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Dentistry Year 1 > Ella Elwood > Flashcards

Ella Elwood Flashcards

1
Q

What type of epithelium is junctional epithelium

A

Stratified non keratinised

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2
Q

What type of epithelium is sulcular epithelium

A

Non keratinised stratified squamous

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3
Q

What type of epithelium is free gingiva

A

Keratinised stratified squamous

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4
Q

What type of epithelium is attached gingiva

A

Keratinised stratified squamous

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5
Q

What type of epithelium is lining mucosa

A

Non keratinised stratified squamous

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6
Q

How many basal laminar does junctional epithelium have

A

2 basal laminae, one against tooth and the other against connective tissue

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7
Q

What are properties of sulcular epithelium

2

A

Tooth facing

Distinct lamina propria

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8
Q

What are properties of free gingiva epithelium

3

A

Faces oral cavity
Has stippling
Distinct lamina propria

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9
Q

What are properties of attached gingiva

3

A

Faces oral cavity
Has stippling
Mucoperiosteum

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10
Q

What is the extra cellular matrix of gingival connective tissue composed of
2

A

Collagen fibres

Ground substance

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11
Q

What cells are present in gingival connective tissue

4

A

Fibroblasts
Macrophages
Mast cells
Neutrophils

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12
Q

What is stippling

A

Orange peel like texture due to presence of coarse collagen bundles attaching epithelium of the attached gingiva to underlying alveolar bone

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13
Q

What is the free gingival groove

A

The junction between the free and attached gingiva

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14
Q

What is the mucogingival junction

A

The junction between the attached gingiva and alveolar mucosa

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15
Q

What is transudate and where is it found

A

A filtrate of blood arising from an increased pressure in veins and capillaries that forces fluid through vessel walls against plasma osmotic pressure
Found in clinically healthy gingiva

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16
Q

What is exudate and where is it found

A

A fluid escaping from the intra vascular to extra vascular compartment containing proteins and cellular material in response to inflammation
Found in gingivitis

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17
Q

What is GCF

A

An inflammatory transudate

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18
Q

Which nerve goes through incisive foramen

Which artery goes through incisive foramen

A

Nasopalatine nerve

Sphenopalatine artery

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19
Q

Which nerve goes through greater palatine foramen

Which artery goes through greater palatine foramen

A

Greater palatine nerve

Greater palatine artery

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20
Q

Which nerve goes through lesser palatine foramen

What artery goes through lesser palatine foramen

A

Lesser palatine nerve

Lesser palatine artery

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21
Q

What part of the palate does the greater palatine foramen supply

What part of the palate does the lesser palatine foramen supply

A

Hard palate

Soft palate

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22
Q

What type of muscles make up the soft palate

A

Skeletal muscle

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23
Q

What muscles make up soft palate

4

A

Tensor veli paltini
Levator veli paltini
Palatoglossus
Palatopharyngeus

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24
Q

Inervation and action of tensor veli paltini

A

Mandibular nerve

Contracts to tense soft palate

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25
Q

Pathway of tensor veli paltini

A

Arises outside pharynx from base of skull

Passes down and hooks around hamulus

Becomes flat triangular tendon that forms framework of soft palate

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26
Q

Innervation and action of levator veli paltini

A

Innervated by pharyngeal plexus of vagus nerve

Contracts to pull palate up

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27
Q

What is the pathway of levator veli paltini

A

Arises from petrous temporal bone and cartilaginous parts of eustacian tube

Passes down towards soft palate

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28
Q

Innervation and action of palatoglossus

A

Innervated by pharyngeal plexus of vagus nerve

Contracts to pull palate down

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29
Q

Pathway of palatoglossus

A

From soft palate to lateral aspects of tongue

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30
Q

Innervation and action of palatopharyngeus

A

Innervated by pharyngeal plexus of vagus nerve

Contracts to pull palate down

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31
Q

Pathway of palatopharyngeus

A

From soft palate to lateral wall of pharynx

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32
Q

What type of epithelium lines hard palate

A

Keratinised stratified squamous epithelium

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33
Q

What type of epithelium lines soft palate

A

non Keratinised stratified squamous epithelium

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34
Q

What is the pharyngeal plexus

A

Network of nerve fibres inner sting most of palate and pharynx located on surface of middle pharyngeal constructor muscle

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35
Q

Which nerves does the pharyngeal plexus receive fibres from

3

A

Vagus nerve- motor innervation to skeletal muscle of palate and pharynx
Glossopharyngeal nerve- provides sensory and secretomotor innervation to pharyngeal mucosa and minor glands of pharynx
Sympathetic chain of cervical branch of facial nerve

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36
Q

What are the features of healthy gingiva

A 
Pale pink
Stippled
Firm
Knife edge interdental papillae
No bleeding on probing
Full bone support
Periodontal ligament attached to tooth at CEJ
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37
Q

How are the teeth divided for BPE

A

Sextants

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38
Q

What features have BPE 0

A

Black band remains completely visible
No plaque retentive factors
No bleeding on probing

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39
Q

What features have BPE score 1

A

Black band remains completely visible
No plaque retentive factors
Bleeding on probing

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40
Q

What features have BPE score 2

A

Black band completely visible

Plaque retentive factors

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41
Q

What features have BPE score 3

A

Black band partially visible

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42
Q

What features have BPE score 4

A

Black band completely disappears

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43
Q

What does a * mean

A

Furcations

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44
Q

What does BPE X mean

A

No teeth or only one tooth in sextant

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45
Q

How do you calculate total attachment loss

A

Probing depth+gingival recession = total attachment loss

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46
Q

What type of epithelium lines floor of mouth

A

Non keratinised stratified squamous epithelium

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47
Q

Where does mylohyoid muscle originate and insert

A

Origin
Mylohyoid line

Insertion
Anterior three quarters of midline raphe and posterior quarter of superior body of hyoid bone

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48
Q

What anatomical structure do mylohyoid muscles form

A

Floor of mouth

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49
Q

What innervates mylohyoid muscle

A

The mylohyoid nerve, a motor branch of inferior alveolar nerve from mandibular division of trigeminal nerve

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50
Q

What artery supplies mylohyoid

A

Sublingual artery

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51
Q

Which gland is associated with the mylohyoid muscle

A

Submandibular gland

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52
Q

What innervates all extrinsic and intrinsic muscles of tongue

A

Hypoglossal nerve

Except palatoglossus which is innervated by vagus nerve

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53
Q

What innervates the anterior 2/3 of tongue

A

Taste innervated by chorda tympani branch of facial nerve

Sensation innervated by lingual branch of mandibular branch of trigeminal nerve

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54
Q

What innervates posterior 1/3 of tongue

A

Glosopharyngeal nerve

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55
Q

What innervates base of tongue

A

Superior laryngeal nerve branching from vagus nerve

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56
Q

What are the types of papillae on anterior 2/3 of dorsum of tongue and their functions
4

A

Circumvallate papillae -taste
Filiform papillae -mastication
Fungiform papillae -taste
Foliate papillae -taste

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57
Q

What type of mucosa is the ventral surface of the tongue lined with

A

Non keratinised oral mucosa with prominent vasculature in sub mucosa

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58
Q

Name the intrinsic muscles of the tongue

4

A

Superior longitudinal
Inferior longitudinal
Transverse
Vertical

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59
Q

What do superior longitudinal intrinsic tongue muscles do

What do inferior longitudinal intrinsic tongue muscles do

A

Raise tip and sides and shorten tongue

Curled tip down and shortens tongue

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60
Q

What do transverse intrinsic tongue muscles do

What do vertical intrinsic tongue muscles do

A

Narrow and lengthen tongue

Flattens and broadens tongue

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61
Q

What are the extrinsic muscles of the tongue

4

A

Genioglossus
Hyoglossus
Styloglossus
Palatoglossus

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62
Q

What does genioglossus extrinsic tongue muscles do

What smooth hyoglossus extrinsic tongue muscles do

A

Raise tip and sides and shorten tongue

Curl tip down and shorten tongue

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63
Q

What does styloglossus extrinsic tongue muscle do

What does palatoglossus extrinsic tongue muscle do

A

Narrow and lengthen tongue

Flatten and broaden tongue

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64
Q

Where does lymph from tip of tongue drain

Where does lymph from anterior 2/3 of tongue drain

Where does lymph from posterior 1/3 of tongue drain

A

Sub mental nodes

Submandibular lymph nodes

Jugulo omohyoid nodes

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65
Q

What are the prevalancies of gingivitis, chronic periodontitis and aggressive periodontitis

A

90% will get gingivitis
60% get chronic periodontitis
5-15% get aggressive periodontitis

66
Q

Define gingivitis

A

Reversible inflammation of the gingivae with no accompanying destruction of the periodontal tissues

67
Q

How long does initial gingivitis take to develop

A

2-4 days

68
Q

What are the features of initial gingivitis

5

A

Vascular dilation of blood vessels
Moderate amounts of infiltration of polymorphonuclear neutrophils to junction and sulcular epithelium
Predominant immune cell polymorphonuclear neutrophils
Peri vascular collagen loss
Increased GCF flow

69
Q

How long does early gingivitis take to develop

A

5-7 days

70
Q

What are the features of early gingivitis

5

A

Vascular proliferation of blood vessels
High amounts of infiltration of polymorphonuclear neutrophils to junctional and sulcular epithelium
Collagen loss
Predominant immune cells are lymphocytes
Bleeding on probing

71
Q

How long does established gingivitis take to develop

A

8-21 days

72
Q

What are the features of established gingivitis

5

A

Vascular proliferation and blood stasis
Very high infiltration of polymorphonuclear neutrophils to junctional and sulcular epithelium
Predominant immune cells are plasma cells
Collagen loss
Gingivae becomes red smooth shiny and inflamed

73
Q

What are the key bacteria’s of periodontitis

4

A

Aggregacibacter spp
Porphyromonas spp
Treponema spp
Prevotella spp

74
Q

What are the pathophysiological features of periodontal disease
5

A 
Chronic inflammation 
Pocketing
Epithelial migration 
Destruction of periodontal fibres
Destruction of alveolar bone
75
Q

What are the progressive stages of periodontal lesion

4

A

Initial lesion
Early lesion
Established lesion
Advanced lesion

76
Q

What are the features of the initial periodontal lesion

5

A

Periodontitis localised to gingival sulcus
Vasculitis and oedima with fluid exudate in gingival sulcus
Increased migration of leukocytes to gingival crevice
Early changes in junctional epithelium
Loss of peri vascular collagen

77
Q

What are the features of early periodontal lesion

3

A

Accentuated features of initial lesion
Signs of basal cell proliferation in junctional epithelium
Further collagen loss

78
Q

What are the features of the established periodontal lesion

5

A

Plasma cells become dominant cell type
Extravascular immunoglobulins in connective tissue and junctional epithelium
Proliferation and apical micration of junctional epithelium
Pocket formation
More Collagen loss

79
Q

What are the features of the advanced periodontal lesion

4

A

Bone and collagen loss
Periodontal pockets
Bone marrow converted to fibrous connective tissue
Abscess formation and furcation

80
Q

What is the difference between gram positive and gram negative bacteria

A

Gram positive have thick peptidoglycan cell wall with no lipopolysaccharides in outer membrane
Gram negative have thin peptidoglycan cell wall with lipopolysaccharides in outer membrane

81
Q

Which enzymes do obligate aerobes poses

Which enzymes do facultative anaerobes poses

Which enzymes do aerotolerant enzymes poses

Which enzymes do obligate anaerobes poses

A

SOD and catalase

SOD and catalase

SOD

-

82
Q

What provides nutrients to supra gingival plaque

A

Diet and saliva

83
Q

What is the main energy source of supra gingival plaque

A

Carbohydrates

84
Q

What supplies nutrients to sub gingival plaque

A

Gingival crevicular fluid proteins

85
Q

What are the differences between tooth associated and epithelium associated sub gingival plaque

A

Tooth associated plaque is densely packed and is associated with root caries, calculus and periodontal destruction
Epithelium associated plaque is loosely adherent and associated with periodontal destruction

86
Q

What properties make the sub gingival environment a niche

4

A

More anaerobic as it gets deeper
Few mechanical forces to remove bacteria
Environment relatively static
Alkaline pH of 7.4-7.8

87
Q

Compare sub gingival environment at gingival health and gingival inflammation
4

A

Low vs high plaque levels

No inflammation vs inflammation

Low GCF flow vs high GCF flow

High redox potential vs low redox potential

88
Q

What type of bacteria are present in the healthy gingival sulcus

A

Mainly gram positive cocci

89
Q

Name the bacteria in healthy gingival sulcus

5

A 
Streptococcus sanguinis
Streptococcus oralis
Actinomycetes naesludil
Actinomycetes viscosus 
Veilonella spp
90
Q

What type of bacteria are present in gingivitis

A

More gram negative

Half gram positive cocci

91
Q

Name bacteria’s present in gingivitis

6

A 
Streptococcus spp
Actinomycetes ssp 
Prevotella intermedia
Capnocytophaga spp
Fusobacterium nucleatum
Veilonella spp
92
Q

What is the key bridging species of periodontitis

A

Fusobacterium nucleatum

93
Q

What type of bacteria are present in periodontitis

A

75% gram negative, mostly obligate anaerobes

Predominantly motile rods and spirochetes

94
Q

What is the red complex and which three bacteria’s are part of it

A

Red complex: associated with progression of periodontal disease

Porphyromonas gingivalis
Tanerella forsythia
Treponema denticola

95
Q

What are the clinical features of periodontal pocket

3

A

Over 3mm
Apical migration of junctional epithelium
Bone loss

96
Q

What does the mandibular nerve supply sensory innervation to

A

Lower 1/3 of face
Lower jaw
Anterior 2/3 of tongue

97
Q

What does the mandibular nerve supply motor innervation to

A

Muscles of mastication

98
Q

What is found in meckels cave/trigeminal fossa?

A

Trigeminal ganglion containing sensory cell bodies

99
Q

What nerve passes through foramen ovale and between which areas

A

Mandibular nerve

From middle cranial fossa to inferior cranial fossa

100
Q

What nerve passes through foramen rotundum and between which two areas

A

Maxillary nerve

From middle cranial fossa to pterygopalatine fossa

101
Q

What passes through foramen spinosum

A

Meningeal branch of mandibular nerve/ nervus spinosus

102
Q

Which nerves pass through superior orbital fissure

4

A

Ophthalmic nerve
Oculomotor nerve
Abducens
Trichoclear nerve

103
Q

What is the lingula

A

Lip of bone protecting mandibular foramen

104
Q

What passes through mandibular foramen

A

Inferior alveolar nerve

105
Q

What passes through mental foramen

A

Mental nerve

106
Q

What is the pterygomandibular raphe

A

A ligamentous band attached to posterior end of mylohyoid line

107
Q

Where does the trigeminal nerve leave the brain stem

A

PONS

108
Q

What is the pterygomandibular space

A

A potential space between medial pterygoid muscle and medial surface of ramus of mandible

109
Q

What anatomical structures are located in pterygomandibular space
3

A

Mandibular division of trigeminal nerve
Inferior alveolar artery and vein
Spenomandibular ligaments

110
Q

Which nerves/branches form the anterior division of the mandibular nerve
4

A

Massateric nerve
Temporal nerves
Nerve to lateral pterygoid
Buccal nerve

111
Q

Which nerves / branches form the posterior division of the mandibular nerve
5

A 
Auriculotemporal nerve
Lingual nerve
Chorda tympani
Inferior alveolar nerve
Mylohyoid nerve
112
Q

Which nerves branch from trunk of mandibular nerve

2

A

Meningeal branch/nervus spinosum

Nerve to medial pterygoid

113
Q

What is Hilton’s law

A

A nerve supplying joint with sensation will be the same nerve supplying the muscles of the joint

114
Q

Which foramen does the vagus nerve pass out of

A

Jugular foramen

115
Q

Which nerves pass through the anterior division of the jugular foramen
2

A

Inferior petrosal sinus

Glossopharyngel nerve

116
Q

Which nerves pass through middle division of the jugular foramen
2

A

Vagus nerve

Accessory nerve

117
Q

Which structure passes through posterior division of jugular foramen

A

Sigmoid sinus

118
Q

What are the functions of the vagus nerve

5

A

Innervates mexhanoreceptors in gag reflex
Taste
Innervates constrictors of pharynx
Innervates muscles of larynx
Innervates all muscles of soft palate except tensor paltini

119
Q

What fibres form pharyngeal plexus

A

Some motor fibres of vagus nerve

Fibres from cranial component of accessory nerve

120
Q

What does the pharyngeal plexus do

A

Provides sensory innervation to oropharynx and laryngopharynx and motor innervation to levator paltini, palatoglossus and palatopharangeus

121
Q

What are the branches of the vagus nerve

5

A 
Auricular branch
Pharyngeal branch
Superior laryngeal branch
Recurrent laryngeal nerve
Sinus nerve
122
Q

What is the role of superior laryngeal nerve

A

Sensation to larynx above vocal folds and motor innervation to cricothyroid

123
Q

What is the pathway of recurrent laryngeal nerve

A

Branches in thorax
Re enters neck
Passes upwards to enter larynx

124
Q

What does recurrent laryngeal nerve innervate

A

Supplies sensation to mucous membrane below vocal folds and motor innervation to intrinsic muscles of larynx

125
Q

What type of tissues bone

A

Connective tissue

126
Q

What are the components of bone

3

A

Extra cellular matrix of primarily type 1 collagen in highly organised fibres

Ground substance of non collagenous proteins- glycoproteins, proteoglycans

Hydroxyapatite crystals

127
Q

What is osteoid

Which components of bone make up osteod

A

The unmineralised organic matrix secreted by bone building cells (osteoblasts)

Extra cellular matrix of type 1 collagen
Ground substance with glycoproteins and proteoglycans

128
Q

Functions of bone

5

A 
Protection 
Support 
Movement 
Reservoir 
Blood cell formation
129
Q

What minerals in bone give it strength

2

A

Calcium

Phosphorus

130
Q

What are the types of bone

3

A

Cortical
Trabecular bone
Woven bone

131
Q

What percentage of skeletal mass is cortical bone

A

80%

132
Q

What is the primary structural unit of cortical bone

A

Osteon

133
Q

What is the structure of cortical bone

A

Solid bone with only few small canals

Surrounds trabecular bone

134
Q

What are properties of cortical Bone

3

A

Bundles of collagen fibres organised into sheets or lamellae

Remodelled from woven bone by vascular channels

Forms internal and external parts of flat bones and external surfaces of long bones

135
Q

What percentage of skeletal mass is trabecular bone

A

20%

136
Q

What are properties of trabecular bone

A

Present on inside of bones
Less dense and more elastic than cortical bone
Higher turnover rate than cortical bone
Makes up most bone tissue of axial skeleton

137
Q

What is the structure of trabecular bone

A

Scaffold like honey comb structure with spaces filled with bone marrow cells

138
Q

Properties of woven bone

A

Immature
Found during embryonic development, fracture healing and some pathological states
Normally replaced with cortical bone
Remains in tooth sockets and where tendons insert into bones

139
Q

Structure of woven bone

A

Randomly arranged collagen bundles and irregular shaped vascular spaces lined with osteoblasts

140
Q

What does the periosteum membrane cover

A

Covers and protects outer surface of bones not covered in cartilage

141
Q

How is periosteum anchored to bone

A

Sharpeys collagen fibres

142
Q

How many layers is periosteum made up of

What are the purposes of these

A

Double layered

Inner layer is an osteogenic layer containing osteoblasts and osteoclasts

Outer layer is a fibrous layer of dense irregular connective tissue proper for protection

143
Q

What does endosteum membrane line

A

Bodies inner cavities that contain marrow or blood vessels

144
Q

What is endosteum made up of

A

Mainly osteocytes and osteoclasts

145
Q

What is intermembranous ossification

A

Mineralisation of tissue with differentiation of mesenchymal cells to osteoblasts

146
Q

Where does intermembranous ossification occur

A

Within membranous plate of mesenchymal cells

147
Q

What are the steps of intermembranous ossification

3

A

At ossification centre mesenchymal cells differentiate into osteoblasts
Osteoblasts deposit osteoid
Thin sheet of woven bone called the periosteal collar is deposited around shaft of cartilage model

148
Q

What is endochondral ossification

A

Formation of bone from cartilage into bone

149
Q

Steps of endochondral ossification

3

A

Periosteal bud invades cartilage model and allows mesenchymal cells to enter cartilage
Invading mesenchymal cells mature into osteoblasts
Osteoblasts deposit bone using framework of calcified cartilage

150
Q

What do osteoblasts do

A

Form collagen, glycoproteins and proteoglycans of matrix and controls deposition of crystals on collagen fibrils

151
Q

What do osteocytes do

A

Control extra cellular concentration of calcium and phosphorus

152
Q

What do osteoclasts do

A

Large multi nucleated bone reabsorbing cells

153
Q 
What are the mineral contents of:
Alveolar bone
Cementum 
Dentine
Enamel
Pulp
A 
70%
70%
70%
96%
0%
154
Q

How is periodontal disease treated

5

A 
Preventative techniques 
Bone grafts 
Tissue grafts
Guided tissue regeneration 
Dentures
155
Q

What makes collagen

A

Fibroblasts and some epithelial cells

156
Q

What are the properties of collagen

5

A

Contributes to stability of tissues and organs
Maintains structural integrity of tissues and organs
High tensile strength
Involved in cell differentiation, polarity and movement
Role in tissue and organ development

157
Q

What is the primary structure of collagen

4

A

Gly X Y: every third amino acid glycine which has no side chains and helps create tight turns
Has carboxyl terminal ends involved in assembly of procollagen
Hydroxyproline involved in H bonding
Hydroxylysine involves in covalent bonding

158
Q

What type of bond is involved in secondary structure of collagen

A

Hydrogen bonding

159
Q

What is the tertiary structure of collagen

A

Triple helical rod molecule of procolagen

Terminal ends
C telopeotides
N telopeptides

160
Q

What is the quaternary structure of collagen

A

Collagen molecules align to form microfibrils, microfibrils align to form collagen fibres

161
Q

What creates longitudinal alignment of microfibrils

A

C terminal aligns with N terminal with N always towards growing tip of fibril

162
Q

What creates lateral alignment of microfibrils

A

C terminal ends with shaft of neighbouring molecule to create cross links

Dentistry Year 1 (5 decks)

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