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Oral Disease - Soft tissue > Introduction to oral mucosa > Flashcards

Introduction to oral mucosa Flashcards

1
Q

List the cells found in the squamous epithelium of the oral mucosa

A
  • Keratinocytes
  • Melanocytes
  • Langerhans cells
  • Neurosensory cells
  • Lymphocytes
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2
Q

What cell is predominant in the squamous epithelium

A

Keratinocytes

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3
Q

List the layers of the squamous epithelium

A
  • Basal cell layer
  • Prickle cell layer
  • (sometimes) keratinised layer
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4
Q

What does the basal cell layer of the squamous epithelium rest on?

A

The basement membrane

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5
Q

How are keratinocytes attached?

A

Via desmosomes

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6
Q

How are keratinocytes attached to the basement membrane

A

Hemidesmosomes

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7
Q

What is the importance of the basement membrane?

A

Maintains integrity of the mucosa by ‘sticking’ the squamous epithelium to the lamina propria

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8
Q

What are the two types of keratinisation seen in oral mucosa?

A

Parakeratinisation

Orthokeratinisation

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9
Q

Describe the cells in parakeratinisation

A

Surface keratinocytes are flattened and the nucleus is dark and shrunken (pyknotic)
They are eventually lose by desquamation

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10
Q

Describe the cells in orthokeratinisation

A

Granular cell layer present between the prickle and keratinised layer, containing keratohyaline granules
The surface squares are flat with no visible nucleus

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11
Q

Role of melanocytes

A

Synthesis of melanosomes

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12
Q

Role of Langerhans cells

A

Antigen trapping and processing

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13
Q

What are the neurosensory cells in the squamous epihtelium

A

Merkel cells

Taste budes

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14
Q

Role of merkel cells

A

Tactile sensory cells

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15
Q

What is the lamina propria

A

Connective tissue directly under the squamous epithelium

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16
Q

What are the layers of the lamina propria

A 
Corium (superficial layer) 
Reticular layer (deeper layer)
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17
Q

Describe the composition of the lamina propria

A

Fibrous tissue with a rich neuromuscular supply

Fibroblasts which form collagen, elastin and extracellular matrix proteins

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18
Q

List the other cells found in the lamina propria

A

Langerhans, macrophages, mast cells and lymphocytes

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19
Q

What is found beneath the oral mucosa?

A

Either

  • Submucosa (in oral mucosa)
  • LP continuous with periosteum (in oral mucoperosteum)
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20
Q

What is the submucosa composed of?

A
  • Fibrous tissue, adipose tissue, minor salv glands and neuromuscular bundles
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21
Q

Where is the oral mucoperiosteum found?

A

Covering the maxilla and mandible

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22
Q

Describe the difference between oral mucosa and oral mucoperiosteum

A

Oral mucosa has a submucosa

Oral mucoperiosteum has no submucosa, instead the LP is continuous with the periosteum that overlies the bone

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23
Q

What factors influence the appearance of mucosa?

A
  • Thickness
  • Amount of keratinisation
  • Melanin or other pigments
  • Vacularity of the LP
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24
Q

List the three main regional mucosal patterns and their relative %

A

Lining - 60%
Masticatory - 25%
Specialised - 15%

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25
Q

List the areas with lining mucosa

A
  • Vermillion border
  • LM, BM, FOM and ventral tongue
  • Soft palate
  • Alveolar mucosa
26
Q

List the areas with masticatory mucosa

A

Hard palate

Gingiva

27
Q

What is the reason for masticatory mucosa?

A
  • Thick epithelium to enable resistance to heavy loading

- Production of an inelastic seal (attached mucosa)

28
Q

List the area with specialised mucosa

A

Dorsum of the tongue

29
Q

Why is specialised mucosa, ‘special’?

A
  • Essentially masticatory mucosa but it is special due to the sensory component (taste buds)
30
Q

What is the dorsum of the tongue organised into?

A

Lingual papilla

31
Q

Describe keratinisation of the gingiva by location

A
  • Attached gingiva and external aspect of free gingiva = para and ortho
  • Sucular epithelium - non-keratinised
32
Q

List the junctions in the oral mucosa

A

Mucocutaneous
Mucogingival
Dentogingival

33
Q

Where is the mucocutaneous junction found?

A

Beterrn skin and oral mucosa of the lips

34
Q

Where is the mucogingival junction found?

A

Between attached gingiva and alveolar mucosa

35
Q

How can you clinically identify the mucogingival junction?

A

Scalloped border with slight indentation and contrasting change in colour

36
Q

What is the dentogingival junction

A

Where the oral mucosa meets the tooth

37
Q

What is the junctional epithelium?

A

The floor of the sulcus and the epithelium cervical to it

It is attached to the tooth

38
Q

What does the junctional epithelium arise from?

A

Reduced enamel epithelium of the tooth germ

39
Q

Describe the junctional epithelium

A

Stratified squamous, non-keratinised epithelium

40
Q

What is the sucular epithelium?

A

Epithelium lining the walls of the sulcus and is continuous with the rest of the oral mucosa

41
Q

What are the types of lingual papilla

A

Filliform
Fungiform
Circumvallate
Foliate

42
Q

Which papilla is most common?

A

Filliform

Gives the tongue the velvet appearance

43
Q

Describe fungiform papilla

A

Dome shaped

Non-ker and keratinised

44
Q

Describe the location of circumvallate pappila

A

V shaped line anterior to the sulcus terminals of the junction between middle and posterior third of the tongue

45
Q

Describe the location of foliate papilla

A

Postero-lateral tongue

46
Q

WHAT IS FOLIATE PAPILLA ASSOCIATED WITH

A

the lingual tonsil

47
Q

Which papilla does not contain taste buds

A

Filliform (the most common type)

48
Q

List the normal variable features of oral mucosa

A

Leukodema
Fordyce spots
Sublingual varicose
Lingual tonsil

49
Q

Describe leukodema

A

Translucent or milky white with a folded appearance to the mucosa
Common in those with racial pigmentation

50
Q

Describe Fordyce spots

A

Sebaceous glands in the oral mucosa

They are small, yellow bodies located on the upper lip, cheeks and anterior pillar of the fauces

51
Q

What are sublingual varicies

A

Varicosities of the branches of the sublingual veins

Usually incr with age and associated with smoking or CVD

52
Q

What is the lingual tonsil made of? where is it located?

A
  • Mucosa-associated lymphoid tissue (MALT)

- Postero-lateral tongue

53
Q

What pathologies are associated with lingual tonsil?

A
  • Trauma from teeth/dentures
  • Reactive limped hyperplasia secondary to local inflammation or infection
  • Obstruction and cystic dilation of tonsillar crypts
54
Q

What is Waldeyer’s ring

A

Largest accumulation of lymphoid tissue found in the posterior aspect of the oral cavity

55
Q

What makes up waldeyer’s ring

A

Lingual, palatine and pharyngeal tonsils

56
Q

What is linea alba

A

White line on the buccal mucosa, at the level of the occlusal plane
Keratinisation in response to trauma (cheek biting)

57
Q

Histology of the lining mucosa

A

Non-keratinised stratified squamous

Except for the vermillion border that is orthokeratinised

58
Q

What are the features of the lining mucosa

A

Stretched and compressed

The presence of the submucosa allows compression of the superficial tissue

59
Q

Histology of masticatory mucosa

A

Keratinised stratified squamous

60
Q

Type of keratinisation of the hard palate

A

Orthokeratinised

61
Q

Histology of specialised mucosa

A

Thick, keratinised and non-keratinised

The papilla are discrete structures of keratinised epithelium and LP

Oral Disease - Soft tissue (12 decks)

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