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BAMS > Oral Biology- structure and functions > Flashcards

Oral Biology- structure and functions Flashcards

1
Q

What are the 3 main functions of the periodontium

A
  1. Retain tooth in socket
  2. Resist masticatory loads
  3. Defensive barrier, protecting tissues against threats from the oral environments
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2
Q

What is the junctional epithelium?

A

The physical barrier separating the body tissues from the oral environment

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3
Q

What are the 2 types of typical types of cementum and define them

A
  1. Acellular cementum
    - no cells within
    - usually adjacent to dentine
    - first formed
  2. Cellular cementum
    - contains cementocytes
    - later formed
    - present in apical part of root and furcation regions
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4
Q

What are the alternative classifications for cementum? Define them

A

Acellular extrinsic fibre cementum

  • collagen fibres from PDL (sharpeys fibres) penetrate it
  • equivalent to primary cementum
  • present at cervical 2/3 of roots

Cellular intrinsic fibre cementum

  • no sharpeys fibres
  • intrinsic collagen fibres parallel to surface
  • no role in tooth attachment
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5
Q

What is the function of alveolar bone and what role does it play in attachment?

A

Alveolar bone supports the teeth

It provides attachment for periodontal ligament fibres (sharpeys fibres)

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6
Q

What happens to the alveolar bone when teeth are lost?

A

The alveolar process is resorbed, leaving a ‘residual ridge’

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7
Q

What is the periodontal ligament and what 5 things does it contain?

A

A connective tissue

  • cells
  • extra cellular matrix
  • fibres
  • nerves
  • blood vessels
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8
Q

What property does the extracellular matrix in the PDL have?

A

Behaves as a viscoelastic gel

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9
Q

What 5 types of cells are present in the PDL?

A 
Fibroblasts
Cementoblasts
Osteoclasts and cementoclast
Epithelial cells
Defence cells
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10
Q

What 2 main divisions of nerves are in the PDL? And any subdivisions within them

A
  1. Sensory
    i) mechanoreceptors (Aβ and Aδ fibres)
    - rapidly and slowly adapting
    - proprioception: chewing control
    ii) nociceptors (Aδ and C fibres)
    - protective reflexes
    - inhibit jaw elevator motor neurons
  2. Autonomic (sympathetic)
    - blood vessel control- vasoconstriction
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11
Q

What is the PDL blood supply for

a) the PDL passing into the alveolar bone
b) the gingiva

A

a) inferior and superior alveolar arteries

b) lingual and palatine arteries

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12
Q

What are the 2 types of periodontal fibres

A

True periodontal ligament
- fibres connecting tooth to bone, at or apical to alveolar crest

‘Gingival’ ligament

  • fibres mainly ABOVE alveolar crest
  • including ‘free gingival’ fibres
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13
Q

What is the function of the periodontal ligament?

A

Attaches tooth to jaw

Transmits biting forces to alveolar bone

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14
Q

What is the width of the PDL

A

Approx 0.2mm

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15
Q

What 3 types of fibres are present in the PDL

A
  1. Collagen (types I and III)
    - principal fibres- true periodontal ligament
    - support tooth; load bearing
  2. Oxytalan fibres
    - present in human PDL
    - function uncertain
  3. Elastic fibres
    - absent in humans
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16
Q

What is the function of gingival fibre groups in the peridontium?
Name the 4 types

A

Support the free gingiva

Dento-gingival
Alveolo-gingival
Dento-periosteal
Circular

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17
Q

Name 4 circumstances the PDL is most subjected to intrusive forces

A

Mastication
Swallowing
Speech
Parafunctions (e.g. Clenching, grinding)

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18
Q

What is the periodontium?

A

The tissues surrounding and supporting the teeth

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19
Q

Describe regional variations in enamel in terms of mineralisation and hardness

A

Surface enamel is more mineralised and harder than deeper enamel

Hardness decreases from cusp tip/incisal edge to cervical region

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20
Q

What is the basic unit of enamel and what is its dimensions?

A

Enamel rod (or prism)

5 μm x 2.5 mm

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21
Q

From where and to where do enamel rods run?

How many HA crystallites are in each rod?

A

Run from ADJ to enamel surface (whole length)

Rods contain >10^6 HA crystallites

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22
Q

What is the composition of enamel?

A

HA: 95% weight 90% volume
Water: 4% weight. 5-10% volume
Organic matrix: 1% weight. 1-2% volume

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23
Q

What makes up HA and what is its chemical formula?

A

Calcium, phosphate and hydroxyl

Ca10(PO4)6(OH)2

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24
Q

What are the dimensions of HA crystallites?

A

70 nm x 25 nm x upto 1 μm

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25
Q

Define enamel tufts (histological)

A

Hypo mineralised regions in enamel due to residual matrix protein at prism boundaries

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26
Q

Define enamel lamella (histological)

A

Incomplete maturation of groups of prisms

‘Fault’ line extending through enamel thickness

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27
Q

Define enamel spindles (histological)

A

Odontoblast processes extending into enamel

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28
Q

What is dental pulp?

A

The connective tissue ‘core’ of the tooth

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29
Q

What 5 components make up dental pulp, and examples where appropriate

A
  1. Cells
    - odontoblasts
    - fibroblasts
    - defence cells
  2. Extracellular components
    - fibres: collagen, oxytalan
    - matrix: proteoglycans, chondroitin sulphate, dermatan sulphate
  3. Nerves
    - sensory
    - autonomic (sympathetic)
  4. Blood vessels
  5. Lymphatics
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30
Q

Name 5 pulp functions and how it achieves them

A
  1. Nutritive- blood vessels
  2. Dentine growth (primary, secondary)
  3. Dentine repair (tertiary)
  4. Defence- immune cells; lymphatics
  5. Neural- sensory
    - control of dentinogenesis
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31
Q

From what do dentine and pulp develop?

A

Dental papilla

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32
Q

Name 6 causes of tooth wear

A
  1. Mastication (abrasion)
  2. Bruxism (attrition)
  3. Abfraction- occlusal overload- fractures and cervical lesions
  4. Diet (erosion)
  5. Caries
  6. Operative procedures- occlusal equilibrium
    - cavity cutting; crown prep etc.
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33
Q

When is tertiary dentine laid down?

A

In response to stimulation

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34
Q

What are the 2 types of tertiary dentine, when are they laid down and by what?

A
  1. Reactionary dentine
    - in response to a mild stimulus
    - laid down by primary odontoblasts
  2. Reparative dentine
    - in response to intense stimulus that destroys primary odontoblasts
    - laid down by secondary odontoblasts
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35
Q

What characteristic makes tertiary dentine different from the other dentines?

A

Tertiary dentine doesn’t have tubules because the odontoblasts lay it down so fast and they don’t bother with structure

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36
Q

What is the function of the odontoblast layer?

A

Acts as permeability barrier
Separates pulp and tubular space
Regulates movement of material between pulp and tubular ECF
Movement may be in either direction

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37
Q

What types of material are exchanged from the pulp to dentine and why?

A

Nutrients

- to sustain cells

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38
Q

What type of materials are exchanged from dentine to pulp, and where do they come from?

A

‘Toxins’ are diffused out

From bacteria; components of filling material

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39
Q

From what nerves do pulp nerves originate?

A

Alveolar nerves

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40
Q

How do neurovascular bundles enter the pulp?

A

Via the apical foramen (opening at base of root)

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41
Q

What 5 effects does outward dentinal fluid flow have?

A 
Cooling
Drying
Evaporation
Hypertonic solutions
Decreased hydrostatic pressure
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42
Q

What 3 effects does inwards dentinal fluid flow have?

A

Heating
Mechanical
Increased hydrostatic pressure

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43
Q

What activates the Aβ and Aδ fibres in pulp nerves?

A

Hydrodynamic stimuli applied to dentine

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44
Q

What activates C fibres in pulp nerves?

A

Probably activated directly by stimuli
Respond to most forms of intense stimulation
Probably mediate pain associated with pulp inflammation

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45
Q

What 4 things control pulp blood flow?

A
  1. Local factors e.g. Metabolites
  2. Nerves
    - sympathetic
    - somatic afferents
  3. Circulating hormones e.g. Adrenaline
  4. Drugs e.g. LA preparations with vasoconstrictors
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46
Q

What 4 functions do pulp nerves have?

A
  1. Sensory- mediating pain
  2. Control of pulp blood vessels
    - sympathetic: vasoconstrictor
    - afferents: vasodilator (axon reflex)
  3. Promote neurogenic inflammation
  4. Promote dentine formation

(Facilitate immune response?)

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47
Q

Immediate pulp response to injury?

A

Nociceptors activation- pain

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48
Q

Pulp response approx. one minute after injury?

A

Early inflammatory response
Konica, prostaglandins, neuropeptides
Vasodilation

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49
Q

Pulp response approx 10 minutes after injury?

A

Nociceptor sensitisation
Extravasation (leakage) of fluid, oedema
Polymorph (WBC) migration

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50
Q

Pulp response approx 100 minutes after injury?

A

Nerve sprouting (NGF- nerve growth factor)
Increased axonal transport
Accelerated excitability of CNS synapses

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51
Q

Pulp response approx 1 week after injury?

A

Repair, tertiary dentine

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52
Q

Define pulpitis

A

Acute inflammation in the dental pulp

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53
Q

What is different about pulpal inflammation to inflammations elsewhere?

A

Pulp cannot swell as it is confined within pulp chamber

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54
Q

What function does the hydrodynamic mechanism have?

A

It activates intradental sensory nerves

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55
Q

Explain the hydrodynamic mechanism

A

Stimulated by- thermal, mechanical, evaporative, chemical
Acts on- exposed dentine to open tubules
This increases rate of dentinal fluid flow
Action potentials are generated in the intradental nerves
These APs pass to brain and cause PAIN

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56
Q

Name and describe the 2 types of macroscopic bone

A
  1. Cortical, compact bone
    - dense outer plate
    - 80-85% skeleton
  2. Cancellous, spongy bone
    - internal trabecular scaffolding (irregular latticework)
    - 15-20% of skeleton
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57
Q

What is the cortical bone lining tooth sockets penetrated by?

A

Bundles of collagen fibres of PDL (Sharpey’s fibres)

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58
Q

By weight, what is the composition of bone?

A

60% inorganic
- hydroxyapatite

25% organic

  • collagen (90%)
  • glycoproteins- osteocalcin, osteonectin, osteopontin, sialoproteins
  • proteoglycans (GAGs)- chondroitin sulphate, heparan sulphate

15% water

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59
Q

What are the 2 types of microscopic bone?

A

Woven bone

Lamellar bone

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60
Q

Describe woven bone

A 
Rapidly laid down
Irregular deposition of collagen
Present in fetus
Fracture repair (callus)
Contains many osteocytes
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61
Q

Describe lamellar bone

A

Laid down more slowly
Collagen fibres laid down in parallel
Normal form in adults
Contains fewer osteocytes

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62
Q

Describe the structure of compact bone

A

Consists of osteons (haversian systems) that contain lamellae (concentric rings of hard, calcified ECM), lacunae (small hollow space), osteocytes and Central Haversian canals (containing blood vessels)
Lateral (volkmann’s) canals link the Haversian canals

63
Q

Describe the structure of cancellous, spongy bone

A

Network of thin trabeculae (columns)

The spaces between the trabeculae are filled with bone marrow

64
Q

Where are osteoblasts found, what are they derived from and how do they help in bone formation?

A

Lie on surface of bone
Derived from mesenchymal stem cells

Synthesise and secrete collagen fibres forming a matrix
The matrix is later mineralised by calcium salts forming bone

65
Q

Define osteocytes

A

Osteoblasts that become trapped in mineralised bone

66
Q

Where are osteocytes in bone and how are they in contact?

A

Lie within spaces- lacunae- in the bone

Contact other osteocytes via cytoplasmic processes that run in canaliculi (small canals)

67
Q

What are osteoclasts derived from, what are they related to and what is there function?

A

Derived from haemopoietic stem cells
Related to macrophages

They resort bone

68
Q

Where are osteoclasts found?

A

Lie in concavities of bone- Howships’s lacunae

69
Q

What percentage of cortical and cancellous bone is replaced every year?

A

Cortical bone- 2%

Cancellous bone- 25%

70
Q

Define cartilage

A

Semi-rigid, unmineralised connective tissue

71
Q

Name 3 types of cartilage and where they are found

A 
Hyaline cartilage (widespread)
- larynx, nasal septum, trachea, embryonic skeleton (precursor to bone)

Fibrocartilage
- intervertebral discs, pubic symphysis

Elastic cartilage
- external ear, epiglottis

72
Q

What forms cartilage?

A

Chrondroblasts

73
Q

What are the 2 types of bone growth?

A

Endochondral ossification

  • cartilage precursor
  • ‘long bones’

Intramembranous ossification

  • no cartilage precursor
  • ‘flat bones’
74
Q

Define achondroplasia

A

Genetic defect of cartilage growth

Endochondral bone growth is impaired

75
Q

Name the muscles of mastication

A

Temporalis
Masseter
Lateral pterygoid
Medial pterygoid

76
Q

Where is the origin of the masseter?

A

Zygomatic arch

77
Q

Where is the insertion of the masseter?

A

Lateral surface and angle of mandible

78
Q

What is the action of the masseter?

A

Elevates mandible

79
Q

How is the masseter examined?

A

It is tender in patients who have a clenching habit

To examine- place on finger intra-orally and other on the cheek

80
Q

Where is the origin of the temporalis?

A

The floor of the temporal fossa

81
Q

Where is the insertion of the temporalis?

A

At the coronoid process and anterior border of ramus

82
Q

What is the action of the temporalis?

A

Elevates and retracts mandible

83
Q

How would you examine the temporalis?

A

It is tender in patients who have bruxist habit

To examine- palpate its origin by asking the patient to clench their teeth together
Digital palpation is performed between the superior and inferior temporal lines just above the ears, extending forwards towards the supra-orbital region

84
Q

Where is the origin of the lateral pterygoid muscle?

A

From the lateral surface of the lateral pterygoid plate

85
Q

Where is the insertion of the lateral pterygoid?

A

The anterior border of the condyle and intra-articular disc via two independent heads

86
Q

What is the action of the lateral pterygoid?

A

Protrudes mandible, depresses mandible and moves mandible side to side

87
Q

Where does the inferior belly and the anterior belly of the lateral pterygoid attach?

A

Inferior belly- head of condyle

Superior belly- intra-articular disc

88
Q

How is the lateral pterygoid examined?

A

Not accessible to manual palpation

Best examined by recording its response to resisted movement

89
Q

Where is the origin of the medial pterygoid?

A

Deep head: medial surface of lateral pterygoid plate

Superficial head: tuberosity of maxilla

90
Q

Where is the insertion of the medial pterygoid?

A

Medial surface of angle of mandible

91
Q

What is the action of the medial pterygoid?

A

Elevates and assists in protrusion of mandible

92
Q

How is the medial pterygoid examined?

A

Not accessible to palpation
Doesn’t respond well to resistive movement test

No reliable way of examining

93
Q

What do the suprahyoid muscles connect?

A

Connect hyoid bone with mandible and skull

94
Q

What is the function of the suprahyoid muscles?

A

To elevate hyoid bone and related structures

95
Q

Name the 4 suprahyoid muscles

A

Digastric
Mylohyoid
Geniohyoid
Stylohyoid

Dicks make girls scream

96
Q

What do infrahyoid (‘strap’) muscles connect?

A

Connect hyoid bone, thyroid cartilage and shoulder girdle

97
Q

Name the 4 infrahyoid muscles

A

Sternohyoid
Omohyoid
Thyrohyoid
Sternothyroid

Sam often tickles shoulders

98
Q

What are the two types of tongue muscles and what are their functions?

A

Intrinsic- alter shape

Extrinsic- alter shape, position

99
Q

Name the 3 intrinsic tongue muscles

A

Longitudinal
Vertical
Transverse

Lindseys vagina talks

100
Q

Name the 4 extrinsic tongue muscles

A

Genioglossus
Hyoglossus
Palatoglossus
Styloglossus

Get her pumped, son

101
Q

What is the TMJ and what does that mean?

A

TMJ is a synovial diarthrodial joint

Means that joint is lubricated by synovial fluid and that the joint space is divided into two separate compartments by means of an intra-articular disc

102
Q

What 2 ways can you examine the TMJ?

A

Lateral palpation- TMJ should be palpated in the immediate pre-auricular area

Intra-auricular palpation- the little finger should be placed in the external auditory meatus and gentle forward pressure applied

103
Q

What is rotational jaw opening?

A

Purely rotational opening (rotating inside socket)

Condyle rotates in a hinge movement

104
Q

What is translation jaw opening?

A

A protrusive opening- TMJ comes out of socket
Condyle moves forward onto articular eminence
Maximum mouth opening
Protrusive and retrusive movements

105
Q

What are the usual maximum biting force between molars?

A

200-700 N

106
Q

What can cause an increase in biting force?

A

Increased muscle mass can increase biting forces

107
Q

What limits biting force?

A

The teeth themselves (could fracture)

108
Q

What are the 2 types of muscle fibres?

A

Type I and Type II

109
Q

Describe type I muscle fibres

A

Slow, weak
Very resilient (not easily fatigued)
Used under normal circumstances

110
Q

Describe type II muscle fibres

A

Fast, strong forces
Fatigue easily
Used for increased force- biting hard
Used under stress

111
Q

What are the subtypes of Type II muscle fibres

A

IIA, IIX, IIB

112
Q

Where is the greatest biting force and why?

A

Between the first molars

Molars are nearer the force generating muscles and the fulcrum (TMJ)
The also have a large root area- PDL support

113
Q

What sensory nerves are involved in innervating lower molar?

A

Inferior alveolar nerve

From the mandibular branch of the trigeminal nerve (CN V)

114
Q

What is the function of the gagging reflex?

A

To prevent material entering pharynx

115
Q

What cranial nerves are involved in the gag reflex?

A

V (trigeminal), IX (glossopharyngeal), X (vagus), XI (accessory) and XII (hypoglossal)

116
Q

What are 12 cranial nerves?

A 
Olfactory
Optic
Occulomotor
Trochlear 
Trigeminal
Abducens 
Facial
Vestibulocochlear 
Glossopharyngeal 
Vagus
Accessory
Hypoglossus
117
Q

What is Bell’s palsy?

A

Type of facial paralysis that does not have any other associated causes

118
Q

What are clinical features of Bell’s palsy?

A

Inability to wrinkle brow
Drooping eyelid; inability to close eye
Inability to puff cheeks
Drooping mouth; food stuck in cheek

119
Q

What motor nerve controls facial muscle and what are it’s branches?

A

Facial nerve

Temporal
Zygomatic
Buccal
Mandibular
Cervical

The zuberi’s bummed my cat

120
Q

Name 5 causes of Bell’s palsy

A 
Infections
Diabetes
Trauma
Toxins
Temporarily by infiltration of LA to facial nerve branches
121
Q

Name 4 general senses

A

Touch (mechanoreceptors)
Proprioception (proprioceptors)
Temperature (thermoreceptors)
Pain (nociceptors)

122
Q

Name 2 special senses

A

Taste (oral chemoreceptors)

Smell (nasal chemoreceptors)

123
Q

Give the 4 types of α nerve fibres and give their function

A

Aα - sensory (proprioception)
Motor (skeletal)

Aβ - sensory (mechanoreception and proprioception)

Aγ - motor (muscle spindles)

Aδ - sensory (mech, thermo, noci)

124
Q

What is the function of B nerve axons?

A

Autonomic (pre-ganglionic)

125
Q

What are the functions of C nerve axons?

A

Sensory (mech, thermo, noci)

Autonomic (post-ganglionic)

126
Q

What is a mechanoreceptor?

A

A sensory receptor that responds to mechanical pressure and distortion

127
Q

How sensitive are periodontal mechoreceptors?

A

Very sensitive

Able to detect material down to 20 μm (half the width of hair)

128
Q

What are the 2 types of thermoreceptors, where are they found and what nerve fibres do they involve?

A

Cold- increased firing rate with decreased temp
Located at dermis-epidermis junction
Aδ and C-fibre afferents axons

Warm- increased firing rate with increased temp.
Located in dermis
C-fibre afferent axons

129
Q

What is proprioception?

A

Awareness of position and orientation of body parts

130
Q

What in interdental discrimination?

A

Ability to gauge extent of mouth opening
Monitoring size of food particles
Detection of ‘high spots’

131
Q

What is the innervation of the taste buds?

A

Anterior 2/3 of tongue: chorda tympani (branch of facial nerve)
Posterior 1/3 of tongue: glossopharyngeal (IX)
Epiglottis: vagus (X)

132
Q

What is perception?

A

The organisation, identification and interpretation of sensory information

133
Q

Define dysphagia

A

Inability to swallow

134
Q

What are 5 cause of dysphagia?

A 
Stroke (unilateral)
Brain injury
MS
Gastroesophageal reflux disorder (GORD)
Tumours
135
Q

What are the three stages of swallowing? State whether they are voluntary or involuntary

A
  1. Buccal/oral phase (voluntary)
  2. Pharyngeal phase (involuntary)
  3. Eosophageal phase (involuntary)
136
Q

What are the 2 functions of swallowing?

A

Transportation of accumulated food through lower pharynx and oesophagus into the stomach = FEEDING function

Prevention of ingested material entering lower airway
= PROTECTIVE function

137
Q

Describe the 3 stages of swallowing liquids

A
  1. Liquid gathered anterior to the pillars of the fauces in the mouth
  2. Posterior oral seal forms between oral cavity and pharynx
  3. Liquid propelled through oropharynx and laryngopharynx into oesophagus
138
Q

Describe the 2 stages of swallowing solids

A
  1. Food is masticatory and bolus is gathered on pharyngeal part of tongue and vallecula (oropharynx)
  2. Bolus is propelled from tongue through hypo-pharynx into the oesophagus
139
Q

Describe the squeeze-back mechanism

A

Forward movement of tongue creates contact between tongue and hard palate
Contact point moves backwards, squeezing the processed food through the fauces

140
Q

Name 4 ways airway protection is achieved during swallowing

A
  1. Upward and forward movement of larynx
  2. Closure of laryngeal inlet
    - aryepiglottic muscles
    - epiglottis
  3. Adduction (movement) of vocal folds
  4. Stop breathing (apnoea)
141
Q

Describe the oral/buccal phase of swallowing

A

Voluntary
Squeeze-back mechanism
Bolus pushed into oropharynx
Duration NOT dependant on food CONSISTENCY

142
Q

Describe the pharyngeal phase of swallowing

A

Involuntary
Controlled by medulla oblongata
Larynx/upper oesophageal sphincter relaxes to allow food through
Duration DEPENDANT on food consistency

143
Q

Describe the oesophageal phase of swallowing

A

Involuntary

Peristalsis; rhythmic contraction of oesophagus

144
Q

What are the 3 stages in the chewing cycle?

A

Occlusal phase- intercuspal position (mandible is stationary, teeth joined)

Opening phase- lateral pterygoid and gravity depress mandible

Closing phase- masseter, medial pterygoid and temporalis elevate mandible back to phase 1

145
Q

What are the key roles of the tongue in the chewing process?

A

Controlling and transporting food ‘bolts’ within mouth

146
Q

Define dysphasia

A

A specific language disorder

Involving damage to particular parts of the brain

147
Q

Define dysarthria

A

Difficulty speaking caused by problems with muscles used in speech
Due to neuro-muscular defects

148
Q

Name 4 oral causes of language and speech defects

A

Malocclusions
Loss of teeth
Cleft palate- oral and nasal cavities not seperated
Dry mouth (xerostomia)

149
Q

Define a consonant

A

Letter which causes the partial or complete stoppage of airflow

150
Q

What term is used for a consonant where air escapes through constriction
Give 4 examples

A

Fricatives

S, f, v, th

151
Q

What term is used for consonants that have a sudden release after complete stoppage of airflow?
Give 6 examples

A

Plosives

B,p,t,d,k,g

152
Q

What term is used for consonants where air flows through the nose
Give 3 examples

A

Nasals

M, n, ng

153
Q

Define a vowel

A

Letter with continuous airflow

154
Q

Define embouchure

A

The position and use of lips, tongue and teeth while playing a wind instrument

BAMS (9 decks)

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