Digestive System Disorders Continuation

Question 1

Caries

Answer 1

Streptococcus mutans—initiating microbe
Lactobacillus follows in large numbers.
Bacteria break down sugars and produce large quantities of lactic acid.
Lactic acid dissolves mineral in tooth enamel
Tooth erosion and caries formation
Caries is promoted by frequent intake of sugars and acids.

Fluoride—anticaries treatment

Question 2

Gingivitis

Answer 2

Changes in the gingivae may be a local or systemic problem.

Inflammation of the gingiva

Tissue becomes red, soft, swollen, bleeds easily

May be a result of accumulated plaque
Inadequate oral hygiene

Toothbrush trauma

Results from improper or excessive brushing

Creates extensive grooving on tooth surface
Increase plaque retention and damage to gingivae

Question 3

Periodontal disease

Answer 3

Infection and damage to the periodontal ligament and bone
Predisposing condition is gingivitis
Caused by microorganisms as a result of poor dental hygiene
Subsequent loss of teeth possible
Several categories, depending on degree of disease
May be aggravated by systemic disease and medications that reduce salivary secretions

Question 4

Periodontitis occurs when organisms enter the

Answer 4

gingival blood vessels and travel to the connective tissues and bone of the dental arch.
Resorption of bone and loss of ligament fibers result in weakened attachment of teeth.
May result in total loss of tooth from socket
Treated by antimicrobials, local surgery of gingiva, and improved dental hygiene

Question 5

Hyperkeratosis

Answer 5

a condition that causes your skin to thicken in certain places.

Leukoplakia (example)

Whitish plaque or epidermal thickening of mucosa

Occurs on buccal mucosa, palate, lower lip

May be related to smoking or chronic irritation
Lesions require monitoring.

Epithelial dysplasia beneath plaque may develop into squamous cell carcinoma.

Question 6

Hyperkeratosis occurs on

Answer 6

buccal mucosa, palate, lower lip

Question 7

Hyperkeratosis may be related to

Answer 7

smoking or chronic irritation

Question 8

Leukoplakia of the Tongue

Answer 8

a condition that causes white, gray, or red patches to appear in the mouth, including on the tongue. These patches are thickened, can’t be scraped off, and are usually painless. They can appear flat or slightly raised, and may be smooth, rough, fuzzy, or ridged

Question 9

Squamous cell carcinoma (common type)
(Cancer of the Oral Cavity)

Answer 9

Often develops in persons older than 40 years

Smokers, preexisting leukoplakia, alcohol abuse

Floor of the mouth, lateral borders of the tongue

Multiple lesions possible

Kaposi sarcoma in patients with AIDS
Lip cancer has a better prognosis.
Common in smokers, particularly pipe smokers

Question 10

Salivary Gland Disorders

Answer 10

Sialadenitis
Inflammation of the salivary glands
May be infectious or noninfectious

Most commonly affected—parotid gland

Mumps—infectious parotitis
Viral infection
Vaccine available

Noninfectious parotitis
Often seen in older adults who lack adequate fluid intake and mouth care

Most malignant tumor of salivary glands is mucoepidermoid carcinoma

Question 11

Most malignant tumor of salivary glands

Answer 11

mucoepidermoid carcinoma

Question 12

Mumps with Unilateral Swelling

Answer 12

The most common symptom of mumps is swelling of the parotid glands, which can occur unilaterally or bilaterally.

Question 13

Dysphagia

Answer 13

Difficulty swallowing

Causes by
Neurological deficit
Muscular disorder
Mechanical obstruction

Results and presentation
Pain with swallowing
Inability to swallow larger pieces of solid material
Difficulty swallowing liquids

Question 14

Neurological deficit that causes Dysphagia

Answer 14

Infection
Stroke
Brain damage

Achalasia
Failure of the lower esophageal sphincter to relax because of lack of innervation

Question 15

Achalasia

Answer 15

Failure of the lower esophageal sphincter to relax because of lack of innervation

Question 16

Mechanical obstruction

Answer 16

Congenital atresia
Developmental anomaly
Upper and lower esophageal segments are separated.

Stenosis
Narrowing of the esophagus
May be developmental or acquired
May be secondary to fibrosis, chronic inflammation, ulceration, radiation therapy
Stenosis or stricture may also result from scar tissue
May require treatment with repeated mechanical dilation

Question 17

Mechanical obstruction (Cont.)

Answer 17

Esophageal diverticula
Outpouchings of the esophageal wall
Congenital or acquired following inflammation
Causes irritation, inflammation, scar tissue
Signs include dysphagia, foul breath, chronic cough, hoarseness

Tumors
May be internal or external

Question 18

Esophageal Cancer

Answer 18

Primarily squamous cell carcinoma
Usually in distal esophagus
Significant dysphagia in later stages
Poor prognosis because of late manifestations

Associated with chronic irritation because of:
Chronic esophagitis
Achalasia
Hiatal hernia
Alcohol abuse, smoking

Question 19

Hiatal Hernia (1 of 2)

Answer 19

Part of the stomach protrudes into the thoracic cavity.

Sliding hernia
More common type
Portions of the stomach and gastroesophageal junction slide up above the diaphragm.

Rolling or paraesophageal hernia
Part of the fundus of the stomach moves up through an enlarged or weak hiatus in the diaphragm and may become trapped.