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ORAL PATHOLOGY! > Exam 1-Healing of Oral Wounds > Flashcards

Exam 1-Healing of Oral Wounds Flashcards

1
Q

EARLY vascular response to injury: Initial transient vaso________ followed by vaso_______

A

constriction….dilation

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2
Q

EARLY vascular response to injury: Vasodilation is caused by action of ________, _________, and other vasodilatory substances

A

histamine, prostaglandins

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3
Q

EARLY vascular response to injury: Dilation causes intercellular _____ to occur, which allow egress of plasma and emigration of leukocytes

A

gaps

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4
Q

Inflammatory stage of Wound Repair: wound fills with clotted blood, inflammatory cells, and ______

A

plasma

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5
Q

Inflammatory stage of Wound Repair: Adjacent _________ begins to migrate into wound along edge of the wound.

A

epithelium

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6
Q

Inflammatory stage of Wound Repair: Undifferentiated mesenchymal cells begin to transform into _______.

A

fibroblasts

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7
Q

MIGRATORY phase of FIBROBLASTIC stage: Continued ________ migration under the fibrinous exudate.

A

epithelial

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8
Q

MIGRATORY phase of FIBROBLASTIC stage: ________ dispose of foreign and necrotic material.

A

Leukocytes

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9
Q

MIGRATORY phase of FIBROBLASTIC stage: _______ ingrowth begins and ________ migrate into wound along fibrin strands.

A

Capillary…fibroblasts

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10
Q

PROLIFERATIVE phase of FIBROBLASTIC stage: Proliferation increases epithelial thickness and __________ are haphazardly laid down by fibroblasts.

A

Collagen fibers

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11
Q

PROLIFERATIVE phase of FIBROBLASTIC stage: Budding _______ begin to establish contact with their counterparts from other sites in the wound.

A

capillaries

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12
Q

REMODELING stage- ________ stratification is restored and Fibrinous exudate resorbs, often leaving a depressed ______.

A

Epithelial…scar

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13
Q

REMODELING stage- ________ is remodeled into more efficiently organized patterns and ________ slowly reduce and ________ integrity is re-established.

A

Collagen..fibroblasts..vascular

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14
Q

Wound contraction: Begins near the END of ________ and continues during the early portion of _______.

A

fibroplasia….remodeling

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15
Q

Wound contraction diminishes the _______ of the wound.

A

SIZE

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16
Q

What are these indications for? Any persistent pathologic condition which cannot be diagnosed clinically….Any lesion thought to be malignant/premalignant…To confirm clinical diagnosis….Any condition not responding to routine management….To allay cancer fears

A

Indications for doing a BIOPSY

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17
Q

What is the removal of tissue from a living individual for the purpose of microscopic examination and diagnosis?

A

Biopsy

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18
Q

What is the GOLD STANDARD of diagnosis?

A

a Biopsy!

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19
Q

***WHAT IS THE FIXANT used for transporting a biopsy specimen?

A

10% neutral, buffered FORMALIN

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20
Q

What are the 4 most common mistakes when retrieving/handling a biopsy? Whats the most common?

A

1.Crushing it 2.Burning it 3.Injecting it with anesthetic 4.MOST COMMON-not Fixating it (10% neutral,buffered formalin)

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21
Q

What can you use as a fixing agent if you don’t have 10% neutral, buffered formalin in your office?

A

any EtOH

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22
Q

Which type of BIOPSY? If the lesion is larger than 1cm or in a hazardous location or whenever there is a great suspicion of malignancy.

A

Incisional

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23
Q

INCISIONAL biopsy: If the lesion is larger than ____ or in a hazardous ______ or whenever there is a great suspicion of ________. They are used to establish a ________!

A

1cm… location… malignancy…used to establish a DIAGNOSIS!

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24
Q

What type of BIOPSY: Is used to remove the lesion….It is a diagnostic and therapeutic biopsy.

A

Excisional biopsy

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25
Q

For lesions that are small and you are confident are benign use THIS type of BIOPSY…

A

Excisional

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26
Q

DO NOT excise a lesion suspected of being _______!!!

A

MALIGNANT

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27
Q

What category of healing? Healing by primary intention…..When the margins can be approximated….Usually heals with minimal scar.

A

Primary Healing

28
Q

What kind of healing? Healing by secondary intention. - An open wound “granulates in”. - Heals with scarring.

A

Secondary Healing

29
Q

Which Biopsy method? the removal of individual cells, usually in order to determine microscopically if they appear normal or abnormal. It usually does not provide a definitive diagnosis.

A

cytology/exfolative cytology

30
Q

What are these advantages for? *Safe *Bloodless *Painless *Quick *Screening

A

Cytology

31
Q

Disadvantages of Cytology: Only for surface lesions affecting ________ *Cannot establish a definitive ________

A

epithelium…diagnosis

32
Q

Cytology Grades: I

A

Normal

33
Q

Cytology Grades: II

A

Atypical-Biopsy

34
Q

Cytology Grades: III

A

Borderline-Biopsy

35
Q

Cytology Grades: IV

A

Sugesstive-Biopsy

36
Q

Cytology Grades: V

A

Positive-Biopsy

37
Q

What are three main indications for using Cytology?

A

1.Premalignant/malignant lesions 2.HSV lesions 3.Candidiasis

38
Q

HSV can be deceiving….it will have _________ that make it look like a malignant, multi-nucleated cell…

A

intranuclear inclusions

39
Q

What are these describing? *Cytological evaluation for premalignant/malignant lesions *Improved cell harvesting *All cell layers *Improved computer-based screening of specimen *Improved diagnostic accuracy *Atypical and positive results must be biopsied *Does not provide definitive diagnosis

A

Oral CDX Brush Biopsy

40
Q

What is the diagnostic technique used to identify autoantibodies?

A

Immunofluorescence

41
Q

Immunofluorescence-which method looks for autoantibodies in tissue?

A

Direct

42
Q

Which immunofluorescence method looks for circulating autoantibodies in BLOOD?

A

Indirect

43
Q

Immunofluorescence: Diagnostic technique to identify __________

A

autoantibodies

44
Q

In general, what types of disorders are immunofluorescent testing usually reserved for? What are two specific examples?

A

Autoimmune…1.Pemphigus Vulgaris 2.Mucus membrane pemphigoid

45
Q

Interesting note about immunofluorescence: Most ORAL diseases are ______ on Direct but _______ on indirect IF.

A

positive on Direct, but negative on indirect

46
Q

Can you use a FIXATIVE for a direct immunofluorescense sample?

A

No, must use a special transport medium

47
Q

In a direct immunofluorescent sample, where are you likely to see the autoantibodies in relation to the cells? Why?

A

they are on the border of the cells, because they are attacking the desmosomes

48
Q

Healing of an EXT wound! Which WEEK of healing?? The blood clot begins to undergo organization by the ingrowth of fibroblasts and capillaries from the residual periodontal ligament and adjacent bone marrow.

A

First Week

49
Q

Healing of an EXT wound! Which WEEK of healing?? The blood clot is becoming organized….PDL begins degeneration and the socket wall appears frayed….Epithelium proliferates over the wound surface

A

Second Week

50
Q

Healing of an EXT wound! Which WEEK of healing?? The original clot is organized by granulation tissue. Early bone (osteoid) is formed by osteoblasts arising in the PDL and adjacent bone. The crest of the alveolar bone is rounded off by osteoclastic resorption. Epithelium completely covers the surface

A

Third Week

51
Q

Which week of healing post EXT has granulation tissue?

A

3rd week

52
Q

Which week of healing post EXT has osteoid formation?

A

3rd week

53
Q

Healing of an EXT wound! Which WEEK of healing?? Continued deposition of bone. Much of the early bone is poorly calcified and is not evident on radiographs. Radiographic evidence of bone formation is seen after six or eight weeks. Evidence of differences in new bone in the alveolar socket will persist for four to six months.

A

4th week

54
Q

HOW LONG after an EXT do we see RADIOGRAPHIC evidence of bone formation?

A

6-8 weeks

55
Q

HOW LONG after an EXT do we see evidence of differences between the new bone in the socket and the existing bone in the alveolus?

A

4-6 months

56
Q

What is the clinical name for dry socket? (4 words)

A

Localized Acute Alveolar Osteomyelitis

57
Q

What is the etiology of Localized Acute Alveolar OsteoMyelitis?

A

Loss of the blood clot from the extraction site

58
Q

Dry Socket: The socket appears dry and the _____ is exposed…Produces a foul odor and severe pain but no _________.

A

bone…supperation

59
Q

WHAT results from a DIFFICULT surgical extraction accompanied by LOSS of lingual and labial or buccal plates of bone with accompanying loss of periosteum??

A

Fibrous healing of an extortion wound

60
Q

Radiographic interpretation of a FIBROUS healing of an ext wound: appears as a _________ radiolucent area at the site of previous extraction wound…What TWO things might this be mistaken for?

A

circumscribed…1.Residual CYST or 2.GRANULOMA

61
Q

Which extraction healing complication is found most often in middle aged females?

A

Focal Osteoporotic Bone Marrow Defect (iron deficiency)

62
Q

What is the term for a radiolucency in bone from bone marrow expansion?…. may not be pathologic (5 words)

A

Focal Osteoporotic Bone Marrow Defect

63
Q

Where is the most common location for a focal osteoporotic bone marrow defect?

A

mandibular posterior

64
Q

Focal osteoporotic bone marrow defect show as Radiolucencies, often ill-defined but with faint internal _________

A

trabeculation

65
Q

Often a fragment of bone will become lodged in the socket and induce tissue hyperplasia and will cause THIS…

A

localized tissue overgrowth

66
Q

BE AWARE: Tissue growing from an extraction site (aka. ________) can also represent MALIGNANCY growing along the course of least resistance…..so don’t

A

localized tissue overgrowth

ORAL PATHOLOGY! (40 decks)

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