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Oral Mucous Membranes (Exam III) Flashcards

1
Q

The main functions of mucous membranes:

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

What are the classifications of oral mucous membranes?

A
  1. Masticatory mucosa (nonkeratinized)
  2. Lining mucosa (nonkeratinized)
  3. Specialized mucosa (contains taste buds)
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3
Q

Masticatory mucosa is _____ mucosa

A

Keratinized

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4
Q

Where would you find masticatory mucosa?

A

Gingiva & Hard palate

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5
Q

Lining mucosa is _____ mucosa

A

Nonkeratinized

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6
Q

Where would you find lining mucosa?

A

Alveolar mucosa
Buccal mucosa
Floor of mouth
Ventral surface of tongue
Soft palate

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7
Q

Specialized mucosa contains:

A

Taste buds

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8
Q

Where would you find specialized mucosa?

A

Dorsal surface of tongue

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9
Q

Classify the mucous membranes present in the image:

What does the blue line represent?

A
  1. Masticatory mucosa
  2. Lining mucosa

Blue line= mucogingival junction

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10
Q

Classify the mucous membrane present in this image:

A

Specialized mucosa

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11
Q

List the microscopic organization of oral mucous membranes:

A
  1. Epithelium
  2. Lamina propria
  3. Submucosa
  4. Periosteum
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12
Q

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

A

Mucoperiosteum

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13
Q

Which component of the microscopic organization of oral mucosa membranes may or may not be present:

A

Submucosa

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14
Q

List the tissues layers (top to bottom)

A

Blue: Epithelium
Green: Lamina propria
Orange: Periosteum
White: Bone

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15
Q

List the tissue layers (top to bottom)

A

Green: Lamina propria
Orange: Periosteum
White: Bone

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16
Q

What is this image displaying?

A

Submucosa of the palate

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17
Q

Name the following zones of submucosa of the palate:

A

A) Gingival zone
B) Fatty Zone
C) Glandular zone

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18
Q

List the microscopic organization of the epithelial layer:

A
  1. Stratum corneum
  2. Stratum granulosum
  3. Stratum spinosum
  4. Stratum basale (Stratum germinativum)
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19
Q

Describe the layers of microscopic organization of the epithelial layer:

  1. Stratum corneum
  2. Stratum granulosum
  3. Stratum spinous
  4. Stratum basal (stratum germinativum)
A
  1. Keratin layer
  2. Granular cell layer
  3. Spinous layer
  4. Basal cell layer
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20
Q

List what the arrows are pointing to in the image of microscopic organization of the epithelial layer:

What is this collectively referred to as:

A

Green: keratin layer
Blue: granular cell layer
White: spinous cell layer
Yellow: basal cell layer

Collectively= cell strata

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21
Q

List what the arrows are pointing to in the image of microscopic organization of the epithelial layer:

A

Green: Connective tissue papilla
Yellow: Epithelial rete pegs

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22
Q

What is the function of both the epithelial retention pegs and connective tissue papilla in oral mucous membranes?

A

Both aid in attachment

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23
Q

What layer of the oral mucous are the epithelial retention pegs and connective tissue papilla located in?

A

Epithelial layer

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24
Q

The epithelial layer of the oral mucous membrane are organized into:

A

Cell strata

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25
Q

The epithelium of the oral mucous membrane rests on a ______

A

Basement membrane

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26
Q

The epithelium of the oral mucous membrane exhibits one or more specialized ____________

A

Intercellular attachements

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27
Q

What are two examples of the specialized intercellular attachments present in the epithelium of the oral mucous membrane?

A

Desmosomes
Tonofilaments

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28
Q

Describe the vascularity of the epithelial layer of the oral mucous membrane:

A

Avascular

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29
Q

Because the epithelial layer of oral mucous membrane is avascular, it gets all of its nutrients from the:

A

Dermis

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30
Q

The epithelium of the oral mucous membrane exhibits a high degree of ______ & a relatively low volume of ______

A

Cellularity
ECM

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31
Q

The epithelium of the oral mucous membranes may exhibit:

A

Cell polarity

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32
Q

List the types borders the epithelial cells of the oral mucous membranes may exhibit:

A

Can exhibit apical, basal & lateral borders

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33
Q

In regards to the epithelium of oral mucous membranes-

Polarity is expressed in the:

A

Distribution of cytoplasmic organelles

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34
Q

Which layer of the oral mucous membrane do the following terms describe?
- Orthokeratosis
- Parakeratosis
- Hyperkeratosis
- Dyskeratosis

a

A

Stratum Corneum

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35
Q

Refers to normal keratin formation with clinically normal presentation within the stratum corneum

A

Orthokeratosis

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36
Q

Retention of pyknotic nuclei in the stratum corneum:

A

Parakeratosis

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37
Q

Abnormal thickening of the stratum corneum; may exhibit aberrant patterns of keratinization:

A

Hyperkeratosis

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38
Q

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

A

Dyskeratosis

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39
Q

Refers to hyperplasia of the epithelial layer (i.e., increase in the number of cells)

A

Acanthosis

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40
Q

Loss of intercellular attachments between epithelial cells (keratinocytes)

A

Acantholysis

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41
Q

A reversible change in which one adult cell type is replaced by another

A

Metaplasia

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42
Q

Transition of columnar squamous epithelium in the respiratory tract as a response to smoking is an example of:

A

Metaplasia

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43
Q

Refers to the disorderly but non-neoplastic growth of tissue including the epithelial layer; characterized by pleomorphism, hyperchomatism, & loss of normal spatial orientation:

A

Dysplasia

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44
Q

Key word for metaplasia:

Key word for dysplasia:

A

Reversible

Non-neoplastic

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45
Q

How might the following masticatory mucosa be described as?

A

Gingival orthokeratosis

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46
Q

What condition is seen in this image of masticatory mucosa?

A

Gingival parakeratosis

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47
Q

What condition is seen in this image of masticatory mucosa?

A

Gingiva hyperkeratosis

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48
Q

What conditions are seen in this image of buccal lining mucosa

A

Ancathosis & Parakeratosis

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49
Q

Describe what is seen in the following image of the buccal lining mucosa:

A

Hyperkeratosis & parakeratosis

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50
Q

What disease state is represented by the following images?

A

Gingival dyskeratosis of the masticatory mucosa

(squamous cell carcinoma)

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51
Q

Describe what is seen in the following image:

A

Gingival dyskeratosis of the masticatory mucosa

(squamous cell carcinoma)

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52
Q

List the nonkeratinocytes in the oral epithelium of the oral mucous membranes:

A
  1. Melanocytes
  2. Langerhans cell
  3. Merkel’s cell
  4. Lymphocytes
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53
Q

Describe the morphology of a melanocyte:

A

Dendritic morphology (long processes)

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54
Q

Where is a melanocyte located within the oral epithelium?

A

Basal cell layer

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55
Q

What is the function of a melanocyte?

A

Synthesis of melanin pigment granules (melanosomes)

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56
Q

Melanin pigment granule

A

Melanosomes

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57
Q

What is represented by the following images?

A

Melanocytes

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58
Q

Describe what cells are seen in the following image:

A

Langerhans cells

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59
Q

Describe the type of cells seen in the following image

A

Lymphocytes

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60
Q

What type of cells are seen in the following image

A

Merkel’s cells

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61
Q

Describe the morphology of a langerhan’s cell

A

Dendritic morphology

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62
Q

Where are langerhan’s cells located within the oral epithelium?

A

Stratum spinosum

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63
Q

What does the characteristic langerhan’s granule look like?

A

Tennis racquet

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64
Q

Langerhan cells function as a _______ in the epithelium and transfers _____ information to ______

A

Antigen trap
Antigen information
CD4 Lymphocytes

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65
Q

Describe the morphology of a Merkel’s Cell:

A

Rounded in morphology

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66
Q

Where are Merkel’s cells located within the oral epithelium?

A

Basal cell layer

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67
Q

Merkel’s cells contain characteristic ______ granules

A

Dense core

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68
Q

What is the possible function of Merkel’s cells?

A

Tactile sensory functions

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69
Q

Describe the morphology of a lymphocyte in the oral epithelium:

A

Rounded morphology

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70
Q

Where are lymphocytes located within the oral epithelium?

A

Found in basal & spinous cell layers

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71
Q

What are lymphocytes within the oral epithelium associated with? (3)

A
  1. Immune surveillance
  2. Antigen message processing
  3. Inflammation (both cellular response & humoral)
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72
Q

What does the yellow arrow point to?

A

The basement membrane

73
Q

What two layers is the basement membrane comprised of?

A

Basal lamina + Lamina reticularis

74
Q

The basal lamina portion of the basement membrane can be further broken down into:

A

Lamina Lucida + Lamina Densa

75
Q

What is represented by A, B & C?

A

A) Lucida
B) Densa
C) Reticularis

76
Q

What is represented by the arrows A, B & C?

A

A) Lucida
B) Densa
C) Reticularis

77
Q

The Lamina Lucida is part of the ________

A

Basal lamina

78
Q

What are two main components the lamina Lucida is comprised of?

A
  1. Bullous pemphigoid antigen
  2. Type VII Collagen
79
Q

What is the function of the type VII collagen in the Lamina Lucida component of the basal lamina?

A

Anchoring fibrils

80
Q

The Lamina Densa is a component of the ________

A

Basal lamina

81
Q

What are two key components of the lamina densa portion of the basal lamina?

A
  1. Type IV collagen
  2. Type VII collagen
82
Q

What is the function of the type VII collagen within the Lamina Densa portion of the basal lamina?

A

Anchoring fibrils

83
Q

The Lamina Reticularis is a part of the _____

A

Basal lamina

84
Q

What four components make up the lamina reticularis portion of the basal lamina?

A
  1. Reticulin
  2. Type I collagen
  3. Type III collagen
  4. Elastin connective tissue
85
Q

What are the two connective tissue components of the lamina reticularis?

A

Reticulin
Elastin

86
Q

What are the three layers of the basal lamina?

A
  1. Lamina Lucida
  2. Lamina Densa
  3. Lamina Reticularis
87
Q

What are the intermediate filaments in the cytoplasm of the cell?

A

Tonofilaments

88
Q

Tonofilaments are made of what types of keratin?

89
Q

The intermediate filaments (Tonofilaments) of the cytoplasm of the cell include (4):

A
  1. Actin
  2. Myosin
  3. Talin
  4. Vinculin
90
Q

The hemidesmosome components of the cell include:

A
  1. Bullous Pemphigoid antigen 1&2 (BPAG1 & BPAG2)
  2. Cadherins
91
Q

What connects the cytoplasm of the cell & all of its intermediate filaments to the lamina Lucida?

A

Hemidesmosomes

92
Q

Types of collagen found in each of the layers of the basal lamina:

Lucida:
Densa:
Reticularis:

A

Lucida= Type VII

Densa= Type IV & VII

Reticularis= Type I & III

93
Q

The following components belong to which layer of the basal lamina-

  • BPAG1 & BPAG2
  • Basement membrane glycoprotein (BMG-1)
  • Classical laminin (Laminin-1)
  • Kalinin & K-laminin (Laminin-5 & 6)
  • Entactin
  • Type VII collagen
  • Epiligrin
A

Lamina lucida

94
Q

The following components belong to which layer of the basal lamina-

  • Classical laminin (Laminin-1)
  • Type IV Collagen
  • Type VII Collagen
  • Basement membrane glycoprotein (BMG-1)
  • Fibronectin
  • Integrins
A

Lamina Densa

95
Q

The following components belong to which layer of the basal lamina-

  • Type I collagen
  • Type III collagen
  • Reticulin
  • Elastin
A

Lamina reticularis of the lamina propria

96
Q

What are the five specialized cell attachments present in oral mucous membranes?

A
  1. Desmosomes
  2. Hemidesmosomes
  3. Intermediate junctions
  4. Tight junctions
  5. Gap junctions
97
Q

Desmosomes in the oral mucous membranes are also called:

A

Macula adherens

98
Q

Intermediate junctions of the oral mucous membranes are also referred to as:

A

Zonula adherens

99
Q

The tight junctions of the oral mucous membranes are also called:

A

Zonula or macula adherens

100
Q

What are the gap junctions of the oral mucous membranes called?

A

Communication junction

101
Q

What type of specialized cell attachment is present in the image below:

A

Desmosomes

102
Q

What are the two main protein components of desmosomes?

A
  1. E-cadherin (Desmoglein)
  2. P-cadherin (Desmocolin)
103
Q

What occurs to the specialized cellular attachments in the oral mucous membranes in the presence of inflammation?

A

Loss of cellular attachments

104
Q

What is occurring in each of the images of the specialized cell attachments below?

A

Left: Normal
RIght: Inflammation

105
Q

FIbroblasts
Monocytes
Basophils
Plasma Cells
Endothelial Cells
Neutrophils
Lymphocytes

These cells belong to the:

A

Lamina Propria

106
Q

List the permanent/resident cell populations of the lamina propria:

A

Fibroblast
Monocyte
Basophil
Plasma cell
Endothelial cell

107
Q

Describe the path of development the monocytes of the lamina propria take:

A

Monocyte —> Histiocyte —> Macrophage

108
Q

What do the basophils of the lamina propria develop into?

A

Mast cells

109
Q

List the transient cell populations of the lamina propria:

A

Neutrophils & lymphocytes

110
Q

Secretes collagen & elastin within the lamina propria:

A

FIbroblast

111
Q

Resident precursor of functional macrophage within the lamina propria:

A

Histiocyte

112
Q

Blood-borne precursor of functional macrophage within the lamina propria:

113
Q

Phagocytic cell capable of antigen processing within the lamina propria:

A

Macrophage

114
Q

Secretes inflammatory mediators, e.g., histamine & heparin within the lamina propria:

115
Q

Synthesis of immunoglobulins (antibodies) within the lamina propria:

A

Plasma cell

116
Q

Phagocytic cell capable of neutralizing antigens & killing bacteria within the lamina propria:

A

Neutrophil

117
Q

Functions in the humoral & cell-mediated immune response & located within the lamina propria:

A

Lymphocyte

118
Q

Functions to line the blood & lymphatic vessels within the lamina propria:

A

Endothelial cell

119
Q

What are two inflammatory mediators that may be secreted by mast cells:

A

Histamine & Heparin

120
Q

What is the yellow arrow indicated in the following image?

A

Free gingival groove

121
Q

What is represented by the arrows in the following image?

A

Blue= sulcular epithelium
Maroon= junctional epithelium

122
Q

What diseased state can be observed in the following images?

A

Inflammatory periodontal disease

123
Q

What can be observed in the following images?

A

Gingival pigmentation

124
Q

What can be observed in the following images?

A

Gingival pigmentation

125
Q

What do each of the arrows represent in the following image?

A

Green- gingival papillae (keratinized)
Blue- attached gingiva (attached & keratinized)
Yellow- Mucogingival junction
Orange- alveolar mucosa

126
Q

What is represented in the following images?

127
Q
  • Papillae that are “hair-like”
  • Most numerous
  • Highly keratinized
  • Found over the dorsal surface of the tongue
A

Filiform papillae

128
Q
  • “fungus-like” papillae
  • small, round, red surface projections
  • may contain tastebuds
  • Commonly found on the tip of the tongue
A

Fungiform papillae

129
Q

Where are Filiform papillae commonly found?

A

Over the entire dorsal surface of the tongue

130
Q

Where are Fungiform papillae commonly found?

A

Commonly found at the tip of the tongue

131
Q
  • “leaf-like” papillae
  • May contain tastebuds
  • Contain lymphoid nodules with germinal centers
  • Forms part of Waldeyer’s ring
  • located on the posterior lateral margins of the tongue
A

Folliate papillae

132
Q

Foliate papillae contains:

A

Lymphoid nodules with germinal centers

133
Q

Foliate papillae forms part of:

A

Waldeyer’s ring

134
Q

Where are foliate papillae commonly found?

A

Posterior lateral margins the tongue

135
Q
  • “Walled” papillae
  • Generally 6-8 in number
  • lightly keratinized
  • located just anterior to the sulcus terminalis on the posterior dorsal tongue surface
A

Circumvallate papillae

136
Q

How many circumvallate papillae are typically found

137
Q

Are cirumvallate papillae keratinized?

138
Q

Location of circumvallate papillae:

A

Anterior to sulcus terminalis on posterior dorsal tongue surface

139
Q

The papillae sulcus is cleared of taste stimuli by:

A

Serous salivary glands of von Ebner

140
Q

The different papillae response to all types of taste stimuli but display bias in:

A

Their sensitivity

141
Q

_____ tend to be more sensitive to bitter compounds

A

Circumvallate

142
Q

_____ respond best to salt & sweet stimuli

A

Fungiform papillae

143
Q

____ shows a bias for sweet

A

Foliate papillae

144
Q

Taste cells are specialized:

A

Epithelial cells

145
Q

Give an example of a taste cell:

A

Neuroepithelial cells

146
Q

Nerve supply for taste:

  1. anterior 2/3 of tongue
  2. posterior 1/3 of tongue
  3. Soft palate
  4. Walls of pharynx & epiglottis
A
  1. facial nerve (CN7) via chordae tympani branch
  2. glossopharyngeal (CN9)
  3. facial nerve (CN7) via greater petrosal branch
  4. Vagus nerve (CN10)
147
Q

Taste fibers from all three nerves (facial, glossopharyngeal & vagus) all converge in the:

A

Tractus solitarius of the brain stem

148
Q

Unknown etiology, but T-lymphocyte infiltrates with Langerhans cell hyperplasia are characteristic of:

A

Lichen planus

149
Q

Cell-mediated immune injury to basal cells is a consequence of:

A

Lichen planus

150
Q

Thickening of the stratum corneum, often with aberrant keratinization:

A

Hyperkeratosis

151
Q

A white plaque of the oral mucous membranes that CANNOT be removed by scraping and CANNOT be classified histologically as another disease entitiy

A

Leukoplakia

152
Q

Until proven otherwise, leukoplakia should be considered:

A

Pre-cancerous

153
Q

Oral cancer that account for about 3% of all cancers

A

Squamous cell carcinoma (SCCA)

154
Q

The highest incidence of SCCA is in:

A

middle aged African American males

155
Q

The overall male-to-female gender ratio of occurrence is:

156
Q

The most common site for SCCA is the:

A

Posterior lateral border of the tongue

157
Q

What are two common sites for SCCA not including the posterior lateral border of the tongue:

A
  1. Ventral tongue surface
  2. Floor of mouth
158
Q

Tobacco, alcohol, phenol exposure, oncogenic viruses (HPV), Immunosuppression (AIDS), Oncogenes & tumor suppressor genes all have a strong relationship with:

159
Q

In SCCA the lesion arises from ____ & features alterations in size, shape & organization of the cellular components, including nuclear polymorphism

A

Dysplastic surface epithelium

160
Q

SCCA lesions exhibit _____ and cords of malignant squamous epithelial cells:

A

Invasive islands

161
Q

In SCCA there is often a strong _____ or ____ response to the invading epithelium and focal areas of ____ may be present

A

Inflammatory or immune cell response; necrosis

162
Q

In SCCA, abnormal production of ____ in the form of _____ is a frequent finding

A

Keratin; keratin pearls

163
Q

Round focus of concentrically layered keratinized cells

A

Keratin pearls

164
Q

Other names for mucosal pemphigoid include: (3)

A
  1. Benign mucous membrane pemphigoid
  2. BMMP
  3. Cicatricial pemphigoid
165
Q

Mucosal pemphigoid is classified as a ____ disease

A

Autoimmune

166
Q

What is the antigen found in mucosal pemphigoid?
Where is it found?

A

Adhesin protein epiligrin found in the lamina Lucida

167
Q

Characterized by the linear accumulations of IgG and C3 along the basement membrane:

A

Mucosal pemphigoid

168
Q

Mucosal pemphigoid is characterized by linear accumulations of ____ & ___ along the ____

A

IgG & C3; Basement membrane

169
Q

Mucosal pemphigoid tends to affect what age range and what is the ratio of affected females to males:

A

older adults 50-60 range

2:1 (female to male)

170
Q

BMMP involvement of the ____ of the eye results in scarring (symblepharon)

A

Conjunctiva

171
Q

A syndrome involving abnormal or lack of development of ectodermal structures such as hair, eyebrows, eyelashes or teeth:

A

Ectodermal dysplasia

172
Q

Peripheral ossifying fibroma is considered to be _____ rather than ____ in nature:

A

Reactive; neoplastic

173
Q

In peripheral ossifying fibroma, the lesion is thought to represent the maturation of:

A

Pyogenic granuloma

174
Q

Peripheral ossifying fibroma occurs exclusively on the:

175
Q

Peripheral ossifying fibroma is predominantly a lesion of ____ & ____ with peak prevalence between the ages of:

A

teenagers & young adults
10-19 years

176
Q

60-65% cases of Peripheral ossifying fibroma occur in:

177
Q

Peripheral ossifying fibroma histologically reveals a gingival mass with islands of _____ derived from ____

A

calcified material
periosteum

178
Q

What is the recommended treatment of Peripheral ossifying fibroma?

A

Surgical excision

179
Q

Peripheral ossifying fibroma lesions are likely to reoccur if:

A

Excision is not extensive and complete

Histopathology (15 decks)

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