Head and Neck Flashcards
What is the underlying cause of dental caries?
Mineral dissolution, acids released by oral bacteria during sugar fermentation.
Demineralization > Reminineralization
What is the mechanism by which fluoride protects against dental caries?
Fluoride replaces calcium producing fluorapatite which is more resistant to acids.
Define gingivitis and clinical signs/symptoms of gingivitis.
Gingivitis: inflammation of oral mucosa surrounding teeth (gums).
Erythema, edema, bleeding, contour change, loss of soft tissue adaptation.
Define dental plaque and how it can become tartar.
Dental plaque:
Sticky, colorless, biofilm that collects between surface of teeth
Unremoved plaque mineralizes to form calculus (tartar).
Define periodontitis and its sequelae.
Inflammatory process affecting the periodontal ligaments, which could cause loosening teeth and eventually loss of teeth.
What is the shift in oral flora associated with periodontitis?
Periodontitis-associated plaque contains anaerobic and microaerophilic Gram-negative flora (as opposed to facultative Gram-positive flora).
Describe the clinical symptoms and appearance of aphthous ulcers.
Painful, shallow, hyperemic
ulcerations initially infiltrated by mononuclear inflammatory
cells; secondary bacterial infection recruits neutrophils.
What infectious agents are associated with orofacial herpetic lesions?
Herpes simplex virus (HSV)
Describe the clinical appearance of orofacial herpetic lesions.
Vesicles and ulcerations of the oral mucosa,
particularly the gingiva; accompanied by lymphadenopathy, fever, anorexia, and irritability.
Define thrush and its most common etiologic agent.
A fungal infection of the oral cavity caused by candida albicans.
Describe the clinical findings of thrush.
Pseudomembranous (white inflammatory membrane/patch that can be scraped off), erythmatous, hyperplastic.
What are several clinical conditions that predispose to thrush?
Immunosuppressive conditions (AIDS, diabetes, organ/bone marrow transplant) Broad-spectrum antibiotics.
What are the characteristic lesion of hairy leuokplakia and what is its etiologic agent?
White patches of fluffy hyperkeratotic thickenings that CANNOT be scraped off; caused by Epstein-Barr Virus (EBV).
Define leukoplakia. What is the “typical” patient with leukoplakia?
White patches that cannot be scraped off, usually tongue.
Ages 40-70; tobacco users.
Describe the locations and appearances of this leukoplakia.
Usually on tongue; also vulva and penis.
White patches, often with demarcated borders.
What are the common risk factors for the development of squamous cell carcinoma of head and neck?
Tobacco, alcohol Human papillomavirus (HPV) Actinic radiation (sun)
What are the clinical signs and symptoms of rhinitis?
Infectious: thickened, edematous, red, narrow nasal cavities
Allergic: mucosal edema, redness
Chronic: ulcerations with inflammatory infiltrates
Describe a nasal polyp and its potential sequelae.
Edematous mucosa infiltrated by neutrophils, eosinophils, and
plasma cells; most are not due to atopy.
Describe underlying pathogenic mechanism of sinusitis.
Impairment of drainage by inflammatory edema. May impound suppurative exudate
What are three characteristics of nasopharyngeal carcinoma and three factors that influence the origin of this disease process?
- distinctive geographic distribution
- close anatomic relationship to lymphoid tissue
- association with EBV infection.
- heredity
- age
- EBV infection
What are the clinical findings most commonly seen with nasopharyngeal carcinoma?
Nasal obstruction, epistaxis, metastases to cervical lymph
What are the common risk factors for development of reactive laryngeal nodules?
Heavy smokers and singers (great strain on vocal cords)
Describe most common presenting symptoms and associated malignant potential of reactive laryngeal nodules.
Change in voice character and hoarseness; virtually never for malignant potential.
What is/are the etiologic agent of laryngeal squamous papillomas?
HPV 6 and 11
What are the clinical symptoms of laryngeal squamous papillomas?
Soft raspberry-like proliferation with finger-like projections.
Rarely malignant.
What is the “typical” patient with carcinoma of the larynx?
Male chronic smokers
What are the potential complications of chronic otitis media? What infectious agent is most commonly seen in diabetic persons with this disease process?
Complications: perforated eardrum, temporal cerebritis or abscess
Diabetes/Infectious agent:
Pseudomonas aeruginosa
Define cholesteatoma and its association with otitis.
Non-neoplastic, cystic lesions lined by keratinized squamous epithelium or mucus-secreting epithelium, filled with amorphous debris
Associated with chronic otitis media.
Define otosclerosis and note its bilaterality.
Abnormal bone deposition in the middle ear around the rim of the oval window. Usually bilateral.
Describe the heritability and outcome of otosclerosis.
Autosomal dominant with variable penetrance.
Slowly progressive which leads to hearing loss.
Describe the cellular origin of acoustic neuromas and list the common signs/symptoms.
Encapsulated benign tumors exhibiting Schwann cell differentiation arising from peripheral nerves.
Local compression of involved nerve can lead to tinnitus and hearing loss.
Define xerostomia and any associated clinical conditions.
Dry mouth resulting from a decrease in the production of saliva.
Autoimmune disorder Sjögren syndrome. Side effects of certain medications.
What are the complications of unmanaged xerostomia?
Increased rates of dental caries, candidiasis, difficulty in swallowing and speaking
What is the difference between sialadenitis and sialolithiasis?
Sialadenitis:
Salivary glands; induced by trauma, viral/bacteria infection, and autoimmune disease; Sjögren syndrome
Sialolithiasis:
salivary glands; induced by obstruction of the orifices of the salivary glands; can lead to sialolithiasis.
