

103
Q

What is the G protein and what does it do

A

Guanosine di phosphate

Activates enzyme subunit

104
Q

Which receptors detect tastants

What receptor family are they from

A

Taste receptors on taste cells in taste buds

Ion channels
G protein coupled receptors

105
Q

What type of receptors detect pain ( noxious stimuli and pressure)
What receptor family are these from

A

Pressure and proprioception receptors
Ion channel
G protein coupled receptors

106
Q

What are the concentrations of potassium and sodium across membrane at resting potential

A

Potassium 20 times more concentrated in cytosol

Sodium 10 times more concentrated in extra cellular fluid

107
Q

What value is resting potential

A

-70mV

108
Q

How many sodium’s and potassium’s does the sodium potassium pump transport

A

3 sodium’s out for every 2 potassium’s in

109
Q

What happens during the initial phase of depolarisation

A

Resting potential to +40mV as vaultage gated sodium channels open

110
Q

What happens during repolarisation

A

Charge returns to resting potential as sodium channels close and potassium channels open and potassium moves out

111
Q

What happens during hyperpolarisation

A

Slowly recovering overshoot of resting potential by sodium potassium pump

112
Q

How long from stimulus to AP

How long from Stimulus to resting state

A

Less than 1ms

5ms

113
Q

What effect does pulpal inflammation have on neurones

A

Increases excitability of primary afferent neurones

Increases sodium ion channels

114
Q

What are the teeth fibre types and what do the detect

3

A

A beta fibres - sharp pain
A delta fibres - sharp pain
C fibres - dull pain

115
Q

Compare size and mylination of the teeth fibre types

A

A beta
5-12 micrometers, myelinated

A delta
2-5 micrometers, mylinated

C fibres
0.3-1.2 micrometers, unmyelinated

116
Q

What is the clinical name of local anaesthetic used by dentists and how does it act

A

Lidocaine

Inhibits influx of sodium ions through voltage gated sodium ion channels so AP not generated and propagation inhibited

117
Q

What is the granular layer of tomes

A

A narrow layer of granular/inter globular unmineralised dentine found in root dentine Adjacent to cementum

118
Q

What is the mineral inorganic component of dentine

A

Hydroxyapatite

119
Q

What does the organic matrix component of dentine consist of

2

A

Collagen- primarily type 1

Non collagenous proteins

120
Q

What is the cellular component of dentine

A

Odontoblasts

121
Q

What is predentine
How thick is it
Where is it thickest

A

An unmineralised layer of dentine containing collagen, glycoproteins and proteoglycans which is 10-50 micrometers thick
Thickest where dentinogenisis occurring

122
Q

What percentage mineralised is dentine

A

70%

123
Q

How thick are dentine tubules from pulp to amelodentine junction

A

2.5 to 0.9 micrometers

124
Q

What are lines of Owen

A

Changes in colour of dentine representing changes in mineralisation through development of tooth

125
Q

What type of tissue is pulp

A

Soft connective tissue

126
Q

What are odontoblasts joined by

A

Gap junctions

127
Q

What are dentine tubules lined by

A

An organic sheath Called lamina limitans

128
Q

What are the components of dentines organic matrix

4

A

Collagen
Non collagenous proteins
Lipids
Proteoglycans

129
Q

What percentage of dentines organic matrix is collagen, what type

A

90% type 1 primarily

130
Q

What percentage of dentines organic matrix is non collagenous proteins
Give examples of non collagenous proteins in dentine
2

A

10%

Dentine phosphoprotein
Dentine sialoprotein

131
Q

What is the difference between hydroxyapatite Cristals found in dentine and enamel

A

Crystals smaller in dentine and found on and between collagen fibrils of organic matrix rather than in prisms

132
Q

What are the pulp zones moving inward

4

A

Odontoblast zone
Cell free zone of Weil
Cell rich zone
Pulp core

133
Q

What is pulp composed of with percentages

3

A

75% water
25% organic matrix
1% inorganic material

134
Q

What is in the organic matrix of pulp

3

A 
Collagen type 1 and 3
Fibronectin
Ground substance (proteoglycans and glycosaminoclycans)
135
Q

What are the most common pulp cells
Where are they located
What is their function

A

Fibroblasts
Found in cell rich zone of coronal portion
Form and maintain pulp matrix and synthesise cytokines

136
Q

How does blood enter pulp

A

Apical foremen

137
Q

Where do arteries terminate in pulp

A

Sub odontoblastic capillary plexus in cell free zone

138
Q

Where are cell bodies of pulp neurones located and where do pulp neurones terminate

A

Trigeminal ganglion

Dorsal horn of medulla

139
Q

What to branching afferent axons of pulp form and where is this structure located

A

Branching afferent axons form subodontoblastic plexus of Roshkow in cell free zone

140
Q

What percentage of axons terminate in coronal and radicular pulp

A

90% terminate in coronal pulp

10% terminate in radicular pulp

141
Q

What percentage of nerve fibres in pulp are A delta, A beta and c fibres

A

A delta = 22%
A beta = 4%
C fibres = 75%

142
Q

What makes up the gingival attachment appuratus

3

A

Cementum
Periodontal ligament
Alveolar bone

143
Q

What is the appearance of bundle bone and what is it capable of

A

Linear appearance

Capable of turning over and remodelling

144
Q

What are the functions of periodontal ligament

4

A

Support
Remideling
Sensory
Nutritive

145
Q

What are the types of cementum and where are they located

4

A

Acellular located at cervical 1/3
Cellular located at apical1/3 and furcations
Mixed found at apical 1/3 and furcations
Acellular afibrillar found close to CEJ

146
Q

What fibre type is acellular cementum and what is it’s function

A

Extrinsic

Anchorage

147
Q

What fibre type is cellular cementum and what is it’s function

A

Intrinsic

Functional adaptation and repair

148
Q

What fibre type is mixed cementum and what is it’s role

A

Extrinsic and intrinsic

Functional adaptation

149
Q

What is the role of acellular afibrillar cementum

A

Unknown

150
Q

What are the canals of cellular cementum cementocytes called

A

Canuliculi

151
Q

What is the role of canuliculi and what direction do they face

A

Canals for nutrients to cementum, point towards periodontal ligament

152
Q

What are the three forms of cemento enamel junction and what are their prevalancies

A

Gap - 5-10%
Edge to edge- 30%
Overlap- 60-65%

153
Q

What is a gap CEJ linked to

A

Hypersensitivity

154
Q

Where do the inner and outer cortical plates of alveolar bone face

A

Inner cortical plates face tongue

Outer cortical plates face cheek

155
Q

What is the central spongiosa of alveolar bone filled with

A

Yellow marrow

156
Q

What structure line’s alveolus

A

Bundle bone

157
Q

Where is periodontal ligament thinnest

A

Middle 1/3 of root

158
Q

What fibres run through periodontal ligament from cementum to alveolar bone, what direction do they run

A

Collagen fibres run transversely

159
Q

What fibres run perpendicularly to collagen fibres along periodontal ligament

A

Oxytalan elastin fibres

160
Q

What components make up the organic matrix of periodontal ligament
4

A

Collagen- primarily type 1
Proteoglycans
Glycoproteins
Oxytalan elastic fibres

161
Q

What are the names of the types of sharpeys fibres

5

A 
Alveolar crest fibres 
Horizontal fibres
Oblique fibres
Peri apical fibres
Inter radicular fibres
162
Q

What is the path of blood supply to periodontal ligament

A

Origionates from
Periodontium, alveolus, adjacent periosteum

Blood passes in coronal direction

Vessels terminate in
Dento gingival plexus, sub capillary loops

163
Q

Which lymph nodes does lymph from periodontal ligament drain into
2

Where do these drain

A

Sub mental lymph nodes
Submandibular lymph nodes

Deep cervical chain of lymph nodes

164
Q

What dental cement is composed of zinc oxide and polyacrylic acid

A

Zinc polycarboxylate cement

165
Q

Which dental cement is composed of polyacrylic acid and allumino silicate glass

A

Glass ionomer cement

166
Q

What dental cement is composed of phosphoric acid and alumino silicate glass

A

Silicate cement

167
Q

What dental cement is composed of zinc oxide and phosphoric acid

A

Zinc phosphate

168
Q

What is in the liquid component of glass ionomer cement

3

A

Polyacrylic acid
Tartic acid
Water

169
Q

What is in the powder component of glass ionomer cement

A

Aluminium fluorosilicate glass particles

170
Q

What is the role of polyacrylic acid in glass ionomer cement
2

A

Decrease viscosity

Reduce gelato on

171
Q

What is the role of tartic acid in glass ionomer cement

5

A 
Increases working time
Increases translucency 
Improves handling 
Decreases viscosity 
Lengthens shelf life
172
Q

What are the uses of glass ionomer cement

A 
Temporary restorations
Paediatric restoration 
Lining
Base 
Luting
173
Q

What are the three phases of the acid base setting reaction of GIC

A

Dissolution- silica gel ring on aluminium fluorosilicate particles breaks down and ions released from glass

Gelation- cross linking of polyacrylic acid molecules due to presence of calcium ions

Hardening- cross linking of polyacrylic acid molecules due to presence of aluminium ions

174
Q

What are the advantages of GIC

8

A

Versitile
Aesthetically pleasing
Anticariogenic A’s has fluoride release
Can bond chemically and directly to enamel and dentine
Radiopaque
Compatible with other materials
Biocompatible as polyacrylic acid can’t penetrate into dentine tubules
Adhesive strength greater than cohesive strength

175
Q

What are the disadvantages of GIC

6

A 
Limited working time
Long setting time
Prone to wear
Early water soulubility
Mild pulpal toxicity 
Can crack
176
Q

What is the liquid component of RMGIC

3

A

Polyacrylic acid
Hydroxyethymethacrylate resin HEMA
Water

177
Q

What is the solid component of RMGIC

A

Fluoroaluminosilicate glass particles

178
Q

What are the advantages of RMGIC over GIC

4

A

Stronger
Stronger bonding strength
Longer working time
Shorter setting time

179
Q

What are compomers composed of

5

A 
Fluoroaluminosilicate glass
Dimethacrylate monomer
Photoinitiator
Special resin containing carboxyl groups
Hydrophilic monomer
180
Q

What is the setting reaction of compomers

2 phases

A

Phase 1
Polymerisation forms 3D network of acid copolymer

Phase 2
Water uptake initiates acid base reaction between carboxyl group on copolymer and acid souluble glass, leading to fluoride release

181
Q

What are the uses for compomers

3

A

Linings
Bases
Permanent and temporary restoration

182
Q

Properties of compomer

4

A

Anticariogenic due to fluoride release
Can’t bond chemically to enamel or dentine
Polymerisation shrinkage
Worse mechanical properties than composite but better than GICs and RMGIC

Dentistry Year 1 (5 decks)

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