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Histopathology > Oral Mucous Membranes > Flashcards

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
Q

Lamina Reticularis (4)

A
  • Reticulin connective tissue
  • Type I collagen
  • Type III collagen
  • Elastin connective tissue
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26
Q

Cytoplasm of Cell (4)

A 
Intermediate Filaments or “tonofilaments” (Keratin 5 & 14)
Actin
Myosin
Talin
Vinculin
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27
Q

Hemidesmosome (5)

A 
Bullous Pemphigoid Antigen 1 (BPAG1)
Bullous Pemphigoid Antigen 2 (BPAG2)
Cadherins
Syndecans
Integrin
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28
Q

Lamina Lucida (7)

A 
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
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29
Q

Lamina Densa (6)

A 
Classical Laminin (Laminin-1)
Type IV Collagen
Type VII Collagen (Anchoring Fibrils )
Basement Membrane Glycoprotein (BMG-1)
Fibronectin
Integrins
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30
Q

Lamina Reticularis of the Lamina Propria (4)

A

Type I Collagen
Type III Collagen
Reticulin (precursor of elastin ?)
Elastin

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31
Q

Desmosome

A

(Macula Adherens)

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32
Q

 Intermediate Junction

A

(Zonula Adherens)

33
Q

 Tight Junction (

A

Zonula or Macula Adherens)

34
Q

 Gap Junction

A

(Communication Junction)

35
Q

Protein components of desmosomes: (6)

A 
 Desmoplakin I & II
 Evoplakin
 Periplakin
 Plakoglobin
 E-cadherin (Desmoglein)
 P-cadherin (Desmocolin)
36
Q

Permanent or Resident Cell Population (5)

A
  • Fibroblast
  • Monocyte Histiocyte Macrophage
  • Basophil Mast Cell
  • Plasma Cell
  • Endothelial Cell
37
Q

Transient or Labile Cell Population (2)

A
  • Neutrophils

* Lymphocytes

38
Q

Fibroblast:

A

Secrets collagen and elastin

39
Q

Histiocyte:

A

Resident precursor of functional macrophage

40
Q

Monocyte:

A

Blood-borne precursor of functional macrophage

41
Q

Macrophage:

A

Phagocytic cell capable of antigen processing

42
Q

Mast Cell:

A

Secretes inflammatory mediators, e.g., histamine,

heparin

43
Q

Plasma Cell:

A

Synthesis of immunoglobulins (antibodies)

44
Q

Neutrophil:

A

Phagocytic cell capable of neutralizing antigens and

killing bacteria.

45
Q

Lymphocyte:

A

Humoral and cell-mediated immune response

46
Q

Endothelial:

A

Lining of blood and lymphatic vessels

47
Q

Filiform Papillae (4)

A 
•
“Hair-like” papillae
• Most numerous
• Highly keratinized
• Found over the entire
dorsal surface of the
tongue
48
Q

Fungiform Papillae (4)

A 
•
“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
Q

Foliate Papillae (5)

A 
•“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
Q

Circumvallate Papillae (5)

A 
•“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
Q

The different papillae respond to all types of taste stimuli

but display bias in their

A

sensitivity

52
Q

Circumvallate papillae tend to be more sensitive to

— compounds

A

bitter

53
Q

Fungiform papillae respond best to (2)

stimuli

A

salt and sweet

54
Q

Foliate papillae show a bias for —

A

sweet

55
Q

Taste cells are a

A

specialized epithelial cell, i.e.,

neuroepithelial

56
Q

Anterior 2/3 of tongue:

A 
Facial nerve (C-VII) via the
 chorda tympani branch
57
Q

Posterior 1/3 of tongue:

A

Glossopharyngeal (C-IX)

58
Q

Soft Palate:

A 
Facial nerve (C-VII) via the greater
 petrosal branch
59
Q

Walls of the pharynx & epiglottis:

A

Vagus nerve (C-X)

60
Q

Taste fibers from all three nerves converge in the

A

tractus solitarius in the brain stem

61
Q

Lichen Planus:

A

unknown etiology, but T-lymphocyte
infiltrates with Langerhans cell hyperplasia are
characteristic. Consequently, cell-mediated
immune injury to basal cells is suspected.

62
Q

Hyperkeratosis:

A

Thickening of the stratum corneum, often

with aberrant keratinization.

63
Q

Leukoplakia:

A

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
Q

Oral cancer accounts for about –% of all cancers

A

3

65
Q

The highest incidence of SCCA is in

A

middle aged

African-American males

66
Q

The overall male-to-female gender ratio of SCCA occurrence

is

A

3:1

67
Q

The most common site for oral SCCA is the

A

posterior
lateral border of the tongue. The floor of the mouth
and ventral tongue surface are also common sites

68
Q

Strong relationships exist between SCCA and: (7)

A
  • 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
Q

Histopathology of SCCA is characterized by: (4)

A

• 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
Q 
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
A

• 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
Q

Ectodermal Dysplasia:

A

A syndrome involving abnormal or
lack of development of ectodermal structures such as hair,
eyebrows, eye lashes, and teeth.

72
Q

Peripheral Ossifying Fibroma

A

 Considered to be reactive rather than neoplastic in nature. The lesion
is thought to represent the maturation of a pyogenic granuloma.

73
Q

Peripheral Ossifying Fibroma

 Occurs exclusively on the —.

A

gingiva

74
Q

Peripheral Ossifying Fibroma
 Predominantly a lesion of teenagers and young adults with peak
prevalence between the ages of — yrs.

A

10 and 19

75
Q

Peripheral Ossifying Fibroma

A

Considered to be reactive rather than neoplastic in nature. The lesion
is thought to represent the maturation of a pyogenic granuloma.

76
Q

Peripheral Ossifying Fibroma

 60% to 65% of cases occur in —.

A

females

77
Q

Peripheral Ossifying Fibroma

Histology reveals a gingival mass with islands of

A

calcified material

(derived from periosteum).

78
Q

Peripheral Ossifying Fibroma

 Recommended treatment is

A

surgical excision

79
Q

Peripheral Ossifying Fibroma

 Lesion is likely to recur if

A

excision is not extensive and complete

Histopathology (15 decks)

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