Mucous Membranes Flashcards
True or False?
The mucous membrane of the mouth is considered to be an organ because it consists of multiple types of tissues working together in harmony
TRUE
Name the 2 types of tissues that make up the oral mucous membrane
- Oral Epithelium
- Connective Tissue
What all makes up the connective tissue of the oral mucosa?
- Lamina Propria & ****sometimes a submucosa layer
- Blood vessels
- Minor salivary glands
- Ducts of both major and minor salivary glands
Type of tissue tht is embedded in the oral mucosa at the lingual and palatine tonsils
Lymphoid Tissue
What part of the oral mucosa serves at the protective barrier?
Epithelium
What part of the oral mucosa serves as anti-microbial protection?
- Lamina Propria’s Immune Cells
- Epithelial cells synthesize and secrete several antimicrobial molecules such as beta-defensins
TERM – cysteine-rich, cationic, bind to negative charges on bacterial membranes and permeabilize
Beta-Defensins
True or False?
The oral mucosa is highly innervated
TRUE
Which option is more capable of more types of sensations?
- Oral Mucosa
- Pulp/dentin & PDL
Oral Mucosa
Dentin and Pulp receive sensations of?
PAIN
The PDL receives sensations of _____ &_____?
Pain and Proprioception
The oral mucosa receives sensations of…
1.
2.
3.
4.
- Touch
- Pain
- Innocuous Thermal
- Taste
True or False
The oral mucosa varies by region but is consistent with 2 types of tissue:
- Epithelium
- Submucosa
FALSE
- Epithelium
- Connective Tissue
(Submucosa is not always present in the connective tissue layer) – Basal Lamina IS present
TERM – defines ALL oral epithelium
Stratified Squamous Epithelium
The deepest layers of the oral epithelium are responsible for _____ ______ while the superficial layers are mature and are sloughed off
Cell Division
Name another type of organ that has the same type of tissue as the oral mucosa?
Skin
Name the type of epithelium in blood vessels
Simple Squamous Epithelium
A fast epithelial turnover can be
Great for?
Bad for?
Great – speed healing
Bad – more vulnerable to conditions that affect cell division
Rank the following in order from fastest to slowest epithelial turnover rates
- taste buds
- cheek
- junctional epithelium
- gingiva
- gut
- skin
- Gut
- Junctional Epithelium
- Taste Buds
- Cheek
- Gingiva
- Skin
TERM – time is takes for the epithelium to entirely replace itself
Turnover Time
A faster turnover can be harmful for patients that under go __________ for cancer
Chemotherapy
True or False?
Effects of head/neck radiotherapy can lead to diffuse mucositis/ulcers
TRUE
TERM – most numerous cell type in the epithelium
Keratinocytes
Keratinocytes are named based off of a their expressed protein called ____
cytokeratin
True or False?
Most of the epithelial volume is occupied by cells
TRUE
True or False?
The oral epithelium only consists of keratinocytes
False!
Non-keratinocytes too!
Name the 3 types of non-keratinized cells of the oral epithelium
- Merkel Cells
- Melanocytes
- Langerhans
These 2 non-keratinized cell types are located in the _______ layer and which one produces a ‘halo’ cytoplasm?
1.
2.
- Merkel Cells
- Melanocytes – halo
Located in the basal layer
What type of non-keratinocytes have immune functions and are also considered to be dendritic cells?
Langerhans
You would be able to differentiate a Merkel cell from a Langerhans cell by atleast 3 characteristics:
1.
2.
3.
- Merkel Cell –NO halo
- Langerhan is more supra-basal compared to Merkel cells (and melanocytes) in the basal layer
- Langerhan cells have dendritic cell processes
How would you be able to distinguish a Langerhan cell from a Melanocyte?
LOCATION
- Melanocytes are @ the basal layer
What is responsible for the “halo” effect in non-keratinized epithelial cells?
Lack of cytokeratin – no staining of cytokeratin
Type of non-keratinocyte that contains melanin pigment packed in melanosomes
Melanocyte
Keratinized or Non Keratinized?
Alveolar Mucosa?
Gingiva?
Alveolar Mucosa? – Non-keratinized
Gingiva? – Keratinized
True or False
Keratinized and non-keratinized epithelium do not have distinctive clinical appearances
FALSE - they dooo
True or False?
Both Keratinized and non-keratinized epithelium contain keratinocytes that express cytokeratins
TRUE
Major function for cytokeratins?
Provide skeletal support when assembled into intermediate filaments
Types of Cytokeratinocytes (progression)
??
- Monomer
- Parallel Dimer
- Antiparallel Tetramer
- Intermediate Filament
Different sets of cytokeratins are expressed by
- Different ________ ________
- Different ______ _________
- Different Epithelial Layers
- Different Epithelial Tissues
TERM –
- not only do these provide mechanical support to cells…
- they are an intracellular component of desmosomes and hemidesmosomes
Cytokeratins
Name this clinical defect
- Mutations in cytokeratins 5/14 – basal layer
- Rare
- Blistering in response to minor trauma
- most severe in epidermis but can also have oral consequences
- Sensitive to the slight touches (toothbrush)
Epidermolysis Bullosa Simplex (EB Simplex)
True or False
Non-keratinized epithelium is tougher and more impermeable compared to keratinized epithelium which is more flexible
FALSE
Keratinized epithelium is tougher and more impermeable compared to non-keratinized epithelium which is more flexible
Which is Non-keratinized epithelium?
- gingiva
- buccal mucosa
- hard palate
Buccal Mucosa
Which is Keratinized epithelium?
- gingiva
- buccal mucosa
- soft palate
- Alveolar mucosa
Gingiva
True or False?
Both Keratinized and Non-keratinized epithelium have a basal layer and prickle cell layer
TRUE
When viewing a histological image, how might you determine the difference between keratinized vs non-keratinized epithelium?
Look at the most superficial layer
Non-keratinized epithelium WILL have cells with organelles in the SF layer unlike Keratinized epithelium which will have a layer of dehydrated cells with NO organelles
True or False
Reguardless of keratinized vs non-keratinized epithelium, the amount of cytokeratin INCREASES in superficial layers
TRUE
Different cytokeratinocytes contribute to differences in _________ properties of keratinized and non-keratinized epithelial
Mechanical
What properties do cytokeratins have in keratinized epithelium?
- Promote aggregation
- Promote binding to fillagrin
- Superficial layers consist of very flat cells, dehydrated, no organelles, packed with cytokeratin
What properties do cytokeratins have in non-keratinized epithelium?
- Do NOT promote aggregation
- Superficial layers are NOT flat or dehydrated, retain nuclei and organelles, contain cytokeratin tonofilaments
Keratinized epithelium is _______ but less ________ than non-keratinized epithelium
Tougher
Flexible
Are desmosomes more numerous in keratinized or non-keratinized epithelium?
Keratinized
What contribute to permeability factors in the different types of epithelium?
Desmosomes
Membrane coated granules:
- Filled with?
- First appear in what layer?
- Released in what layer?
- Non-keratinized or keratinized or both?
- Serves as an _____ ____ to aqueous substances
- What creates the effectiveness of the barrier in keratinized epithelium?
- Glycolipids
- Upper prickle cell layer
- Released in more superficial layers to coat cell
- BOTH keratinized and non-keratinized epithelium
- intercellular barrier
- differences in chemical composition
True or False?
Membrane thickening is more pronounced in keratinized epithelium
True
The cornified envelope which is more pronounced in ________ epithelium consists of 15nm cross-linked protein sheat comprised of ________ & other proteins
Keratinized
Loricril
TERM– name for epithelium which is a hybrid between keratinized and non-keratinized epitheilium
Parakeratinized Epithelium
True or False?
Some nuclei are retained in parakeratinized epithelium
True
Name 2 other types of keratinizaton
- Incomplete keratinization
- Hyperkeratiniztion
Unlike the epithelial layer, the lamina propria is occupied mostly by _____
ECM
Name the type of cell NOT present in the lamina propria layer
- fibroblasts
- macrophages
- keratinocytes
- mast cells
Keratinocytes
Most numerous cell type in the lamina propria?
Fibroblasts
Proteoglycans, GAG’s, glycoproteins, collagen I&III and elastin are all components of the _____ in the lamina propria
ECM
A more flexible region of the oral cavity will have a greater amount of ____ collagen and lower amount of ______ collagen
Type III
Type I
Since the gingival is not as flexible as the buccal mucosa, what type of collagen would you suspect to see more of?
Type I
If you see tiny black dots that are stained for type I collagen, what is the histological technique?
Immunogold labeling
True or False?
Elastin is more prominent in the oral mucosa than in the pulp or PDL
TRUE
How is the epithelial and connective tissue layer connected?
Convoluted border consisting of rete pegs (epithelium) and connective tissue papillae (connective tissue) = PAPILLARY LAYER
True or False?
The length of rete pegs differs from location?
True
Areas in the oral cavity where mastication forces are strong will most likely have (short//long) rete pegs?
Long
________ of the gingiva reflects underlying pegs and connective tissue papillae
Stippling
What might be found in the submucosa layer (CT)
- Large blood vessels
- Nerves
- Glands
** supplying the lamina propria
The submucosa separates the lamina propria from ____?
Bone
True or False?
The submucosa layer is present in the tongue, gingiva, rugae region, and median raphe region
False
The gingiva and hard palate are examples of______ mucosa
Mastictory
Masticatory Mucosa is more rigid or flexible than lining mucosa?
Rigid
The following are examples of ______ Mucosa
- Alveolar Mucosa
- Soft Palate
- Cheek
- Underside of tongue
- Floor of mouth
Lining Mucosa
Would an injection site be more or less painful if given to areas of lining mucosa?
Less painful
What type of mucosa is less likely to gap if an incision is made?
Masticatory Mucosa
True or False?
The lining mucosa varies thickness levels between different areas of the oral cavity
TRUE
Is submucosa present in the lining mucosa?
Yes, usually
Compared to the masticatory mucosa, how would you describe the connective tissue papillae of the lining mucosa?
Short & Broad connective tissue papillae
What are the 3 regions of the lips?
- Exterior Skin
- Vermillion Zone
- Labial Mucosa
True or False?
Of the lip region, the exterior skin and vermillion border are considered to be keratinized epithelium
True
Mucous glands are located on which part of the lip epithelium?
Labial Mucosa
What is a logical explanation for why the vermillion zone of the lips becomes very dry?
No sweat OR mucous glands
Hair follicles are associated with which part of lip epithelium?
Exterior skin
Why is the vermillion border a distinguishable red-pink “line”?
Very superficial blood vessels
Superficial _____ ____ are present in the connective tissue papillae of the vermillion border epithelium region of the lips
capillary loops
Describe the lamina propria of the masticatory mucosa
Very dense; more collagen fibers and less elastic fibers
The submucosa is variably present in the ____ ____
Hard palate
Instead of the submucosa, ______ is present in gingiva?
Mucoperiosteum
Describe the appearance of the connective tissue papillae
Many long and tin connective tissue papillae
TERM – part of the free gingiva which faces the tooth, generally non-keratinized
Sulcular Epithelium
TERM –
- forms seat with hard tissue (enamel & cementum)
- oriented along the long axis of the tooth
- straight BM
- Simple epithelium -keratin expression
- relatively non-differentiated cells
- highly permeable
Junctional Epithelium
What consequences might a highly permeable junctional epithelium have?
- Suseptibility to bacteria
- Increased inflammatory molecules
Name the 2 types of basal lamina for the junctional epithelium
- external – JE/LP
- internal – JE/tooth
What 3 things are not present in internal BL but are present in external BL?
- Type IV collagen
- Proteoglycan BM-1
- Type VII collagen
What collagen components of the basal lamina provide direct connection to the collagen fibrils of the lamina propria
- Lamina Densa
- Anchoring Fibril
Name 3 unique proteins that are produced by ameloblasts during the maturation phase (internal BL of JE)
- AMTN – amelotin
- ODAM – odontogenic ameloblast assoc.
- SCPPPQ1 – secretory calcium binding photphoproteins proline-glutamine rich 1
When the 3 unique proteins made by ameloblasts are mixed together, they form a _____ _____ hypothesized to facilitate sealing of the JE to tooth surface
Porous Stucture
True or False?
JE can regenerate rapidly
Can also occur around implants
TRUE
Vascular supply of what 3 components go to supply the gingiva
- PDL
- Interdental septa
- Oral Mucosa
________ ________ demonstrates the blood vessels in the papillary layer of the gingiva using crevicular fluid
Fluorescein Angiopathy