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Pathophysiology > EXAM 1 Oral Cavity > Flashcards

EXAM 1 Oral Cavity Flashcards

1
Q
  • calcium hydroxyapatite

- It is hard, inert, acellular tissue (hardest in body)

A

enamel

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2
Q

contains cells (odontoblasts) which can produce new dentin

A

dentin

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3
Q

consists of loose connective tissue rich in nerves, lymphatics and capillaries

A

pulp chamber

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4
Q
  • provide a strong and flexible attachment

- They attach to the alveolar bone of the jaw on one side and to cementum, which anchors the ligament to the tooth

A

periodontal ligaments

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5
Q

covers bony surfaces

A

gingiva

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6
Q

One of the most common diseases, the most common cause of tooth loss before age 35

A

dental caries

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7
Q

Improved oral hygiene and fluoridation of the drinking water has _____ caries risk

A

Improved oral hygiene and fluoridation of the drinking water has reduced caries risk

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8
Q

Increased “Westernization” of global diet is dramatically _______ risk of caries in developing countries

A

Increased “Westernization” of global diet is dramatically increasing risk in developing countries

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9
Q

Result from demineralization of tooth structure by acids, produced from bacterial metabolism of sugars

A

dental caries

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10
Q

Streptococcus mutans and Lactobacillus most common cause of:

A

dental caries

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11
Q

_______ incorporates into the crystalline structure of enamel, forming fluoroapatite, which is resistant to bacterial acids

A

Fluoride incorporates into the crystalline structure of enamel, forming fluoroapatite, which is resistant to bacterial acids

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12
Q

squamous mucosa between and around the teeth

A

gingiva

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13
Q

inflammation of the gingiva and associated soft tissues

A

gingivitis

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14
Q

-Usually caused by accumulation of dental plaque

A

gingivitis

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15
Q

____ _____ is a “biofilm” of bacteria, saliva and bacterial proteins, and desquamated epithelial cells on and between teeth

A

Dental plaque is a “biofilm” of bacteria, saliva and bacterial proteins, and desquamated epithelial cells on and between teeth

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16
Q

With time, dental plaque becomes mineralized to form ______ (_____)

A

With time, dental plaque becomes mineralized to form calculus (tartar)

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17
Q

Plaque bacteria metabolize ____, releasing ____ which cause caries

A

Plaque bacteria metabolize sugar, releasing acids which cause caries

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18
Q

Bacterial proteins and metabolic products promote ______ ________, i.e., gingivitis

A

Bacterial proteins and metabolic products promote gingival inflammation, i.e., gingivitis

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19
Q

characterized by gingival erythema, edema, bleeding, changes in gingival contour, and altered tooth attachment

A

chronic gingivitis

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20
Q

Associated with risk for periodontitis

A

gingivitis

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21
Q

caused by inflammation of the supporting structures of the teeth, including the periodontal ligaments, alveolar bone, and cementum

A

periodontitis

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22
Q

Results in loss of attachment due to destruction of periodontal ligaments and loss of alveolar bone

A

periodontitis

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23
Q

Periodontitis is related to change in oral bacterial ____

A

Periodontitis is related to change in oral bacterial flora

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24
Q

Associated with complications with pregnancy, endocarditis, abscess

A

periodontitis

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25
Q
  • Associated with certain diseases like HIV/AIDS, diabetes, other immune deficiency states
  • Associated with increased risk for developing diabetes, heart disease, other systemic disease
A

periodontitis

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26
Q
  • Most common nodular oral mass

- Primarily occurs in the buccal (cheek) mucosa along the bite line or at the gingivodental margin

A

irritation fibroma

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27
Q
  • A nodular mass of fibrous tissue, with few inflammatory cells, covered by squamous mucosa
  • Associated with repeated injury (chronic inflammation)
A

irritation fibroma

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28
Q
  • Relatively common chronic inflammatory nodule derived from cells of the periodontal ligament
  • Results from chronic irritation
A

peripheral ossifying fibroma

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29
Q
  • Occurs on the gingiva between the teeth (interdental papilla)
  • Peak incidence in young and teenage females
A

peripheral ossifying fibroma

30
Q
  • Red or pink in color
  • Smooth or pebbled irregular surface
  • Ulcerated or not
  • Broad base attachment, less often pedunculated
A

peripheral ossifying fibroma

31
Q
  • A highly vascular pedunculated lesion (hanging on stalk)

- Usually on the gingiva of children, young adults, pregnant women (pregnancy tumor)

A

pyogenic granuloma

32
Q
  • Typically has an ulcerated surface and red to purple color

- Can grow rapidly causing fear of cancer

A

pyogenic granuloma

33
Q
  • Histologically are highly vascular similar to granulation tissue (chronic inflammatory lesion)
  • May develop into a peripheral ossifying fibroma
A

pyogenic granuloma

34
Q

-Single or multiple, shallow, hyperemic (red) ulcerations covered by a thin exudate and rimmed by a narrow zone of erythema

A

apthous ulcer

35
Q
  • Inflammatory lesion with macrophages causing tissue injury and ulceration of oral mucosa
  • Cause unknown, can be found with celiac disease and inflammatory bowel disease
  • More common in the first two decades of life
A

apthous ulcer

36
Q
  • Extremely painful and often recurrent

- Spontaneously resolve in 1-2 weeks but may persist for weeks

A

apthous ulcer

37
Q
  • Inflammation to the tongue for any reason, including trauma, chemicals, infection, or metabolic
  • May be swelling, color changes, pain, papilla changes, or any combination of these
  • Includes changes to the tongue resulting from certain vitamin deficiencies (B vitamins) and iron deficiency
A

glossitis

38
Q
  • Some presentations with no known cause (e.g., migratory glossitis)
  • Includes changes to the tongue resulting from certain vitamin deficiencies (B vitamins) and iron deficiency
A

glossitis

39
Q

highly resistant to normal bacterial flora

A

oral mucosa

40
Q

defenses of oral mucosa

A
  • Normal flora is low virulence
  • Secretory IgA in saliva (antibody that blocks microbial attachment to mucosal surfaces)
  • Tonsils and adenoids (lymph nodules – like lymph nodes, site for lymphocyte exposure to oral antigens)
41
Q

Most bacterial infections of the oral mucosa are related to:

A
  • Immunodeficiency (e.g., young, old, pregnant, disease)

- Disruption of the normal flora (e.g., antibiotics)

42
Q

cytomegalovirus, Epstein-Barr virus (EBV, infectious mononucleosis), varicella-zoster virus, other (130+)

A

other herpes family viruses

43
Q
  • Typically occurs in children age 0.5 to 5 years

- infects at site of exposure and replicates in keratinocytes and epithelial cells (including mucosal epithelium)

A

viral oral cavity infections

44
Q
  • Infection results in cell death (red-rimmed, painful ulcer) and inflammation (vesicles/bullae), positive Tzanck test (acantholytic [separated] keratinocytes, multinucleate giant cells, cytoplasmic inclusions)
  • Acute (initial) infection may be accompanied by lymphadenopathy, fever, anorexia, and irritability
A

viral oral cavity infections

45
Q

-Within 24 hours of infection, virus enters neuronal termini and is transported to sensory ganglia, continue to replicate and establish latency in ganglia
Unique to HSV*

A

viral oral cavity infections

46
Q

Reactivation from latent infection results in anterograde axonal transport to terminals of affected sensory nerves, replication in epithelial cells forming lesions at site of primary infection

A

recurrent infection of herpesvirus

47
Q
  • Frequently associated with immunosuppression, e.g., stress, diabetes, concurrent illness
  • Usually less severe presentation than primary infection
A

recurrent infection of herpesvirus

48
Q

Other viral infections of the oral cavity, head and neck

A
  • enterovirus –> includes Coxackie A and B, Echovirus, other Enterovirus species i.e. hand-foot-and-mouth disease
  • rubeola virus –> measles
49
Q

fungus causing thrush

A

candida albicans

50
Q

Superficial infection of mucosal membranes by yeast, may extend into _____ (also found on other mucosal membranes, moist skin areas)

A

Superficial infection of mucosal membranes by yeast, may extend into esophagus (also found on other mucosal membranes, moist skin areas)

51
Q
  • Most commonly presents with a superficial, curd-like, gray to white inflammatory membrane (a “pseudo-membrane” of yeast in a fibrinosuppurative exudate)
  • Readily scraped off to reveal an underlying erythematous inflammatory base
A

thrush

52
Q

Risk increased with immunodeficiency, change in mucosal flora (e.g., after antibiotics)

A

thrush

53
Q

____ fungal infections usually have higher morbidity, predilection for the oral cavity and the head and neck region

A

Deep fungal infections usually have higher morbidity, predilection for the oral cavity and the head and neck region

54
Q
  • Manifested by deep ulcers with or without pseudomembranes, may also involve other tissues of head and neck (or elsewhere)
  • Risk higher in immunosuppressed populations
A

deep fungal infections

55
Q 
Histoplasmosis,
Blastomycosis
Coccidioidomycosis
Cryptococcosis
Zygomycosis
Aspergillos
A

deep fungal infections

56
Q

Scarlet fever, B-vitamin deficiency, iron deficiency, celiac disease, Sjögren syndrome associated with _____ changes

A

Scarlet fever, B-vitamin deficiency, iron deficiency, celiac disease, Sjögren syndrome associated with tongue changes

57
Q

Crohn’s disease, celiac disease associated with _____ ______

A

Crohn’s disease, celiac disease associated with aphthous ulcers

58
Q

Measles associated with ____ _____

A

Measles associated with Koplik’s spots

59
Q

Infectious mononucleosis, diphtheria, streptococcal pharyngitis associated with _________ _______

A

Infectious mononucleosis, diphtheria, streptococcal pharyngitis associated with pseudomembranous tonsillitis

60
Q

a white, thickened mucosal patch or plaque, usually with sharply demarcated borders, that cannot be scraped off

A

leukoplakia

61
Q
  • Caused by hyperplasia of the squamous epithelium, occurs prior to dysplastic and neoplastic transformation
  • Also seen in purely inflammatory conditions not associated with malignancy
A

leukoplakia

62
Q
  • Also seen in purely inflammatory conditions not associated with malignancy
  • Associated with human papillomavirus (HPV)
A

leukoplakia

63
Q
  • Until proved otherwise (histology), all leukoplakias are considered ________
  • 1-20% progress to carcinoma within ___ years
A
  • Until proved otherwise (histology), all leukoplakias are considered precancerous
  • 1-20% progress to carcinoma within 10 years
64
Q

red, velvety plaque on epithelial/mucosal surfaces, may be at surrounding height or slightly depressed

A

erythroplakia

65
Q

Less common than leukoplakia and higher cancer risk

A

erythroplakia

66
Q

Histologically shows intense subepithelial inflammation with vascular dilation, giving the reddish clinical appearance

A

erythroplakia

67
Q

Virtually all (approximately 90%) have superficial erosions with dysplasia, carcinoma in situ, or already developed carcinoma

A

erythroplakia

68
Q

most common form of head and neck cancers (95%), usually arising in the oral cavity

A

squamous cell carcinoma

69
Q

__% of oropharyngeal cancers are associated with HPV

A

50% of oropharyngeal cancers are associated with HPV

70
Q
  • May arise anywhere but usually the ventral surface of the tongue, floor of the mouth, lower lip, soft palate, and gingiva
  • Typically preceded by premalignant lesions (leukoplakia, erythroplakia)
A

squamous cell carcinoma

71
Q
  • Start as raised, firm, pearly plaques or as irregular, roughened, or verrucous (wart-like) areas of mucosal thickening
  • As they enlarge, they typically create ulcerated and protruding masses that have irregular and indurated (rolled) borders
A

squamous cell carcinoma

72
Q

5-year survival rate of early-stage oral cancer is approximately __%, survival drops to __% for late-stage disease

A

5-year survival rate of early-stage oral cancer is approximately 80%, survival drops to 19% for late-stage disease

Pathophysiology (4 decks)

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