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Oral Mucous Membranes Flashcards

1
Q

Main functions of mucous membranes

are: (3)

A
  1. Absorption
  2. Excretion
  3. Protection
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2
Q

Masticatory mucosa (keratinized) (2)

A
  • Gingiva

* Hard palate

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3
Q

Lining mucosa (nonkeratinized) (5)

A
  • Alveolar mucosa
  • Buccal mucosa
  • Floor of the mouth
  • Ventral surface of the tongue
  • Soft palate
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4
Q

Specialized mucosa (contains taste buds) (1)

A

• Dorsal surface of the tongue

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5
Q

Mucoperiosteum:

A

Defined as a periosteum with a mucosal
surface, i.e., close approximation of mucous membrane
(epithelium and lamina propria) with the periosteum of
bone to form an apparent single layer.

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6
Q

Oral Mucous Membranes

Microscopic Organization of the Epithelial Layer) (4

A 
 Stratum Corneum
 Stratum Granulosum
 Stratum Spinosum
 Stratum Basale (a.k.a.) Stratum Germinativum
or
 Keratin Layer
 Granular Cell Layer
 Spinous Cell Layer
 Basal Cell Layer
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7
Q

Oral Mucous Membranes

Characteristics of Epithelium) (5

A

 Rests on a basement membrane
 Exhibits one or more specialized intercellular
attachments (desmosomes, tonofilaments)
 Avascular (gets all nutrients from dermis)
 Exhibits a high degree of cellularity and relatively
low volume of extracellular matrix
 May exhibit cellular polarity

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8
Q

May exhibit cellular polarity (2)

A

• Cells exhibit apical, basal, and lateral borders
• Polarity is expressed in the distribution of
cytoplasmic organelles

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9
Q

Orthokeratosis

A

• Refers to normal keratin formation with clinically

normal presentation.

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10
Q

Parakeratosis

A

• Retention of pyknotic nuclei in the stratum corneum

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11
Q

Hyperkeratosis

A

• Abnormal thickening of the stratum corneum. May

exhibit aberrant patterns of keratinization.

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12
Q

Dyskeratosis

A

• Abnormal keratinization below the level of the stratum
corneum, i.e., keratinization within the stratum
granulosum and/or stratum spinosum.

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13
Q

Acanthosis

A

• Refers to hyperplasia of the epithelial layer, i.e.,

increase in the number of cells.

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14
Q

Acantholysis

A

• Loss of intercellular attachments between epithelial

cells (keratinocytes).

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15
Q

Metaplasia

A

• A reversible change in which one adult cell type is replaced by
another, e.g., transition of columnar to squamous epithelium in
the respiratory tract as a response to smoking.

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16
Q

Dysplasia

A

• Refers to a disorderly but non-neoplastic growth of
tissue including the epithelial layer. Characterized by
pleomorphism, hyperchromatism, and loss of normal
spatial orientation.

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17
Q

 Melanocyte (3)

A

• Dendritic morphology (long processes)
• Located in the basal cell layer
• Synthesis of melanin pigment granules
(melanosomes)

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18
Q

Langerhans Cell (4)

A

• Dendritic morphology
• Located in the stratum spinosum
• Characteristic Langerhans granule (tennis racquet)
• Functions as an antigen trap in epithelium and transfers
antigen information to CD4 lymphocytes

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19
Q

Merkel’s Cell (4)

A
  • Rounded morphology
  • Located in the basal cell layer
  • Contain characteristic “dense core” granules
  • Possibly has tactile sensory functions
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20
Q

Lymphocytes (4)

A

• Rounded morphology
• Found in basal and spinous cell layers
• Associated with immune surveillance and antigen
message processing
• Associated with inflammation – both humoral and
cellular response

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21
Q

Basement Membrane =

A

basal lamina + lamina reticularis

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22
Q

basal lamina =

A

lamida lucida

lamina densa

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23
Q

Lamina Lucida (8)

A
  • Bullous Pemphigoid antigen
  • Basement Membrane Proteoglycan (BMG-1)
  • Classic laminin (laminin-1)
  • Kalinin (laminin-5)
  • K-laminin (laminin-6)
  • Entactin
  • Type VII collagen (anchoring fibrils)
  • Epiligrin (AgAb complex in BMMP)
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24
Q

Lamina Densa (6)

A
  • Classical laminin (laminin-1)
  • Type IV collagen
  • Type VII collagen (anchoring fibrils)
  • Basement Membrane Proteoglycan (BMG-1)
  • Fibronectin
  • Integrins (adhesion molecules)
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25
Lamina Reticularis (4)
* Reticulin connective tissue * Type I collagen * Type III collagen * Elastin connective tissue
26
Cytoplasm of Cell (4)
``` Intermediate Filaments or “tonofilaments” (Keratin 5 & 14) Actin Myosin Talin Vinculin ```
27
Hemidesmosome (5)
``` Bullous Pemphigoid Antigen 1 (BPAG1) Bullous Pemphigoid Antigen 2 (BPAG2) Cadherins Syndecans Integrin ```
28
Lamina Lucida (7)
``` BPAG1 & BPAG2 Basement Membrane Glycoprotein (BMG-1) Classical Laminin (Laminin-1) Kalinin & K-laminin (Laminin-5 & Lsminin-6) Entactin Type VII collagen (Anchoring Fibrils ) Epiligrin ```
29
Lamina Densa (6)
``` Classical Laminin (Laminin-1) Type IV Collagen Type VII Collagen (Anchoring Fibrils ) Basement Membrane Glycoprotein (BMG-1) Fibronectin Integrins ```
30
Lamina Reticularis of the Lamina Propria (4)
Type I Collagen Type III Collagen Reticulin (precursor of elastin ?) Elastin
31
Desmosome
(Macula Adherens)
32
 Intermediate Junction
(Zonula Adherens)
33
 Tight Junction (
Zonula or Macula Adherens)
34
 Gap Junction
(Communication Junction)
35
Protein components of desmosomes: (6)
```  Desmoplakin I & II  Evoplakin  Periplakin  Plakoglobin  E-cadherin (Desmoglein)  P-cadherin (Desmocolin) ```
36
Permanent or Resident Cell Population (5)
* Fibroblast * Monocyte Histiocyte Macrophage * Basophil Mast Cell * Plasma Cell * Endothelial Cell
37
Transient or Labile Cell Population (2)
* Neutrophils | * Lymphocytes
38
Fibroblast:
Secrets collagen and elastin
39
Histiocyte:
Resident precursor of functional macrophage
40
Monocyte:
Blood-borne precursor of functional macrophage
41
Macrophage:
Phagocytic cell capable of antigen processing
42
Mast Cell:
Secretes inflammatory mediators, e.g., histamine, | heparin
43
Plasma Cell:
Synthesis of immunoglobulins (antibodies)
44
Neutrophil:
Phagocytic cell capable of neutralizing antigens and | killing bacteria.
45
Lymphocyte:
Humoral and cell-mediated immune response
46
Endothelial:
Lining of blood and lymphatic vessels
47
Filiform Papillae (4)
``` • “Hair-like” papillae • Most numerous • Highly keratinized • Found over the entire dorsal surface of the tongue ```
48
Fungiform Papillae (4)
``` • “Fungus-like” papillae • Small round, red surface projections (color is due to a highly vascular connective tissue core) • May contain taste buds • Commonly found at the tip of the tongue ```
49
Foliate Papillae (5)
``` •“Leaf-like” papillae • May contain taste buds • Contains lymphoid nodules with germinal centers • Forms part of Waldeyer’s Ring • Located on the posterior lateral margins of the tongue ```
50
Circumvallate Papillae (5)
``` •“Walled” papillae • Generally 6-8 in number • Lightly keratinized • Located just anterior to the sulcus terminalis on the posterior dorsal tongue surface • Papillae sulcus is cleared of taste stimuli by serous salivary glands of von Ebner ```
51
The different papillae respond to all types of taste stimuli | but display bias in their
sensitivity
52
Circumvallate papillae tend to be more sensitive to | --- compounds
bitter
53
Fungiform papillae respond best to (2) | stimuli
salt and sweet
54
Foliate papillae show a bias for ---
sweet
55
Taste cells are a
specialized epithelial cell, i.e., | neuroepithelial
56
Anterior 2/3 of tongue:
``` Facial nerve (C-VII) via the chorda tympani branch ```
57
Posterior 1/3 of tongue:
Glossopharyngeal (C-IX)
58
Soft Palate:
``` Facial nerve (C-VII) via the greater petrosal branch ```
59
Walls of the pharynx & epiglottis:
Vagus nerve (C-X)
60
Taste fibers from all three nerves converge in the
tractus solitarius in the brain stem
61
Lichen Planus:
unknown etiology, but T-lymphocyte infiltrates with Langerhans cell hyperplasia are characteristic. Consequently, cell-mediated immune injury to basal cells is suspected.
62
Hyperkeratosis:
Thickening of the stratum corneum, often | with aberrant keratinization.
63
Leukoplakia:
A white plaque of the oral mucous membranes that cannot be removed by scraping and cannot be classified histologically as another disease entity. Until proven otherwise, leukoplakia should be considered precancerous.
64
Oral cancer accounts for about --% of all cancers
3
65
The highest incidence of SCCA is in
middle aged | African-American males
66
The overall male-to-female gender ratio of SCCA occurrence | is
3:1
67
The most common site for oral SCCA is the
posterior lateral border of the tongue. The floor of the mouth and ventral tongue surface are also common sites
68
Strong relationships exist between SCCA and: (7)
* Tobacco smoking * Chewing tobacco * Alcohol consumption * Phenol exposure * Oncogenic viruses (Human Papilloma Virus or HPV) * Immunosuppression (e.g., AIDS) * Oncogenes and tumor suppressor genes
69
Histopathology of SCCA is characterized by: (4)
• The lesion arises from dysplastic surface epithelium and features alterations in size, shape, and organization of the cellular components, including nuclear pleomorphism. • Lesion exhibits invasive islands and cords of malignant squamous epithelial cells. • There is often a strong inflammatory or immune cell response to the invading epithelium, and focal areas of necrosis may be present. • Abnormal production of keratin in the form of “keratin pearls” (i.e., a round focus of concentrically layered keratinized cells) is a frequent finding.
70
``` Mucosal Pemphigoid (a.k.a. Benign Mucous Membrane Pemphigoid or BMMP, or Cicatricial Pemphigoid): (6) ``` ``` type of disease protein characterized by affects which gender cicatricial ```
• Autoimmune disease • Antigen is the adhesin protein epiligrin found in the lamina lucida • Characterized by linear accumulations of IgG and C3 along the basement membrane • Affects older adults in the 50-60 year old range • Females affected more often than males by a ratio of 2:1 • Cicatricial is derived from the word cicatrix which mean “ scar”. BMMP involvement of the conjunctiva of the eye results in scarring (symblepharon).
71
Ectodermal Dysplasia:
A syndrome involving abnormal or lack of development of ectodermal structures such as hair, eyebrows, eye lashes, and teeth.
72
Peripheral Ossifying Fibroma
 Considered to be reactive rather than neoplastic in nature. The lesion is thought to represent the maturation of a pyogenic granuloma.
73
Peripheral Ossifying Fibroma |  Occurs exclusively on the ---.
gingiva
74
Peripheral Ossifying Fibroma  Predominantly a lesion of teenagers and young adults with peak prevalence between the ages of --- yrs.
10 and 19
75
Peripheral Ossifying Fibroma
Considered to be reactive rather than neoplastic in nature. The lesion is thought to represent the maturation of a pyogenic granuloma.
76
Peripheral Ossifying Fibroma |  60% to 65% of cases occur in ---.
females
77
Peripheral Ossifying Fibroma | Histology reveals a gingival mass with islands of
calcified material | (derived from periosteum).
78
Peripheral Ossifying Fibroma |  Recommended treatment is
surgical excision
79
Peripheral Ossifying Fibroma |  Lesion is likely to recur if
excision is not extensive and complete

Histopathology (15 decks)

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