Oral Mucous Membranes Flashcards by Michael McMahan

What are the 3 functions of oral mucous membranes?

Absorption, excretion, and protection

How well did you know this?

Not at all

Perfectly

____ mucosa is composed of Gingiva

and Hard palate

Masticatory mucosa

How well did you know this?

Not at all

Perfectly

\_\_\_\_\_ mucosa is composed of:
Alveolar mucosa
• Buccal mucosa
• Floor of the mouth
• Ventral surface of the tongue
• Soft palate

Lining mucosa

How well did you know this?

Not at all

Perfectly

_____ mucosa is composed of dorsal surface of the tongue

Specialized mucosa

How well did you know this?

Not at all

Perfectly

What are the 4 layers of the microscopic organization of oral mucous membranes?

Epithelium, lamina propria, submucosa, and periosteum

How well did you know this?

Not at all

Perfectly

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.

Mucoperiosteum:

How well did you know this?

Not at all

Perfectly

What are the 4 epithelial layers of the oral mucous membrane?

 Stratum Corneum
 Stratum Granulosum
 Stratum Spinosum
 Stratum Basale (a.k.a.) Stratum Germinativum

How well did you know this?

Not at all

Perfectly

Characteristics of _____
 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

Epithelium

How well did you know this?

Not at all

Perfectly

_____ of epithelium is expressed in the distribution of cytoplasmic organelles

Polarity

How well did you know this?

Not at all

Perfectly

Refers to normal keratin formation with clinically

normal presentation.

Orthokeratosis

How well did you know this?

Not at all

Perfectly

Retention of pyknotic nuclei in the stratum corneum

Parakeratosis

How well did you know this?

Not at all

Perfectly

Abnormal thickening of the stratum corneum. May

exhibit aberrant patterns of keratinization.

Hyperkeratosis

How well did you know this?

Not at all

Perfectly

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

Dyskeratosis

How well did you know this?

Not at all

Perfectly

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

increase in the number of cells.

Acanthosis

How well did you know this?

Not at all

Perfectly

Loss of intercellular attachments between epithelial

cells (keratinocytes).

Acantholysis

How well did you know this?

Not at all

Perfectly

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.

Metaplasia

How well did you know this?

Not at all

Perfectly

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

Dysplasia

How well did you know this?

Not at all

Perfectly

Which mucosa is affected by Gingival Orthokeratosis ?

Masticatory Mucosa

How well did you know this?

Not at all

Perfectly

Which mucosa is affected by gingival parakeratosis?

Masticatory Mucosa

How well did you know this?

Not at all

Perfectly

Which mucosa is affected by gingiva hyperkeratosis?

Masticatory Mucosa

How well did you know this?

Not at all

Perfectly

Which mucosa is affected by acanthosis and parakeratosis?

Buccal lining mucosa

How well did you know this?

Not at all

Perfectly

Which mucosa is affected by hyperkeratosis and parakeratosis?

Buccal lining mucosa

How well did you know this?

Not at all

Perfectly

Which mucosa is affected by gingival dyskeratosis?

Masticatory Mucosa

How well did you know this?

Not at all

Perfectly

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

melanocyte

How well did you know this?

Not at all

Perfectly

• 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

Langerhans Cell

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

Merkel’s Cell

• 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

Lymphocytes

What are the 2 layers that make up the basement membrane?

Basal lamina and lamina reticularis

What are the 2 layers that make up the basal lamina?

Lamina lucida and lamina densa

What component of the basal lamina is made up of bullous pemphigoid antigen and collagen type VII?

Lamina lucida

What component of the basal lamina is made up of type IV and VII collagen and fibronectin?

Lamina densa

The ____ is made up of reticulin connective tissue, type 1 and 3 collagen and elastin connective tissue

Lamina reticularis

_____ is a circular attachment that attach cells together

Desmosome

_____ is half a desmosome that is found at the basement membrane

Hemidesmosomes

____ are composed of E-cadherin and P-cadherin

Desmosomes

What are the resident cells within the lamina propria?

Fibroblast, macrophage, Mast cell, plasma cell, and endothelial cell

What are the transient cells in lamina propria?

Neutrophils and lymphocytes

``` Which layer of mucous membrane is made up of the following: Fibroblast • Monocyte -> Histiocyte -> Macrophage • Basophil -> Mast Cell • Plasma Cell • Endothelial Cell • Neutrophils • Lymphocytes ```

Lamina propria

Secrets collagen and elastin

Fibroblast:

Resident precursor of functional macrophage | response

Histiocyte:

Blood-borne precursor of functional macrophage

• Monocyte:

Lining of blood and lymphatic vessel

• Endothelial:

Phagocytic cell capable of antigen processing

• Macrophage:

Secretes inflammatory mediators, e.g., histamine, | heparin

• Mast Cell:

Synthesis of immunoglobulins (antibodies)

• Plasma Cell:

Phagocytic cell capable of neutralizing antigens and | killing bacteria.

• Neutrophil:

Humoral and cell-mediated immune

• Lymphocyte:

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

Filiform papillae

``` •“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 ```

Fungiform Papillae

``` •“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 ```

Foliate Papillae

``` •“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 ```

Circumvallate Papillae

______ papillae tend to be more sensitive to | bitter compounds

Circumvallate

______ papillae respond best to salt and sweet | stimuli

Fungiform

_____ papillae show a bias for sweet

Foliate

T/F: The different papillae respond to all types of taste stimuli but display bias in their sensitivity

true

Taste cells are a specialized ____ cells

epithelial cells

Taste for Anterior 2/3 of tongue comes from which CN?

``` Facial nerve (C-VII) via the chorda tympani branch ```

Taste for Posterior 1/3 of tongue comes from which CN?

Glossopharyngeal (C-IX)

Taste for Soft Palate comes from which CN?

``` Facial nerve (C-VII) via the greater petrosal branch ```

Taste for Walls of the pharynx & epiglottis comes from which CN?

Vagus nerve (C-X)

Taste fibers from all three nerves converge in the | _____ in the brain stem

tractus solitarius

____ reactions occur via drugs, hypertrophic, and luekoplastic

Lichenoid reaction

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

Lichen Planus:

____ is abnormal filiform papilla; increased growth

Hairy tongue

___ is benign inflammation and desquamation of the tongue

Geographical tongue

Thickening of the stratum corneum, often | with aberrant keratinization.

Hyperkeratosis:

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.

Leukoplakia:

Oral cancer accounts for about ____% of all cancers

The highest incidence of SCCA is in middle aged | _____

African-American males

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

3:1

The most common site for oral SCCA is the posterior ______. The floor of the mouth and ventral tongue surface are also common sites.

lateral border of the tongue

``` Strong relationships exist between ____ and: • Tobacco smoking • Chewing tobacco • Alcohol consumption • Phenol exposure • Oncogenic viruses (Human Papilloma Virus or HPV) • Immunosuppression (e.g., AIDS) • Oncogenes and tumor suppressor genes ```

SCCA

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.

SCCA

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).

Mucosal Pemphigoid

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

Ectodermal Dysplasia:

Considered to be reactive rather than neoplastic in nature. The lesion is thought to represent the maturation of a pyogenic granuloma.  Occurs exclusively on the gingiva.  Predominantly a lesion of teenagers and young adults with peak prevalence between the ages of 10 and 19 yrs.  60% to 65% of cases occur in females.  Histology reveals a gingival mass with islands of calcified material (derived from periosteum).  Recommended treatment is surgical excision  Lesion is likely to recur if excision is not extensive and complete

Peripheral ossifying fibroma