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Oral Histology Exam 3 > Oral Mucosa > Flashcards

Oral Mucosa Flashcards

1
Q

what is the mouth lined by?

A

moist mucous membrane

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2
Q

what is mucous membrane?

A

organ composed of two tissues- epithelium and lamina propria

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3
Q

where does the blood vessels penetrate?

A

lamina propria/submucosa- do not penetrate in epithelium

arise in connective tissue

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4
Q

where are salivary glands?

A

lamina propria or submucosa (main location)- lubricate surface via ducts

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5
Q

how does oral mucosa serve as protection?

A

barrier between outside world and deeper tissue of oral cavity- epithelium>basal lamina
epithelium composed of sheets of cells connected via desmosome- keep things out of underlying tissue
also antimicrobial functions with immune cells more in lamina propria than epithelium. epithelial cells called beta defensins is secreted.

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6
Q

how does the oral mucosa help ingestion?

A

flexibility, moist surface- help us eat or otherwise can’t chew swallow, pass food anterior to posterior

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7
Q

is oral mucosa highly innervated?

A

yes

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8
Q

how does oral mucosa contrast with pulp and pdl

A

capable of more types of sensation

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9
Q

what fibers are in dentin and pulp?

A

c, adelta, abeta fibers- mostly pain

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10
Q

what fibers are in pdl?

A

c and a delta fibers- pain

a beta- proprioceptive

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11
Q

what fibers are in oral mucosa?

A

abeta- touch
adelta and c- pain
adelta and c- thermal
adelta- possible pain

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12
Q

what are the two types of tissue that are always present in oral mucosa?

A

epithelium and connective tissue- lamina propria and sometimes submucosa

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13
Q

what cells are all oral epithelium made of?

A

stratified squamous epithelium
*skin- stratified squamous
lining of blood vessels- endothelium- simple squamous epithelium
lining of stomach- simple columnar

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14
Q

is epithelium self renewing?

A

yes
deep layers= cell division
superficial layers- migrate and mature, surface- sloughed off

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15
Q

what happens with fast turnover?

A

can speed healing but also can make tissue more vulnerable to conditions that affect cell division (chemotherapy and radiotherapy)

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16
Q

turnover times for various epithelia

A

fastest- gut, junctional epithelium, taste buds, cheek, gingiva, skin

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17
Q

what occupies the most volume in epithelium?

A

cells

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18
Q

what cells are most numerous in epithelium

A

keratinocytes

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19
Q

what are the non-keratinocytes and where are they located?

A

melanocytes- pigment cells- make melanin- basal layers
langerhans (dendritic) cells- immune- supra-basal layers
merkel cells- sensory- basal layers
all clear cells

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20
Q

what are clear cells?

A

revealed by lack of cytokeratin staining

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21
Q

what do langerhan cells look like

A

simialr to melanocyte- but in suprabasal layers

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22
Q

what are melanocyte

A

have processes where melanin can be transported out. transferred to keratinocytes- darker skin

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23
Q

what are different oral regions lined by?

A

keratinized epithelium ex. gingva, hard palate

or non- keratinized epithelium ex. alveolar mucosa, buccal mucosa, soft palate

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24
Q

keratinized vs nonkeratinized

A

both: basal layer- cell division
both: prickle layer- appearance due to desmosomes- stratum spinosum
more superficial layers- distinct
granular layer in keratinized and intermediate layer in non-keratinized
keratinized layer in keratinized- no organelles, dehydrated, tougher
superficial layer in non- keratinized- organelles, flexible

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25
Q

what does all epithelial cells have?

A

keratinocytes- they contain cytokeratins

26
Q

what are cytokeratins

A

large (30) multigene family of proteins
assemble into intermediate filaments, provide cytoskeletal support
2 major groups: type 1: acidic, type 2: basic

27
Q

how are cytokeratins assembled?

A

central helical core flanked by non-helical ends
each cell expresses at least 2 cytokeratins- one of each type
assemble into coiled heterodimer
~10k heterodimers- intermediate filament (10nM)
coiled dimer assemble again and again until get robust fibers- intermediate filament

28
Q

characteristics of cytokeratins

A

mechanically tough- provide support- intermediate filaments- strongest cytoskeletal element- resist mechanical force without breaking
intracellular component of demosomes (cell-cell junction) and hemidesmosomes (junctions between basal cells and basal lamina)

29
Q

what derives epidermolysis bullosa simplex (EB simplex)

A

mutations in cytokeratins (basal layer)
rare
blistering in response to minor trauuma
most severe in epidermis but also oral consequences

30
Q

where do characteristic cytokeratins reside?

A

different epithelial layers and different epithelial tissues

31
Q

is there a complex pattern of cytokeratin expression in gingiva?

A

yes

32
Q

can cytokeratin expression change with disease state?

A

yes= 8 and 18 only in junctional epithelium normally but increase in other epithelium during cancer in mouth

33
Q

can mutations in cytokeratin genes produce regionally specific diseases?

A

yes
white sponge nevus- autosomal dominant disorder- mutation in one allele
mutation in cytokeratin 4 and 13- helical region
affects oral non- keratinized epithelia+ nasal mucosa, esophagus, anogenital region
soft white spongy plaques, clinically benigh
epithelial thickening, parakeratosis and vacuolization of suprabasal layers

34
Q

functional diff between keratinized and nonkeratinized

A

keratinized tougher
non-keratinized- more flexible
keratinized- more impermeable to outside substances

35
Q

what is important for mechanical properties of keratinized vs nonkeratinized epithelia?

A

different cytokeratin types

36
Q

what are the biochemical properties of cytokeratins in keratinized?

A 
promotes aggregation= form tonofibrils
permit binding to with fillagrin- keratohyalin granules- in granular layer 
superficial layers (keratinized)- very flat cells, dehydrated, no organelles, packed with cytokeratin (tonofibril/fillagrin complexes
37
Q

what do both non-keratinized and keratinized have in common?

A

amount of cytokeratin increases in superficial layers

38
Q

what are the biochemical properties of cytokeratins in nonkeratinized?

A

cytokeratin type does not [promote aggregation, cant complex with fillagrin
superficiall layers- cells not as flat or dehydrated, retain nuclei +cytokeratin tonofilaments

39
Q

what accounts for the permeability differences in keratinized and non-keratinized epithelium?

A

more directly related to other factors instead of type of cytokeratin
desmosomes contribute- more numerous in keratinized epithelia
membrane coating- intercellular permeability barrier
more membrane thickening in keratinized

40
Q

membrane coating granules

A

membrane-bound organelles, filled with glycolipids
1st appear in upper prickle cell layers
released in more superficial layers to coat cell
occur in both keratinized and nonkeratinized epithelia and serve as intercellular barrier to aqueous substances
differences in chemical composition creates a more effective barrier in keratinized

41
Q

membrane thickening

A

inner face of keratinocytes in upper layers of both non-keratinized and keratinized epithelium
much more pronounced in keratinized epithelium- cornified envelope- 15nm crosslinked protein sheath comprised of loricrin and other proteins instead of phospholipid bilayer
differences in membrane thickening produces a effective paracellular permeability barrier in keratinized epithelium

42
Q

what is parakeratinized epithelium-

A

intermediate variant

ex, inflamed gingiva

43
Q

incomplete keratinization

A

surface keratin separate from underlying epithelium and fill with fluid

44
Q

hyperkeratinization

A

occur in hard palate, smokers- surface layer hypertrophic

45
Q

what occupies most volume in lamina propria?

A

ecm

46
Q

what cells are present in lamina propria

A

fibroblasts, macrophages, mast cells, other inflammatory cells

47
Q

what does the ecm composed of?

A

pgs and gags
glycoproteins (fibronectin)
collagen 1 and 3
elastin

48
Q

what is the relative amt of type 1: type 3 collagen

A

greater for less flexible regions of the oral cavity
type 1- hard+rigid ct
type 3- softer ct

49
Q

what is elastin?

A

more prominent in oral mucosa than in pulp or pdl

more prominent in lamina propria or of oral mucosa

50
Q

what is at the epithelial connective tissue interface?

A

basal lamina- tough ct sheath- separate epithelium and lamina propria.
it is convoluted- contains epithelial rete pegs, connective tissue papillae
papillary layer, reticular layer- deeper layer of lamina propria
resist shear forces on interface- facilitate adhesion between epi and lp

51
Q

submucosa

A

2nd layer of ct
present under some regions of oral mucosa
contains larger blood vessels and nerves supplying superficial lp
glands
separates lp from bone and muscle

52
Q

where is there no submucosa?

A

tongue- lp to muscle

mucoperiosteum- gingiva, hardpalate next to gingiva, rugae region, median raphe- lp-bone

53
Q

lining mucosa

A

non-keratinized or parakeratinized epithelium
buccal and labial mucosa- thick
floor of mouth- thin
lamina propria- fewer collagen fibers and more elastiic fibers
relatively short broad connective tissue papillae
submucosa usually present
attachment to bone or muscle are loose and flexible
clinical implications: incisions more likely to gape and need to be sutured
injections less painful*

54
Q

masticatory mucosa

A

keratinized (or parakeratinized)
dense lamina propria
more collagen fibers/fewer elastic fibers than lining mucosa
many long thin connective tissue papillae
submucosa variably present in hard palate, not present in rugae, along midline raphe, adjacent to gingiva
clinical implications- incisions don’t gape, may not require suturing, injections more painfuk

55
Q

sulcular epithelium

A

part of free gingiva which faces tooth, generally non-keratinized

56
Q

junctional epithelium

A

unique
function- forms seal with hard tissue of tooth (enamel/cementum)
oriented along long axis of tooth
15-30 cells thick at top taper to 3-4 cells thick at bottom
straight basement membrane
keratin expression- simple epithelium
relatively non-differentiated cells, regardless of layer
no tonofilaments, desmosomes, no membrane coating granules= highly permeable
have 2 basal lamina: external (between je/lamina propria)- typical moelcular components
internal (between je and tooth)- integrin and laminin but lacks type 3 and 7 collagen
special laminin seal to tooth

57
Q

Odontogenic ameloblast associated protein odam

A

je expresses a protein initially associated with ameloblasts- consistent with its origin from reduced enamel epithelium
not known of function

58
Q

col

A

interdental space

characterized by junctional epithelium

59
Q

can junctional epithelium regenerate?

A

yes
relatively rapid
occurs around dental implants

60
Q

vascular supply of gingiva

A

superior alveolar and palatine- maxillary
inferior alveolar buccal, mental, sublingual- mandibular
goes to pdl, interdental; se[ta and oral mucosa into gingiva

Oral Histology Exam 3 (5 decks)

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