Mucous Membrane Variances

Question 1

what does gingival pigmentation vary due to

Answer 1

differences in melanocyte activity in the basal cell layer. melanin granules vary in density person to person

Question 2

what does less attached gingiva mean

Answer 2

more non-keratinized unattached gingiva

Question 3

what does the lip contain

Answer 3

-capillary loops
-vermillion border: line between keratinized and non keratinized tissue on the inside of the lip which has an increased amount of capillary loops
-thin para keratinized layers
-mucous secreting glands

Question 4

describe filiform papillae and their location

Answer 4

-hair like papillae
-most numerous
-highly keratinized
- located over the entire dorsal surface of the tongue

Question 5

describe fungiform papillae and their location

Answer 5

-fungus like
-small, round red surface projections
-tend to contain taste buds for salt and sweet
-located at the tip of the tongue

Question 6

describe foliate papillae and their location

Answer 6

-leaf like papillae
-contain lymphoid nodules with germinal centers
- contain taste buds for sweet
-located on the posterior lateral margins of the tonuge

Question 7

what makes up waldeyers ring

Answer 7

-palatine tonsils
-pharyngeal tonsils
lingual lymphoid nodules on the foliate papillae

Question 8

describe circumvallate papillae and their location

Answer 8

• walled papillae
  -generally only about 6-8 per tongue
  -lightly keratinized
  -contains taste buds for bitter
• papillae sulcus is cleared of taste stimuli by serous salivary glands of Von Ebner
  -located anterior to the sulcus terminalis on the posterior dorsal tongue surface

Question 9

where are taste buds located and what do they contain

Answer 9

line inside of papillae and usually contain glands of von ebner that sit inside crevice and pump out fluid to wash away stimulus from taste bud so you can continue to taste over and over again

Question 10

what are taste cells

Answer 10

neuroepithelial cells, specialized epithelial cells that can detect different taste sensations. depending on the part of the oral cavity affected there will be different cranial nerve that is activated

Question 11

where do taste fibers from all three nerves 7,9 and 10 converge

Answer 11

in the tractus solitarius in the brain stem

Question 12

what cranial nerve is activated in the anterior 2/3 of the tongue

Answer 12

CN VII via chorda tympani branch

Question 13

what cranial nerve is activated in the posterior 1/3 of the tongue

Answer 13

CN IX

Question 14

what cranial nerve is activated in the soft palate

Answer 14

CN VII via the greeter petrosal branch

Question 15

what cranial nerve is activated in the walls of the pharynx and epiglottis

Answer 15

CN X

Question 16

what happens in coffee coating

Answer 16

foliate papilla are coated

Question 17

what happens in drug induced linchenoid reaction

Answer 17

can be ulcerative, leukoplakic, or hypertrophic

Question 18

what happens in lichen planus

Answer 18

-T lymphocytes infiltrates with langerhans cell hyperplasia are characteristic
-cell mediate immune injury to basal cells is suspected
-ulceration/loss of tissue above the basal cell layer is seen due to lymphocyte attraction from langerhans cells
- can be stress induced

Question 19

what is the treatment for lichen planus

Answer 19

steroids to decrease immune response

Question 20

what is candidiasis

Answer 20

caused by candida albicans
- fungal infection
-typically asymptomatic and can be wiped off

Question 21

what is the treatment for candidiasis

Answer 21

anti-fungal agents

Question 22

what is a fissured tongue

Answer 22

thickened tongue, multiplied epithelial layers causes swelling and deep fissures
-age related and connected to xerostomia patients

Question 23

what is hairy tongue

Answer 23

abnormal growth of the filiform papillae and delayed shedding of the keratin layer

Question 24

what is the treatment for hairy tongue

Answer 24

tongue scraper

Question 25

what is geographic tongue and causes

Answer 25

-not pathological - inflammation and desquamination of filiform papillae - asymptomatic and doesnt need treatment -idiopathic but could be stress, nutritional and genetically induced

Question 26

what is hyperkaratosis

Answer 26

thickening of stratum corneum often with abberant keratinization -considered precancerous

Question 27

what is the most common oral cancer

Answer 27

squamous cell carcinoma

Question 28

what populations have sqamous cell carcinoma more

Answer 28

-african american males -male to female ratio 3:1

Question 29

what is the most common site for squamous cell carcinoma

Answer 29

posterior lateral border of the tongue, floor of the mouth and ventral tongue surface

Question 30

strong relationship exists between sqaumous cell carcinoma and ____

Answer 30

-tobacco smoking -alcohol consumption - phenol exposure -oncogenic viruses (HPV) - immunosuppression (AIDS) - oncogenes and tumor suppressor genes

Question 31

what is the histopathology of sqamous cell carcinoma characterized by

Answer 31

-arises from dysplastic surface epithelium and features alterations in size, shape and organization of the cellular components -lesion exhibits invasive islands and cords of malignant squamous epithelial cells -inflammatory response to epithelium and necrosis may be present -abnormal production of keratin in form of keratin pearls

Question 32

what is mucosal pemphigoid

Answer 32

autoimmune disease, issue with adhesion of CT and epithelium

Question 33

what happens in mucosal pemphigoid

Answer 33

antigen attacks lamina lucida which contains pemphigoid receptors. antigen is the adhesion protein epiligrin found in the lamina lucida

Question 34

what is mucosal pemphigoid characterized by

Answer 34

linear accumulations of IgG and C3 along the basement membrane

Question 35

who is affected by mucosal pemphigoid

Answer 35

older adults 50-60 - females more than males by 2:1

Question 36

what is cicatrical

Answer 36

form of mucosal pemphigoid involving scaring -characterized by BMMP involvement of the conjunctiva of the eye resulting in scarring (symblepharon)

Question 37

what is a positive nikolyskys sign

Answer 37

if there is separation from the epithelial layer form CT underneath. either by air or probing

Question 38

what is ectodermal dysplasia

Answer 38

syndrome involving abnormal lack of development of ectodermal structures such as hair, eyebrows, eyelashes, and teeth

Question 39

what are the features of ectodermal dysplasia

Answer 39

-hypohidrosis (no sweat glands so they overheat) - depressed ridge of nose, pronounced supraorbital arches, severe xerostomia, and lack of development of teeth

Question 40

what is the inheritance pattern of ectodermal dysplasia

Answer 40

x-linked recessive

Question 41

what is peripheral ossifying fibroma

Answer 41

considered to be reactive (non-cancerous). the lesion is thought to represent the matruation of pyogenic granuloma

Question 42

where is POF exclusively present

Answer 42

on the gingiva

Question 43

what is the occurence of POF

Answer 43

teenagers and young adults with peak prevalence between ages 10-19 years due to hormonal changes -60-65% female cases

Question 44

what is the treatment for POF

Answer 44

surgical excision

Question 45

what is the histological appearance of POF

Answer 45

gingival mass with islands of calcified material derived from the periosteum