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semester 2 > Oral Biology > Flashcards

Oral Biology Flashcards

1
Q

occlusion definition

A

contact relationships of teeth or equivalent (dentures etc)

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2
Q

articulation definition

A

dynamic relationships of teeth when in sliding contact

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3
Q

jaw relationship definition

A

positional relationship which mandible bears to maxilla

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4
Q

rest/postural position of teeth

A

-teeth = apart

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5
Q

what maintains resting/postural position of teeth

A
  • minimal muscle activity

- muscle elasticity

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6
Q

why is resting/postural position important

A
  • remains reproducible/stable throughout life in dentate and edentulous subjects
  • important as a reference for full dentures
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7
Q

intercuspal position (ICP)

A
  • maximal intercuspation/interdigitation between mandibular and maxillary teeth depending on dentition
  • curve of wilson and spee
  • angles classification etc
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8
Q

position of condyles and teeth during retruded contact position/RCP/ligamentous position

A
  • condyles retruded in the glenoid fossa

- mandibular teeth 1-2mm posterior to ICP (this = ICP in 10-20% of patients)

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9
Q

clinical signif of retruded contact position

A
  • symmetrical retrusion
  • gives reproducible relationship between maxilla and mandible
  • can correct patients bite if incorrect with dentures etc
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10
Q

occlusal vertical dimension (OVD)

A
  • face height with teeth in ICP
  • measured between two arbitrary points
  • governed by height of teeth, therefore changes overtime due to wear
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11
Q

how is occlusal vertical dimension (OVD) measured

A

between two arbitrary points using a willis gauge

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12
Q

rest/postural vertical dimension (RVD)

A
  • face height with mandible in rest/postural position
  • measured between two arbitrary points
  • should not alter signif throughout life
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13
Q

what is freeway space (FWS)

A
  • space between teeth in rest position
  • diff in RVD and OVD
  • 2-5mm
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14
Q

during lateral excursion which side is the working side

A

-the side teeth move towards

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15
Q

during lateral excursion which side is the non working side

A

-the side teeth move away from

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16
Q

contact between teeth on working side during lateral excursion and importance

A
  • the teeth that touch during movement are called guidance teeth and can either be:
  • > canine guidance
  • > group function
  • important when restoring teeth as you have to stimulate lateral movements
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17
Q

contact between teeth on non working side during lateral excursion

A
  • teeth do not contact (disclude)

- may contact during cross bite, after extraction or due to upper removable appliances (URA’s)

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18
Q

condylar movement at working side during lateral excursion

A

-rotates around vertical axis
-lateral bodily movement
=bennett movement

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19
Q

condylar movement at non working side during lateral excursion

A
  • moves downwards and forwards and forwards over eminence
  • moves medially
  • creates bennett angle
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20
Q

bennett movement

A

at working side during lateral excursion

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21
Q

bennett angle

A
  • at non working side during lateral excursion

- describes the PATH of movement

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22
Q

balanced occlusion concept

A
  • tooth contact during excursions at both working/non working sides
  • ideal for F/F dentures (maintains stability and controls cusp shape/tooth position and orientation)
  • difficult to achieve because teeth are rarely in contact
  • cannot exist in a normal dentate occlusion
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23
Q

masticatory efficiency

A
  • experimental tests to define capacity to reduce size of food particles by chewing
  • eg. test food and serial sieve
  • can also use swallowing threshold test (how many times you chew before you swallow)
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24
Q

factors affecting masticatory performance

A
  • no. of teeth in functioning occlusion
  • replacement of teeth (fixed and/or removable prostheses)
  • F/F masticatory performance is less efficient (can be improved by implants)
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25
Q

muscle used in RCP

A

temporalis

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26
Q

condylar movement for protrusion

A

-symmetrical on left and right

=downwards and forwards

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27
Q

how is mastication controlled (3)

A
  • voluntary
  • pattern generator (happens semi-automatically, generator=programming centre)
  • reflex (rapid automatic control)
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28
Q

reflex definition

A

predictable response to a given stimulus

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29
Q

eg’s of reflexes (6)

A
  • knee jerk reflex
  • jaw jerk reflex
  • pupillary reflex
  • gag reflex
  • masticatory- salivary reflex
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30
Q

reflex pathway

A

stimulus -> receptor -> afferent neurone (from periphery to CNS) -> snapse (s) -> efferent neurone (from CNS to periphery) -> effector
-> response

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31
Q

stretch reflex and examples

A
  • simple
  • mono-synaptic (1 synapse)
  • eg:
  • > knee jerk reflex
  • > jaw jerk reflex
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32
Q

knee jerk reflex:

  • stimulus
  • receptor
  • synapse (s)
  • effect
  • latency
A
  • stretch via patellar tendon tap
  • muscle spindle
  • 1
  • contraction of quadriceps femoris
  • 19-24ms
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33
Q

reflex latency

A

=time from stimulus to effect

  • conduction time of afferent neurone + conduction time of efferent neurone + synaptic delay (max synaptic delay = 0.2ms per synapse)
  • > conduction time depends on the speed of the neurone and the time
34
Q

jaw jerk reflex:

  • stimulus
  • receptor
  • synapse (s)
  • effect
  • latency
A
  • stretch via chin tap
  • muscle spindle
  • 1 in V (trigeminal) motor nucleus
  • contraction of masseter muscle
  • 7-8ms
35
Q

role of jaw jerk reflexes (3)

A
  • tonic (resist gravity/help maintain posture, synapse constantly stimulated due to gravity?)
  • phasic/active (load COMPENSATES FOR LOAD DURING CHEWING, stabilises jaw during vigorous head movements e.g. running)
  • clinical (tests integrity of trigeminal nerve)
36
Q

protective reflexes:

  • synapse(s)
  • stimulus
  • eg’s
A
  • polysynaptic (greater than 1 synapse) reflexes
  • often response to noxious (damaging) stimulus
  • eg. limb flexion withdrawal reflex, jaw ‘opening’ reflexes
37
Q

flexion-withdrawal reflex

A
  • excite nociceptors, gives sensation of pain, one nerve (to biceps) is activated, other (to the triceps) is inhibited
  • excitatory neurone to the biceps
  • inhibitory neurone to the triceps
38
Q

jaw opening reflexes:

  • stimuli
  • receptors
  • response in sub primates (e.g. cats)
  • response in primates (inc. humans)
A
  • intra oral mechanical or noxious and extra oral noxious
  • mechanoreceptors and nociceptors
  • activation of jaw depressors/openers in cats
  • inactivation of jaw closers (inhibiting jaw closing) in humans
39
Q

response and latency of reflex following a gentle tap to tooth

A
  • response = early inhibition (of clenching, inhibits jaw closing)
  • latency= approx 10ms
40
Q

response and latency of reflex following harder tap to tooth

A
  • response = early and late reflex (stop clenching, inhibits jaw closing)
  • latency= approx 10 and 40 ms
41
Q

response and latency of reflex following painful stimulus to the lip

A
  • response = late reflex (stop clenching, inhibits jaw closing)
  • latency= approx 40 ms
42
Q

responses of inhibitory jaw reflexes

A
  • inactivation of jaw closing muscles
  • two phases:
  • > early (10-30ms)
  • > late (40-90ms)
43
Q

role of inhibitory jaw reflexes

A
  • prevent overloading of the masticatory system

- facilitates opening (to expel noxious material, and to minimise damage to intra-/peri-oral structures)

44
Q

jaw unloading reflex:

  • stimulus
  • response
  • result
A
  • sudden closure following hard biting (e.g. a hard/brittle food breaks)
  • inactivation of jaw closing muscles and activation of jaw opening muscles
  • teeth do not crash together
45
Q

EMG

A
  • electrodes put onto skin or needles into muscles to measure electrical activity of the muscle
  • to stimulate inhibitory response, patient clenches first before applying stimulus (mechanical and noxious can inhibit muscle activity stimulating jaw opening)
46
Q

CMD

A

=cranio-mandibular dysfunction/disorder

  • pain involving masticatory muscles and TMJ joints
  • protective reflexes are absent in these patients
47
Q

role of mastication (3)

A
  • breakdown of foodstuffs
  • > prepare for swallowing
  • > increase surface area for chemical digestion
  • > release of chemicals for sense of taste
  • stimulation of salivary flow
  • growth and maintenance of pro-facial tissues
48
Q

importance of mastication depending on food type:

  • very important
  • quite important
  • not very important
A
  • very important for red meat and vegetables
  • quite important for white meat
  • not very important for fish, egg, rice, bread and cheese (may speed up absorption)
  • > large particles take longer to pass through gut
49
Q

mechanics of ingestion/consumption (separate in most animals, overlap in humans) (4 steps) important

A
  • stage I transport (food from lips to cheek teeth, inc. molars and premolars)
  • mastication (chewing, except for liquids)
  • stage II transport (food from cheek teeth to the back of the tongue)
  • swallowing
50
Q

mechanics of mastication (4)

A
  • jaw movements (chewing cycles)
  • tongue movements (directing food onto crushing surfaces after it has been displaced due to chewing, crushing food, mixing food and saliva)
  • cheek movements (directing food)
  • lip movements (accepting food, retaining food via anterior oral seal and directing food)
51
Q

duration of the chewing cycle

A

0.5-1.2 seconds

52
Q

phases of chewing cycle (and diff. terminologies) (3)

A
  • opening, closing, occlusal phases
  • opening, fast closing, power closing phases
  • opening, fast closing, slow closing, intercuspal phases
53
Q

at which phases during the chewing cycle does food breakdown occur (2)

A
  • slow closing

- intercuspal

54
Q

masticatory forces (2)

A
  • physiological chewing forces (70-150N dentate and 4-55N edentulous)
  • maximum clenching forces (500-700N between molars, record = 4,345N)
55
Q

normal and abnormal masticatory movement pathways (4)
use these diagrams when asked to reproduce chewing cycle/phases, DO NOT use envelope of movement as this is extreme movements, whereas the cycle is not

A
  • tough foods = clockwise, wide oval, open go out to side and close again (quite lateral movement)
  • brittle foods = clockwise, thin oval (more vertical movement)
  • abnormal = anticlockwise or figure of 8 movements
56
Q

movements of condylar head during opening and closing on working side

A
  • opening = rotates around vertical axis, moves slightly (1-1.4mm) laterally (bennett movement)
  • closing = moves medially to normal position in glenoid fossa early on in closing phase, and rotates back to normal orientation
57
Q

movements of condylar head during opening and closing on non working side

A
  • opening = moves downwards, forwards and medially (described by bennett angle)
  • closing = moves upwards, backwards and laterally and returns to normal position in glenoid fossa late in closing phase
58
Q

movement of condylar head during opening of chewing cycle (working and non working side)

A
  • working side rotates around vertical axis, moves slightly (1-1.4mm) laterally (bennett movement)
  • non working sidemoves downwards, forwards and medially (described by bennett angle)
59
Q

movements of condylar head during closing of chewing cycle (working and non working side)

A
  • working side moves medially to normal position in glenoid fossa early on in closing phase, and rotates back to normal orientation
  • non working sidemoves upwards, backwards and laterally and returns to normal position in glenoid fossa late in closing phase
60
Q

sequence of muscle activation during opening phase of chewing cycle (3)

A

mylohyoid -> digastric -> lateral pterygoid

61
Q

sequence of muscle activation during closing phase of chewing cycle (3)

A

temporalis -> masseter -> medial pterygoid

62
Q

historical perspective on theories of masticatory control

A

-reflex chain theory (too simple)

63
Q

current theory of masticatory control

A

-combination of brainstem central pattern generator, cortical (voluntary) and reflex modulation

64
Q

central pattern generator theory of mastication (4 combinations) (long card, break it down)

A
  • peripheral influences -> jaw reflexes -> ‘masticatory’ muscle motor neurones -> ‘masticatory’ muscles
  • peripheral influences -> central neural pattern generator (pons) -> ‘masticatory’ muscle motor neurones -> ‘masticatory’ muscles
  • peripheral influences -> higher centres (e.g. cerebral cortex) -> central neural pattern generator (pons) (this stage can be skipped out) -> ‘masticatory’ muscle motor neurones -> ‘masticatory’ muscles
65
Q

stages of ingestion

A
  • food into front of mouth
  • transport?
  • > no (spit out)
  • > yes (stage I transport to posterior teeth)
  • tranpsort?
  • > no (chew)
  • > yes (stage II transport to back of tongue, bolus formation)
  • ready for swallowing?
  • > no (bolus formation continues)
  • > yes (swallow)
66
Q

swallowing frequency

A
  • approx 500-2500 per day
  • depends on activity:
  • > 25% while eating
  • > 65% when awake
  • > 10% when asleep
67
Q

seals involved in ‘command’ swallow (2)

A
  • applies to swallowing liquids
  • > anterior oral seal (lips)
  • > posterior oral seal (tongue-soft palate)
68
Q

phases of ‘command’ swallow (3)

A
  1. oral
  2. pharyngeal
  3. oesophageal
69
Q

describe oral phase of ‘command’ swallow (3)

A
  • tongue (stabilised and raised to hard palate)
  • soft palate (raised, nasopharyngeal seal, importance of cleft palate repair)
  • lower airway protected (breathing stopped, larynx raised)
70
Q

describe the pharyngeal phase of ‘command’ swallow (4)

A
  • tongue (backwards)
  • pharyngeal constrictors (squeezed)
  • upper oesophageal sphincter (cricopharyngeus, opens)
  • lower airway protected (epiglottis is down and vocal cords are closed)
71
Q

oesophageal phase of ‘command’ swallow (5)

A
  • primary peristalsis (moves bolus)
  • lower oesophageal sphincter opens
  • secondary peristalsis (reflex response to debris, cleansing- more for solids than liquids)
  • sphincters close
  • respiratory system (airway re-opens and breathing resumes)
72
Q

describe peristalsis

A
  • unidirectional wave of muscle contraction in a tubular organ (oesophagus, intestine, ureter)
  • powerful (normally gravity assisted, but can swallow upside down)
  • diff to other GI movements (e.g. segmentation is not unidirectional)
73
Q

diff between peristalsis in oesophagus and in intestine

A
  • eosophagus = wave of contraction above food bolus

- intestine = wave of contraction above food bolus AND wave of relaxation below food bolus

74
Q

diff between solid & liquid swallow

A
  • liquid = swallowed from the mouth and has distinct oral phase
  • solid = stalled from mouth and/or oropharynx, has an oro-pharyngeal phase
75
Q

diff between adult and infant swallow

A
  • adult = teeth together, jaw/tongue stabilised by jaw closing muscles, tip of tongue stable behind incisors
  • infant = gums apart, jaw/ tongue stabilised by facial muscles, ‘tongue thrust’ (anterior open bite = cause or effect)
76
Q

type of muscles that control swallowing

A
  • mainly skeletal muscle (motor neurone control)

- some smooth muscle (autonomic control)

77
Q

reflex swallowing pattern

A
  • sensory nerves -> higher centres (eg. cerebral cortex) -> swallowing centre (brainstem) -> swallowing muscle motor neurones -> swallowing muscles
  • can go from sensory nerves to either of the 2nd-5th stages
  • reflexes go straight to 5th step from sensory nerves
78
Q

voluntary swallowing pattern

A
  • higher centres (eg. cerebral cortex) -> swallowing muscle motor neurones -> swallowing muscles
  • > involves CNS
79
Q

description of reflex swallowing sensory nerves (3)

A
  • mechanoreceptive (back of mouth/pharynx)
  • water sensitive (epiglottis)
  • chemoreceptive (mouth)
80
Q

gag reflex

A
  • stimuli = mechanical at the back of mouth/oropharynx (rarely food, usually dental impressions)
  • CNS determines whether the stimuli are for swallowing or gagging, then produces one response or surpasses the other

semester 2 (9 decks)

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