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CSP3 YR5- Restorative RESET > Oral Mucosa > Flashcards

Oral Mucosa Flashcards

1
Q

Mucous membrane - defintion?

A
  • the moist lining of body cavities that communicate with the exterior
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2
Q

The oral mucosa - definition?

A

Mucous membrane lining the oral cavity

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3
Q

Oral mucosa - functions?

A
  • protection against compressigenamd sharing forces
  • barrier against organisms and toxins
  • immunological defences
  • secretions providing lubrication, buffering and abs secretion
  • sensation of touch, proprioception, pain and taste
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4
Q

Oral mucosa - types? Role and anatomy?

A

Types:

  • masticatory oral mucosa (area of high compression such as the hard palate and gingiva)
  • lining oral mucosa (less compression and friction such as the lips, cheeks, alveolar mucosa, soft palate, ventral tongue and mouth floor
  • specialised (top tongue, lingual tonsils, gongival attachment to teeth and vermilion border)
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5
Q

Oral mucosa - components? Names?

A

Epithelium
Lamina propria
Submucosa (for softer tissues)

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6
Q

Oral mucosa - Oral epithelium - characteristics?

A
  • Stratified squamous epith (several layers)
  • keratinised or non-keratinised
  • ectodermal ir endodermal
  • different layers according to keratinocyte differentiation
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7
Q

Oral mucosa - oral epithelium - layers of keratinised epithelium?

A

Keratinised epithelium layers:

  • stratum germinstivum (stratum basale)
  • stratum spinosum (prickle cell layer)
  • stratum granulosum (granular layer(
  • stratum corneum (keratinised or cornified layer)
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8
Q

Oral mucosa - oral epithelium - layers of non-keratinised epithelium?

A

Non-keratinised layers:

  • stratum germinstivum (stratum basale)
  • stratum spinosum (prickle cell layer)
  • stratum intermedium (intermediate layer)
  • stratum superficiale
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9
Q

Oral mucosa - stratum germinativum - (layers, shape, separated by, replication, differentiation, stem cells, feedback)

A 
Progenitor cells.of keratinocytes
Layers:
- single
Shape:
- cuboidal
Separated by:
- from the lamina propria by basal lamina (base mem)
Replication:
- mitosis
- daughter cells mature while ascending to other layers
Differentiation:
- least
Stem cells:
- are though to be within the ridges that project in the underlying lamina propria
Feedback:
- negative to inhibit further maturation
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10
Q

Oral mucosa - stratum spinosum - layers? Shape? Maturation? Size? Specalisim? First apperance? Obland bodies? Appearance? Deepest layers?

A 
Layers:
- several
Shape:
- round to avoid
Size:
- larger and rounder than basal cells
Specialism:
- cytokeratin types contribute to from tonofilaments
Apperance:
- involcurin 
Obland bodies:
- intracellular granules rich in phospholipids
Apperance:
- spiny due to cell shrinkage 
Deepest layer:
- parabasal layer
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11
Q

Oral mucosa - stratum granulosum - organelles? Shape? granules? Precursor?

A 
Organelles:
- reduced
Shape:
- larger and flatter cells
Granules:
- more keratohyaline granules
Precursor:
- to filaggrin
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12
Q

Oral mucosa - stratum cornrum - organelles? Filled with/surrounded? Desmosomes? Thickness? Para vs ortho-keratin?

A 
Organelles:
- all lost
Filled with:
- tonofilaments surrounded by filaggrin
Desmosomes:
- weakened and so allows desquamantion 
Thickness:
- 20 cell thick
Para:
- has piknotic nuclei in stratum corneum 
Ortho:
- no nuclei
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13
Q

Oral mucosa - non-keratinised epith - tonofilaments? Keratohyaline? Location?

A 
Tonofilaments:
- less developed 
Keratohyaline:
- lack of
Location:
- intermedium and superficiale
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14
Q

Oral mucosa - cytokeratins - definition? #? Genes?

A 
Defintion:
- intermediate filaments specific to epith cells
#:
- 20 types 
Genes:
- 2 gene families
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15
Q

Oral mucosa - cytokeratins - 2 gene families? Distribution?

A

2 gene families:
- basic type II CK (1-8, 40-56 kDa)
- acidic type I CK (9-20, 53-67 kDa)
Each epith has a pair of each gene family

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16
Q

Oral mucosa - cytokeratins - simple vs stratification?

A

Simple:
- CK 7,8 and 18
Stratified:
- CK5/15, CK 4/13 and CK1/10

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17
Q

Oral mucosa - cytokeratins - functions?

A

Functions:

  • as part of the cytoskeleton
  • also form part of desmosomes and hemidesmosomes
  • important in metabolic integrity of cell
  • CK14 related to innveration of superficial mucosa through signal transduction
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18
Q

Oral mucosa - cytokeratins - distribution? CK5/14? CK14? CK1/10 and CK2/11? CK4/13? CK6/16? CK19? CK5/6/14? CK7/8/18 and 19?

A
  • CK5 and 14 restircyudd to the basal and parabasal layers
  • CK14 expressed by suprabasal layer
  • CK1/10 and CK2/11 expressed in suprabasal layer of masticatory mucosa
  • CK4/13 in the suprabasal layers in mucosa lining
  • CK6/16 assoc with rapid turnover epith
  • CK19 inconsistent marker of basal layer in mucosa lining
  • CK5/6 and 14 ventral tongue
  • soft palate (simple keratins) CK7,8 and 18 as well as CK19
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19
Q

Oral mucosa - cytokeratins - clinical considerations?

A
  • changes in CK due to inflammation
  • diagnostic histopatho
  • dysplastic changes revealed by CK alterations
  • CK determine cyst origin
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20
Q

Oral mucosa - non-keratinocytes - names? Characterisitics?

A 
Names:
- melanocytes 
- langerhans
- Merkel
- inflammatory
Characterisitics:
- lack cells CK and all ear as clear cells in H and E stained sections
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21
Q

Oral mucosa - non-keratinocytes - melanocytes - Function? Location? Derivatives? Melanin production? Organelles? Cell contact? Contact? Control of melanocytes? Melanin taken up? Pigment affected by?

A 
Function:
- melanin producing cells
Location:
- within the basal cell.kager
Derivatives:
- neural crest
Melanin production:
- tyrosinase
Organelles:
- protein synthesising
Cell contact:
- melanosomes
Contact:
- up to 40 keratinocytes
Control of melanocytes: 
- keratinocytes releases mediators important for melanocytes function 
Melanin taken up:
- kaeratinocytes actively take up melanin by phagocyptsing the melanocytes dendritic tips
Pigment affected by:
- size and degree of branching melanocytes
- size fo melanosomes
- number and degree of dispersion of melanosomes
- degree of melanisation of melanosomes
- degrad rate of pigment
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22
Q

Oral mucosa - melanocytes - melanin pigmentation - developmental causes?

A

Developmental causes:

  • melanin produced by melanocytes in the basal cell
  • no difference in the number of melanocytes between fair and dark skinned people, diff in activity
  • racial variations in the intensity and the distribution of the pigmentation
  • gingiva most common site
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23
Q

Oral mucosa - melanin pigmentation - Peutz-Jeghers Syndrome - Gene? Pigment type? Affected areas? Fades? Other signs?

A 
Gene:
- autosomal dominant
Pigment type:
- mucocutaneous pigment (resembles freckles)
Affected areas:
- buccal and lips
Fades:
- during adult life
Other signs:
- GI polyposis (SIl
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24
Q

Oral mucosa - melanin pigmentation - acquired causes? Addison’s disease? Hyperkeratosis? Drug induced?

A

Acquired causes:
- systemic disease, malignancy or simple local disorder
Addison’s disease:
- adrenal deficiency
- elevated secretion of ACTH by pituitary
- melanocytes stim properties
- pigment in masticatory trauma areas
Hyperkaratosis:
- assocnwith melanic pigment
- lesions dusky to greyish
- smoking (melanocytic reaction to irritation)
- melanin incontinence (present in subepith macro having leaked out
- similar to lichen plants (degrad of basal cell layer)
Drug induced:
- cystostatic and oral contraceptives
- antimalarial drugs (hard palate)
- tetracycline derivative (acne), discolour bones and teeth
Oral freckle
Malignant melanoma

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25
Q

Oral mucosa - Langerhans Cells - what is it? Location? Derivatives? Chemokines? Movement through body? Granules? Interactions? Functions?

A

Characterisitics:
- dendritic cells and APCs
Location:
- above basal cell layer
Derivatives:
- of bone marrow precursor, they leave blood stream and enter lamina propria before penetrating stratum germinativum
Chemokines:
- secreted by keratinocytes act as chemotactic agent
Movement:
- from local lynoh nodes via dermal lymphatic
Granules:
- birbeck granules (rod shaped)
Interaction:
- with T lympho
Functions:
- contact hypersensitivity reaction of skin
- anti-tumour immunity
- grant rejection
- propagator of HIV1 transmission to T cells

26
Q

Oral mucosa - non-keratinocytes - Merkel cells - found? Role? Derivatives? CK specific? Nuc apperance? Organelles?

A 
Found:
- in basal cell layers, close to nerve fibres and common in masticatory mucosa but absent in mucosa lining
Role:
- receptor
Derivatives:
- neural crest
CK specific:
- CK8/18 and 20
Organelles:
- deeply invag nucleus, nuclear rodlet, mito, free ribo and granules and vesicles adj to nerve
27
Q

Oral mucosa - lamina propria - 2 parts? Composition? ECM?

A

2 parts:
- superficial papillary layer (loose thin Col fibres)
- deep reticular layers (thick parallel collagen bundles)
Compsition:
- fibroblasts and immune cells
ECM:
- Col I 90% and Col III 8%
- small non-fibrillar collagen, elastin and oxytalan
- proteoglycans and glycoprots

28
Q

Oral mucosa - epithelial connective tissue interface - Name? Components? 2 zones? Synthesis of components? Laminin? Lamina densa? Linkage?

A

Name:
- basal lamina
Composition:
- fibrils and ground substance
2 zones:
- lamina lucida, found immediately under epith
- lamina densa (fibroreticular lamina)
Synth:
- by epithelial cells
- lamina lucida made of laminin
Laminin:
- cements type IV Col between the lamina densa and epith cells
Lamina densa:
- made of Col IV coated with heparan sulphate
- fibronectin found and bind fibroblast and proteoglycan
Linkage:
- thick Col fibre attached to lamina densa to link basal lamina to CT

29
Q

Oral mucosa - role of basal lamina?

A

Rolle:

  • provide mechanical adhesion between epith and CT
  • molecular barrier
  • response to injury
30
Q

Oral mucosa - submucosa - whatbis it? Contains? Composition influence?

A

What is it:
- layer of loose fatty or glandular CT
Contains:
- major BVs and nerves supplying the mucosa and separating it from the underlying bones and muscles
Compsition:
- determines the flexibility of the mucosal attachment to underlying structures
- minor salubery glands and serous and sebaceous present (rarelt)
- nodes of lymphoid tissue also be seen

31
Q

Oral mucosa - classification - types?

A

Masticatory oral mucosa
Lining oral mucosa
Specialised mucosae

32
Q

Oral mucosa - masticatory oral mucosa - subjected to? Covers what? Keratinised? Lamina propria?

A 
Subjected to:
- high compression and friction
Covers:
- the hard palate and the gingiva
Epith:
- keratinsied 
Lamina propria is thick
33
Q

Oral mucosa - lining oral mucosa - subjected to? Special fucntion? Covers the? Keratinised? Lamina propria?

A 
Subjected to:
- no high friction
Special function:
- mobile and distensible
Covers:
- lips, cheeks, alveolar mucosa, soft palate, ventral surface of tongue and floor of the mouth
Epith:
- non-kerat
Loose lamina propria
34
Q

Oral mucosa - specialised oral mucosa - located?

A

Located:

  • dorsal surface of tongue
  • lingual tonsils
  • gingival attachment to the teeth
  • vermilion border
35
Q

Oral mucosa - lip - skin/labial mucosa? Vermilion zone? Muscle type? Glands?

A 
Mucosa:
- skin on outer surface and labial mucosa on inner side
Vermilion:
- zone in between (transition zone, red)
Muscles:
- striated muscles in lip core
Glands:
- minor salivary gland in submucosa
36
Q

Oral mucosa - skin of lip - epidermis/dermis? Glands? Hair?

A

Keratinised epidermis and CT dermis
Hair follicles
Sebaceous glands and sweat glands

37
Q

Oral mucosa - vermilion zone - appendages? Glands? Keratinised? Lamina propria? Apperance colour? Junctional region? Infantile?

A
  • No skin appendages
  • Occasional sebaceous glands, but no mucous glands
  • Keratinised
  • Lamina propria has capillary loop
  • Red appearance clinically
  • junctional region between the vermilion zone and the labial mucosa is the intermediate zone
  • parakaratinsed
  • infants becomes thickened and forms suckling pad
38
Q

Oral mucosa - labial mucosa - epith? Lamina propria? Submucosa composition? CT fibres?

A 
Epith:
- thick non-kerat epith
Lamina:
- wide with short and irregular papilla
Submucosa:
- many minor salivary glands
CT fibres:
- dense bind the mucosa to the orbicularis oris muscle
39
Q

Oral mucosa - the cheek - located? Epith type? Keratinised? Submucosa composition? Muscle? Line across buccal? Ectopic gland?

A 
Located:
- buccal mucosa 
Epith type:
- lining mucosa
Keratinised:
- non-kerat with dense lamina propria 
Submucosa:
- many minor salivary
Muscle:
- buccinator muscle beneath glands 
Line:
- linea alba buccalis (kerat line in the buccal mucosa along occlusal plane)
Ectopic gland:
- sebaceous (Fordyce's granules)
40
Q

Oral mucosa - the gingiva - what is it? 2 main regions (definitions)? demarcation? gingival anatomy? gingival margin? gingival sulcus? JE? free gingival groove? principal fibres? healthy?

A

What is it:
- the portion of the oral mucosa that surrounds and is attached to the teeth
2 main regions:
- the attached gingiva (directly bound to the underlying bone and tooth)
- the free gingiva (narrow, not bound to any bone)
The free gingival groove demarcates the free from the attached gingiva (40% of teeth)

41
Q

Oral mucosa - the gingiva - gingival anatomy? gingival margin? gingival sulcus? JE? free gingival groove? principal fibres? healthy?

A 
Anatomy:
- JE
- enamel space
- sulcular epith
- gingival epith
- gingival lig
- alveolodental lig
- alveolar crest
Gingival margin:
- is the coronal limit of the free gingiva
Gingival sulcus:
- the unattached region between the free gingiva and the tooth
JE:
- area where the gingiva is bound to the tooth
Free gingival groove:
- follows contours of the CEJ
Principal fibres:
- running from cementum to gingiva
Healthy:
- shows stippling, corresponding to epith ridges
42
Q

Oral mucosa - attached gingiva - external surface? variations? 75% of surface? other characteristics?

A 
External surface:
- is masticatory mucosa
- keratinised epith variation
75%:
- parakeratinised
Characteristics:
- rete ridges
- mucoperiosteum
43
Q

Oral mucosa - free gingiva - what is it? sulcus size? depth matters?

A 
What is it:
- identical to attached gingiva
Sulcus:
- 0.5-2.0 is healthy
Depth:
- greater than 3.0mm is considered a perio pocket
44
Q

Oral mucosa - sulcular epith - formation/with? compared to lamina propria? CK? characteristics? base?

A 
Form:
- sulcular and JE form the gingival cuff
Compared:
- more folded interface
CK:
- different profiles
Character:
- thin and non-kerat
Base:
- sulcus at same level as free gingival groove
45
Q

Oral mucosa - JE - what is it? thinner? 2 layers? turnover rate? 2 basal laminae? lamina densa?

A 
What is it:
- junctional epithelium
extends from CEJ to the
sulcus base (2mm)
Thinner
- apically
2 layers:
- stratum basale and spinosum
Turnover rate:
- 5/6 days
2 basal laminae:
- interal (adj to enamel) and external (adj to lamina propria)
Lamina densa:
- internal lamina not clearly delineated (lacks Col IV and laminin)
46
Q

Oral mucosa - JE - spaces? fluid passes through space? length vari? on eruption? occlusion? later on in life? recession?

A 
Spaces:
- smaller number of desmosomes result in space (5% of tissue vol)
Fluid:
- crevicular fluid and immune cells pass through spaces
Length:
- varies with the stage of eruption
On erupt:
- most of enamel covered by JE
Later lon:
- JE and CEJ
Recession:
- apical mig and contact with cementum
47
Q

Oral mucosa - crevicular fluid - seal environment? location? course? function?

A

Seal environ:
- dentogingival junction seals lamina propria from oral environment
Location:
- within sulcus, results from the permeability of the JE
Course:
- pass from the lamina propria into the sulcus
Function:
- important for defence mech

48
Q

Oral mucosa - interdental papilla - location? shape and size? between? interdental col? fills?

A

Location:
- interdental gingiva occupies area between adj teeth
Shape and size:
- depend on contact point
- wedge shaped appearance on buccal and lingual
Between:
- anterior teeth
Interdental Col:
- a curved depression across the buccolingual plane
FIlls:
- the contour around the contact point

49
Q

Oral mucosa - col - what is it? kerat? spaced teeth?

A 
Col:
- epith of col continuous with the JE
Non-keratinised
Spaced teeth:
- no col, have thin keratinised gingiva instead
50
Q

Oral mucosa - gingival lamina propria - fibroblasts? less characteristics? turnover rate? rich in? histamin resp? dense Col bundles? principal fibres?

A 
Fibroblasts:
- lack alkaline phosphatase 
- less contractile prots, ground sub, Col III
Turnover:
- lower
Rich in:
- vasc, 2 plexi beneath the oral SE and beneath GE
Histamin:
- release more prostaglandin
Dense Col bundles:
- support fee gingiva
- bind attached gingiva to alveolar bone and tooth
- lankage to adj teeth
Principal fibres:
- divided into groups on location
51
Q

Oral mucosa - gingival lamina propria - fibres?

A 
Dentogingival 
Longitudinal
Circular
Alveologingival
Dentoperiosteal
Transseptal
Semicircular
Transgingival
Interdental
Vertical 
Oblique
Apical
Interradicular
52
Q

Oral mucosa - alveolar mucosa - what is it? location? characteristics? attached to

A

What is it:
- attached gingiva is demarcated from the
alveolar mucosa by the mucogingival junction
Location:
- 3-5mm below the alveolar crest
Characteristics:
- non-kerat, loose submucosa (elaston), BVs near surface and minor salivary
Attached to:
- submucosa attached to periosteum

53
Q

Oral mucosa - hard palate - mucosa type? epith type? submucosa exists? nasal surface lining? type of submucosa?

A 
Mucosa type:
- masticatory
Epith type:
- keratinised
Submucosa:
- none present especially centrally
- exists where the palate meets the alveolus (contains main neurovascular bundle)
Nasal surface:
- lined with respiratory epith
- ciliated columnar epith with goblet cells
Type of submucosa:
- vascular submucosa with minor glands
54
Q

Oral mucosa - soft palate - epith type? histo description? submucosa?

A 
Epith type:
- non keratinised
Histo description:
- short broad CT papillae
submucosa:
- with many salivary
 glands
55
Q

Oral mucosa - floor of the mouth - FoM and ventral tongue lining? function? epith type? submucosa? lamina propria?

A

FoM and ventral tongue lining:
- both the floor of the mouth and the ventral surface of the tongue have a typical lining mucosa
Function:
- need for mobility
Epith type:
- thin, non keratinised epithelium with short
papillae
Submucosa:
- submucosa considerable for the floor of the mouth, but almost absent for the ventral surface of the tongue
Lamina propria:
- highly vasc (drug route)

56
Q

Oral mucosa - tongue - split? cover 2/3? has lots 1/3? types of papillae? filiform? kerat? central core? papillae (function)

A 
Split:
- anterior 2/3 are divided from the post 1/3 by sulcus terminalis 
Cover 2/3:
- covered with papillae
Has lots 1/3:
- lymphatic nodules
Types of papillae:
- filiform, fungiform, foliate and circumvallate
Filiform:
- largely cover the ant 2/3 of dorsum tongue
Kerat:
- yes (para or ortho)
Central core:
- of lamina propria with 2nd papillae branch
Function:
- highly abrasive (mechanical)
57
Q

Oral mucosa - tongue - fungiform papillae - location? size? epith type? core? also found here?

A 
Fungiform:
- found as isolated elevated mushroom shaped papillae between filiform
Size:
- 150-400um
Epith type:
- kerat or non-kerat
Core:
- vasc lamina propria
also found:
- taste buds on surface
58
Q

Oral mucosa - tongue - foliate papillae - located? epith type? other found?

A

Foliate:
- may be found as 1-2 longitudinal clefts at the side of the posterior part of the tongue
Epith type:
- non-kerat
Other found:
- taste buds maybe found within their epithelium

59
Q

Oral mucosa - tongue - circumvallate - size? surrounded by? projection? epith type? other found?

A 
Size:
- large and rounded
surrounded by:
- trench like structures
projection:
- not beyond surface of tongue
Epith type:
- non-kerat
other found:
- taste buds on lateral wall of trenches
60
Q

Oral mucosa - tongue - Von Ebner’s glands - type? empty into?

A 
Von Ebner's
- serous gland
Empty into:
- base of trenches
Mucous glands also present
61
Q

Oral mucosa - tongue - taste bud - what is it? types? opening? types of cells? sensory cell types (appearance)? I and III form? separate bud from?

A 
What is it:
- a chemoreceptive organ of taste
Types:
- circumvallate, fungiform and foliate
Opening:
- small pore opens from surface into bud
types of cells:
- tase and supporting cells
Sensory cell types:
- I (appear dark)
- II (appear light)
- III (appear light)
- IV (are undiff, lay basally and possess intermediate filaments)
I and III:
- form synapses with intrageminal nerves
Separate:
- basal lamina separates bud from lamina propria
62
Q

Oral mucosa - lingual tonsils - what are they? Part of? deep crypts? gland presence?

A

What are they:
- masses of lymphoid tissue on the lateral
border of the posterior third of the tongue
Part of:
- Waldeyer’s ring (lingual, palatine and pharyn)
Deep crypts:
- lined with epith containing masses of lymphoid tissue
Gland:
- mucous gland

CSP3 YR5- Restorative RESET (44 decks)

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