oral mucosa Flashcards

1
Q

what lines the mouth

A

Moist mucous membrane like the nasal pasages and GI tract

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2
Q

what tissues make up the Mucous membrane

A

an organ of epithelium and connective tissue

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3
Q

what makes up the connective tissue of the mucous membrane

A

lamina propria and sometimes submucosa

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4
Q

where are blood vessels in a mucous membrane

A

LAmina propria/submusosa

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5
Q

where are minor salivary glands

A

Lamina propria or submucosa

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6
Q

ducts from noth major and minro salivary glands travel through what

A

connective tissue to communication with mucosal surface

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7
Q

where is lymphoid tissue

A

embeddded in oral mucosa lingual and palatine tonsils

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8
Q

function of oral mucosa

A

PRotection as a barrier, antimicrobia

INgestion

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9
Q

what protects more basal lamina or epithelium

A

epithelium more protection

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10
Q

antimicrobial roll of oral mucosa

A

Immune cells

epithelial cells

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11
Q

What is more important for oral mucsa anti-microbial protection lamina propria or epithelium

A

Lamina propria

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12
Q

where are immune cells found int eh oral mucosa

A

in the lamina propria

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13
Q

roll of epithelium as an anti-microbial

A

synth and secrete several antimcrobial molecules

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14
Q

what antimicrobial molecules do epithelial cell synth

A

beta defensins
cathelicidin
calprotectin
adrenomedulin

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15
Q

features of beta defensins

A

Cysteine rich

cationic

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16
Q

how does BEta defensins work

A

Bind to negative charges on bacterial membranes and permeabilizes it

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17
Q

ingestion roll of the oral mucosa

A

Flexibility and moist surface

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18
Q

Innervation of the oral mucsa

A

Highly innervates

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19
Q

roll of sensory innervation of oral mucsa

A

augments protective and ingestive function

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20
Q

how is oral mucosa sensastion different from pulp/dentin and the PDL

A

MOre types of sensaation

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21
Q

what does touch in oral mucosa

A

A beta

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22
Q

what does pain in oral muscoa

A

A delta and C

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23
Q

what does innocuous thermal

A

A delta and C

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24
Q

what does taste

A

A delta

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25
Q

is oral mucosa always the same

A

Varies by region, but alwyas made of epithelium and connective tissue (lamina propria and submucosa)

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26
Q

what type of cells are all oral epithelium

A

stratified squamous epithelium

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27
Q

Deep layesr roll of epithelium of oral mucosa

A

Cell division

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28
Q

superficial layers roll of oral mucosahed off

A

Migrate and mature

sruface and sloughed off

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29
Q

layers of oral epithelium

A

Superficial layer
Intermediate layer
Prickle cell layer
Basal cell layer

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30
Q

pros and cons of fast turnover of oral mucosa

A

speeds healing but more vulnerable to conditions that affect cell divisions (Chemo and radiotherapy

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31
Q

Turnover time

A

Time it takes for epithelium to entirely replace itself

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32
Q

what fills most of the eptihelium

A

Occupied by cells

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33
Q

what type of cell is most common in epithelium

A

Keratinocytes most numerous

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34
Q

how are kertinocytes named

A

On the basis of their cytokeratin

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35
Q

types of Non-kertinocytes in the epithelium

A

Merkel cells
Melanocytes
Langerhands (dendritic cells)

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36
Q

clear cells of the eptihlium

A

Merkel cells

Melanocytes

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37
Q

Roll of merkel cells

A

Sneory

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38
Q

Roll of melanocytes

A

Pigment cells

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39
Q

Roll of Langerhans (dendritic) cells

A

Immunee

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40
Q

location of merkel cells

A

Basal layers

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41
Q

Location of melanocytes

A

Basal layers

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42
Q

Lcation of Langerhans cells

A

Supra-basal layers

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43
Q

how are celar cells revelaed

A

By a lack of cytokeratin staining

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44
Q

structure of melanocytes

A

Cell bone with processes in the basal layer

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45
Q

how is pigment packed in melanocytes

A

MElanosomes

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46
Q

how to tell difference between Langerhan’s and Melanocytes because both have process

A

Langerhands in supra basal layers

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47
Q

is oral mucosa keratinized or non-keratiinized

A

different regions (alveolar is non keratinized, gingiva is keratinized)

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48
Q

do keratinized and nonkeratinized epitheliu lok the same

A

Distincitive clinical appearance

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49
Q

what epithelium contains keratinocytes

A

both kertinized and non-keratinized epithelium

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50
Q

what do keratinocytes express

A

Cytokeratins

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51
Q

what are Cytokeratins

A

large multigene family of proteins

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52
Q

what do cytokeratins do

A

Assembling into intermediate filaments to provide cytoskeletal support

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53
Q

Types of Cytokeratins

A
type I (Acidic)
Type II (basic)
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54
Q

what is a cytokeratin made of

A

Central helical core flanked by non-helical ends

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55
Q

do all cells express cytokeratin

A

each cell expresses at least 2 cytokeratins ( 1 of each type)

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56
Q

How do cytokertatins assemble

A

into coiled heterodimers (helical regions cricical)

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57
Q

what forms an intermediate filament

A

10k heterodimers

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58
Q

Different sets of Cytokeratins are expressed by

A

Different epithelial layers

Different epithelial tissues

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59
Q

what types of keratin is expressed in the basal layer throughout the mouth

A

K5/14

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60
Q

Physical features of Cytokeratins

A

MEch tough to provide support

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61
Q

The stronest sytoskeletal element to resist mech force without breaking

A

Intermediate filaments

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62
Q

Roll of intermediate filaments between cells

A

Desmosomes and hemidesmosomes

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63
Q

mutation of Cytokeratins 5/14 Basal layer lead to

A

Epidermolysis bullosa simplex (EB simplex)

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64
Q

Commonness of EB simplex

A

rare

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65
Q

symptoms of EB simplex

A

blistering in response to minor trauma

most severe in epidermis but also in oral consequences

66
Q

Physical characteristics of keratinized vs non keratinized epithelium

A

KEratinized: tougher and more impermeable

Non-keratinized: more flexible

67
Q

where is keratinized epithlium found

A

gingiva

hard palat

68
Q

where is non-keratinized epithelium found

A

Buccal mucosa and soft palate

69
Q

what layers do both Keratinized and non-keratinized have

A

Basal layer

Prickle cell layers

70
Q

what layers distinguish KEratinizned and non-keratinized epithelium

A
The more superficial layers
Granular: keratinized
Intermediate: non-keratinized 
Keratinized layer: keratinized 
SUperficial: non-keratinized
71
Q

difference betwen keratinized and superficial layer

A

KEratinized: no organelles, dehydrated, tougher
superficial: organelles, flexible

72
Q

Roll of Cytokeratins

A

Contribute to mech toughness in both keratinized and non-keratinized oral mucosa

73
Q

amount of Cytokeratins as you go up in layer

A

Amount of cytokeratin increases in superficial layers in both types of oral mucosa

74
Q

what do different cytokeratine types contribute to

A

differences in mech properties of keratinized vs non-keratinized eptihlia

75
Q

tonofibrils

A

Cytokeratins that promote aggregation

76
Q

Fillgrin

A

Cytokeratins that promote binding to another molecules as the main component of keratohyalin granules

77
Q

morphology of superficial keratinized layers

A

Very flat
dehydrated
no organelles
packed with cytokeratin (tonofibril and fillgrain complexes)

78
Q

what dont Cytokeratins do in non keratinized epithelium

A

Do not promote aggregation

79
Q

morphology of superficial non-keratinized layers

A

Cells not as flat/dehrated
retain nuclei
kytokeratin tonofilaments

80
Q

physical properties of keratinized vs non-keratinized epithelium

A

KEratinized is tougher and less flexible

81
Q

what controls the permeability of keratinized and non-keratinized epithelium

A

Not the keratin but instead the desmosomes (more numerous in keratinized epithelia)

82
Q

what are membrane coating granules

A

MEmbrane-bound organelles filled with glycolipids

83
Q

where do membrane coating granules 1st appear

A

In upper prickle cell layers

84
Q

where are membrane coating granules released

A

Released in more superficial layers to coat cell

85
Q

what cells have membrane coating granules

A

Both keratinized and non-keratinized epithelia but have different in chem composition
greater effective barrier to keratinized epithelium

86
Q

what is the roll of MEmbrane coating granules

A

Serve as intercellular barrier to aqueous substances

87
Q

where does Membrane thickening occur

A

Inner face of keratinocytes in upper layers of both non-keratinized and keratinized epithleium

88
Q

what kind of epithelium experiences more membrane thickening

A

much greater pronounces in keratinized epithlium

89
Q

what is the cornified envelope

A

15nm of cross-linked protein sheath comprised of loricrin and other proteins to do membrane thickening

90
Q

the 3rd type of simple squamish epithelium in the mouth

A

Parakeratinized epithelium

91
Q

properties of parakeratinized epithelium

A

intermediate between the two types of epithlium

92
Q

morphology of parakeratinized epithelium

A

changes similar to keratinized (tonofibril/fillagrin complex)
nucleui and organelles may be retained in superficial layers

93
Q

incomplete keratinization

A

refers to rehydration of the dehyrated surface layer by saliva

94
Q

why does hyperkeratinization occur

A

mech trauma or irritation causing the keratinized layer of keratinized epithelium to becoe thick

95
Q

what makes up most of the volume of the Lamina propria

A

ECM

96
Q

cells of the lamina propria

A

Fibroblasts (most numerous)

macrophages, mast cells, inflammatory cells

97
Q

what makes up the ECM of the lamina propria

A

PG and GAG
Glycoproteins (fibronectin)
Collagen (type I and III)
elastin

98
Q

the relative amounts of type I: type III collagen is greater for what regions of the oral cavity

A

greater for less flexible regions

99
Q

least fleible regions of the mouth

A

Gingiva

100
Q

most flexible regions of the mouth

A

Buccal mucosa

101
Q

where is elastin more prominent

A

In oral mucosa more than pulp or PDL

102
Q

what is the Epithelial connective tissue interface

A

Basal Lamina

103
Q

shape of the Epithelial connective tissue interface

A

Convoluted

104
Q

what is in the papillary layer

A

rete pegs from the epithlium

connective tissue papilla from the lamina propria

105
Q

what is the papillary layer

A

the interdigitation of the epithelium with lamina propria

106
Q

what is the reticular layer

A

the part of the lamina propria that is just lamina propria

107
Q

what happens to gingiva to reflect the underlying rete pegs and connective tissue papillae

A

Stippling

108
Q

where is the submucosa found

A

present under some regions of oral mucosa

109
Q

what is found in the submucosa

A

larger blood vessels and nerves supplying superficial LP glands
Glands

110
Q

what does the submucosa separate

A

Separates LP from bone and muscle

111
Q

where is there no submucosa between lamina propria and muscle

A

the tongue

112
Q

where is there no submucosa between the lamina propria and bone (mucoperiosteum)

A

Gingiva
Rugae region
Median raphe

113
Q

where is masticatory mucosa found

A

Hard palate and gingiva

114
Q

where is lining mucosa found

A
Under of tongue
floor of mouth
alveolar mucosa
soft palate
check
verminon bornder of lip
Dorsal tongue
115
Q

what is the epithelium of lining mucosa

A

Non-keratinized or parakeratinized epithlium of variable thickness

116
Q

thickness of lining mucosa at the buccal and labia

A

thick about .5mm

117
Q

thickness of lining mucosa at the floor of the mouth

A

thin about .1mm

118
Q

what are the fibers of the lamina propria of lining mucosa

A

Fewer collagen fibers

More elastic fibers

119
Q

tissue papillae of lining mucosa

A

relativlet short broad connective tissue papillae

120
Q

submucosa of lining mucosa

A

usually presant

121
Q

attachments of lining mucosa

A

Bone or muscle atachement are loose and flexible

122
Q

Clinical implication of lining mucosa

A

Incisions more likely to gape and need to be sutured

Injections less painful

123
Q

Epithelium of the exterior skin of lip

A

Keratinized

124
Q

Thickness of lip exterior skin

A

Thinnest epithelium

125
Q

what is found in the exterior skin of the lip

A

Sweat glands
Sebacous glands
hair follicles

126
Q

Epithlium of the vermillion zone

A

keratinized

127
Q

Epithelium thickness of vermillion zone

A

THin

128
Q

blood vessl of the vermillion zone

A

close to the surface

129
Q

glands in the vermillion zone

A

No sweat glands or mucous glands

130
Q

epithlium of the labial mucosa

A

Non-keratinized

131
Q

thickness of labial mucosa

A

Thicker epithelium

132
Q

glands of labial mucosa

A

Mucous glands

133
Q

keratin of masticatory mucosa

A

Keratinized or parakeratinized

134
Q

Lamina propria of masticatory mucosa

A

Dense with more collagen fibers and less elastic fibers

135
Q

papillae of masticatory mucosa

A

long thin connective tissue

136
Q

submucosa of masticatory mucosa

A

Variably present in hard palate

no present in rugae region and along midline raphe, or gingiva

137
Q

when submucosa not present in gingiva

A

Mucoperiosteum

138
Q

clinical implications of masticatory mucosa

A

Incisions don’t gape
may not require suturing
injections hurt

139
Q

part of the free gingiva which faces tooth

A

Sulcular epithlium

140
Q

keratin of sulcular epithlium

A

non-keratinized generally

141
Q

how special is junctional epithlium

A

Unique

142
Q

what are parts of the periodontium

A

sulcular and junctional epithlium

143
Q

function of junctional epithlium

A

forms a seal with hard tissue tooth (enamel and cementum)

144
Q

orientation of junctional epithlium

A

long axis of tooth

145
Q

cell thickness of junctional epithelium

A

15-30 cells thick at top

3-4 cell thick at bottom

146
Q

basement membrane of junctional epithiium

A

straight basement membrane

147
Q

keratin of junctional epithlum

A

keratin expression for simple epithlium

148
Q

cells of junctional epithlium

A

relatively non-differentiated cells regardless of layer

149
Q

granules of juctional epithlium

A

< tonofilaments
< desmosomes
no membrane-coating granules

150
Q

permiablility of junctional epithlium

A

highly permiable

151
Q

basal lamina of junctional epithlium

A

external (JE/lamina propria) typical molecular components

Internal or speciailized (JE/tooth)

152
Q

what is found in the external basal lamina of the junctional epithlium

A

all components (type IV collagen, proteoglycan, VII collagen)

153
Q

what components are absenent in the internal/specialized basal lamina

A

No collagen components

154
Q

what parts of basal laina provie connection to lamina propria

A

Collagen of basal lamina provide firect connection to collagen of lamina propria

155
Q

what proteins are made by ameloblasts during the maturation phase by intenral/specialized basal lamina of Junctional epithlium

A

Amtn (amelotin)
ODAM (odontogeneic ameloblast-associated)
SCPPPQ1 (secretory Ca++ binding phorphoprotein prline glutamin rich 1

156
Q

what do the proteins of the junctional eptihlium do togethre

A

form a porous strucutre to facilitate sealing the JE to tooth surface

157
Q

where does junctional epithlium extend

A

junctional epithlium extends all the way around the entire tooth

158
Q

can junctional epithlium regenerate

A

yes at a rapid pace even around implants

159
Q

maxillary supply to gingiva

A

Superior alveolar

Palatine

160
Q

Mandibular supply to gingiva

A

Inferior alveol
buccal
mental
sublingual

161
Q

how does Vascular supply get to gingiva

A

PDL
intergenal septa
oral mucosa
then gingva