Oral Mucous Membranes- Exam III Flashcards
1
Q
The main functions or mucous membranes: (3)
A
- Absorption
- Excretion
- Protection
2
Q
What are the classifications of oral mucous membranes?
A
- masticatory mucosa (keratinized)
- Lining mucosa (nonkeratinized)
- Specialized mucosa (contains taste buds)
3
Q
Masticatory mucosa is ____ mucosa
A
keratinized
4
Q
locations of masticatory mucosa:
A
- gingiva
- hard palate
5
Q
Lining mucosa is ____ mucosa:
A
nonkeratinized
6
Q
locations of lining mucosa:
A
- alveolar mucosa
- buccal mucosa
- floor of mouth
- ventral surface of tongue
- soft palate
7
Q
Specialized mucosa is mucosa containing _____.
A
taste buds
8
Q
Location of specialized mucosa:
A
- dorsal surface of tongue
9
Q
Classify the mucous membranes present in the image:
What does the blue line represent?
A
- masticatory mucosa
- lining mucosa
blue line: mucogingival junction
10
Q
Classify the mucous membrane present in this image:
A
specialized mucosa
11
Q
List the microscopic organization of oral mucous membranes:
A
- Epithelium
- Lamina Propria
- Submucosa
- Periosteum
12
Q
A periosteum with a mucosal surface, i.e., close approximation of mucous membrane (epithelium and lamina propria) with the periosteum of bone t form an apparent single layer
A
mucoperiosteum
13
Q
Which component of the microscopic organization of oral mucous membranes may or may not be present?
A
submucosa
14
Q
List the tissue layers from top to bottom:
A
Blue: epithelium
Green: lamina propria
Orange: periosteum
White: Bone
15
Q
List the tissue layers from top to bottom:
A
Green: Lamina propria
Orange: Periosteum
White: Bone
16
Q
What is this image displaying?
A
submucosa of the palate
17
Q
Name the zones of the submucosa of the palate:
A
A: Gingival zone
B: Fatty zone
C: Glandular zone
18
Q
List the microscopic organization of the epithelium layer (both ways):
A
- stratum corner
- stratum ganulosum
- stratum spinous
- stratum basal
or
- keratin layer
- granular cell layer
- spinous cell layer
- basal cell layer
19
Q
List the components of the microscopic organization of the epithelial layer:
A
Green: Keratin layer
Blue: Granular cell layer
White: Spinous cell layer
Orange: Basal cell layer
20
Q
What are the arrows pointing to?
A
Yellow: Epithelial Rete Pegs
Green: Connective tissue papilla
21
Q
Both the epithelial rete pegs and the connective tissue papilla aid in:
A
attachment
22
Q
The stratum basal may also be referred to as:
A
stratum germinativum
23
Q
Characteristics of epithelium:
rests on:
A
a basement membrane
24
Q
Characteristics of epithelium:
Exhibits:
A
one or more specialized intercellular attachments
25
Characteristics of epithelium:
Exhibits one or more specialized intercellular attachments such as:
desmosomes and tonofilaments
26
Characteristics of epithelium:
The epithelium is _____ and gets all its. nutrients from ____.
avascular; dermis
27
Characteristics of epithelium:
Exhibits a high degree of ___ and a relatively ____ volume of _____.
cellularity; low; extracellular matrix
28
Characteristics of epithelium:
The epithelium may exhibit:
polarity
29
Characteristics of epithelium:
The cells may exhibits ____ borders
apical, basal, and lateral
30
Characteristics of epithelium:
The polarity of the epithelium is expressed in:
the distribution of cytoplasmic organelles
31
Terminology related to the stratum corneum:
Refers to the normal keratin formation with clinically normal presentation
orthokeratosis
32
Terminology related to the stratum corneum:
Refers to the retention of pyknotic nuclei in the the stratum corneum
Parakeratosis
33
Terminology related to the stratum corneum:
Refers to the abnormal thickening of the stratum corneum. May exhibit aberrant patterns of keratinization
hyperkeratosis
34
Terminology related to the stratum corneum:
Refers to the abnormal keratinization below the level of the stratum corneum, i.e., keratinization within the stratum granulosum and/ or stratum spinous
Dyskeratosis
35
Orthokeratosis, Parakeratosis, Hyperkeratosis, and dyskeratosis are all terms relating to the:
stratum corneum
36
Aconthosis, acontholysis, metaplasia, and dysplasia are all terms relating to the:
epithelial layer
37
Terminology related to the epithelial layer:
Refers to the hyperplasia of the epithelial layer, i.e., increase in the number of cells
acanthosis
38
Terminology related to the epithelial layer:
Refers to the loss of intercellular attachments between epithelial cells (keratinocytes)
acantholysis
39
Terminology related to the epithelial layer:
Describes a reversible change in which one adult cell type is replaced by another:
metaplasia
40
An increase in the number of cells would be an example of:
acanthosis
41
Transition of columnar to squamous epithelium in the respiratory tract in response to smoking would be an example of:
metaplasia
42
Metaplasia is a ____ change in which one adult cell type is replaced by another.
reversible
43
Terminology related to the epithelial layer:
Refers to a disorderly but non-neoplastic growth of tissue including the epithelial layer:
Dysplasia
44
Dysplasia refers to a disorderly but _____ growth of tissue including the epithelial layer
non-neoplastic
45
What condition is characterized by pleomorphism, hyperchromatism and loss of normal spatial orientation?
Dysplasia (epithelial layer)
46
This image is displaying:
Masticatory mucosa- gingival orthokeratosis
47
This image is displaying:
Masticatory mucosa- gingival parakeratosis
48
This image is displaying:
Masticatory mucosa- gingiva hyperkeratosis
49
This image is displaying:
Buccal lining mucosa- Acanthosis and Parakeratosis
50
This image is displaying:
Buccal lining mucosa- Hyperkeratosis + Parakeratosis
51
These images are showing:
Masticatory Mucosa-gingival dyskeratosis: squamous cell carcinoma
52
This image is showing:
Masticatory Mucosa- gingival dyskeratosis: squamous cell carcinoma
53
Melanocytes, Langerhans cells, Merkel's cells, Lymphocytes, are all _____ in the oral epithelium
non-keratinocytes
54
Type of non keratinocyte located in the oral epithelium characterized by:
- dendritic morphology (long processes)
- located in the basal cell layer
- Synthesis of melanin pigments granules (melanosomes)
Melanocyte
55
Melanocytes have _____ morphology
Dendritic
56
Melanocytes are located in the:
Basal cell layer
57
Melanocytes synthesize ____ pigment granules
Melanin
58
Melanin pigment granules:
Melanosomes
59
This image is showing what type of nonkeratinocyte?
Melanocytes
60
This image is showing what type of nonkeratinocyte?
Melanocytes
61
What type of cell is this image showing?
Melanocyte
62
Type of nonkeratinocyte located in the oral epithelium characterized by:
- dendritic morphology
- located in the stratum spinosum
- function as an antigen trap in the epithelium and transfers antigen information to CD4 lymphocytes
Langerhans cell
63
Langerhans cells are located in the:
Stratum spinosum
64
Melanocytes are located in the:
Basal cell layer
65
What characteristic is typically found in langerhans cells?
Langerhans granules (tennis racquets)
66
Functions as an antigen trap in epithelium and transfers antigen information to CD4 lymphocytes:
Langerhans Cell
67
What is this image displaying?
Langerhan’s Cells
68
What is this image displaying?
Langerhan’s Cell
69
What is this image displaying?
Langerhan’s granule (Langerhan’s cell)
70
What nonkeratinocyte located in the oral epithelium is characterized by:
- rounded morphology
- located in the basal layer
- contains characteristic “dense core” granules
- possibly has tactile sensory functions
Merkel’s Cell
71
Merkel’s Cells display a ____ morphology
Rounded
72
Merkel’s cells are located in the:
Basal cell layer
73
Merkel’s Cells contain characteristic:
Dense core granules
74
What is a possible function of Merkel’s Cells?
Tactile sensory functions
75
This image is displaying:
Merkel’s Cells
76
This image is displaying:
Merkel’s Cell
77
Describe the morphology of the lymphocyte in the oral epithelium
rounded morphology
78
Where are the lymphocytes located within the oral epithelium?
found in basal and spinous cell layers
79
What are lymphocytes within the oral epithelium associated with? (3)
1. immune survelince
2. antigen message processing
3. inflammation (both cellular response and humeral)
80
What two layers is the basement membrane comprised of?
basal lamina + lamina reticularis
81
The basal lamina portion of the basement membrane can further be broken down into:
lamina lucida + lamina densa
82
The lamina Lucida is part of the:
basal lamina
83
What two main components is the lamina lucida comprised of?
1. bulbous pemphigoid antigen
2. type VII collagen
84
What is the function of the type 7 collagen in the lamina lucida component of the basal lamia
anchoring fibrils
85
The lamina dense is a component of the:
basal lamina
86
What are the two key components of the lamina dense portion of the basal lamina?
1. Type IV collagen
2. Type 7 collagen
87
What is the function of the type 7 collagen within the lamina densa portion of the basal lamina?
anchoring fibrils
88
THe lamina reticularis is part of the:
basal lamina
89
What four components make up the lamina reticularis portion of the basal lamina?
1. reticulin
2. type 1 collagen
3. type 3 collagen
4. elastin connective tissue
90
What are the two connective tissue components of the lamina reticularis?
elastin and reticulin
91
What are the three layers of the basal lamina?
1. lamina lucida
2. lamina densa
3. lamina reticularis
92
What are the intermediate filaments in the cytoplasm of the cell?
tonofilaments
93
Tonofilaments are made of what types of keratin?
5 & 14
94
The intermediate filaments (tonofilaments) of the cytoplasm of the cell include (4):
1. actin
2. myosin
3. talin
4. vinculin
95
The hemidesmosome components of the cell include?
BPAG 1 and 2 & cadherins
96
What connects the cytoplasm of the cell and all of its intermediate filaments to the lamina lucida?
hemidesmosomes
97
Types of collagen found in each of the layers of the basal lamina:
Lucida:
Densa:
Reticularis:
Lucida= type 7
Densa= type 4 and 7
Reticularis= type 1 and 3
98
What are the five specialized attachments present in oral mucous membranes?
1. desmosomes
2. hemidesmosomes
3. intermediate junctions
4. tight junctions
5. gap junctions
99
Desmosomes in the oral mucous membranes are also called:
macula adherens
100
Intermediate. junctions of the oral mucous membranes are also called:
zonula adherens
101
The tight junctions of the oral mucous membranes are also called:
zonula or macula adherens
102
What are the gap junctions of the oral mucous membranes called?
communication junction
103
What are the two main protein components of desmosomes?
1. E-cadherin (desmogelin)
2. P-cadherin (desmocolin)
104
What occurs to the specialized cellular attachments in the oral mucous membranes in the presence of inflammation?
Loss of cellular attachments
105
What do the basophils of the lamina propria develop into?
mast cells
106
List the transient cell populations of the lamina propria:
neutrophils and lymphocytes
107
secretes collagen and elastin within the lamina propria:
fibroblast
108
blood borne precursor of functional macrophage within the lamina propria:
monocyte
109
Phagocytic cell capable of antigen processing within the lamina propria:
macrophage
110
Secretes inflammatory mediators, E.g., histamine and heparin within the lamina propria:
mast cell
111
Synthesis of immunoglobulins (antibodies) within the lamina propria:
plasma cell
112
Phagocytic cell capable of neutralizing antigens and killing bacteria within the lamina propria:
neutrophil
113
Functions in humoral and cell mediated immune response and located within the lamina propria:
lymphocyte
114
Functions to line the blood and lymphatic vessels within the lamina propria:
endothelial cell
115
what are th two inflammatory mediators that may be secreted by mast cells:
histamine and heparin
116
papilla that are hair-like, most numerous, highly keratinized, and found over the dorsal surface of the tongue;
filiform papilla
117
Fungus-like papilla, small and round, red surface projections, may contain tastebuds, commonly found on the tip of the tongue:
fungiform papilla
118
Where are filiform papilla commonly found?
over the entire dorsal surface of the tongue
119
Where are fungiform papilla commonly found?
commonly found at the tip of the tongue
120
Leaf-like papilla, may contain tastebuds, contain lymphoid nodules with germinal centers, forms parts of waldeyers ring, located on the posterior lateral margins of the tongue:
foliate papillae
121
Foliate papilla contains:
lymphoid nodules with germinal centers
122
Foliate papilla forms part of:
waldeyers ring
123
Where are foliate papillae commonly found?
posterior lateral margins of the tongue
124
Walled papilla, generally 6-8 in number, light keratinized, located just anterior to the sulcus terminals on the posterior dorsal tongue surface:
circumvallate papilla
125
How many circumvallate papilla are typically found?
6-8
126
Are circumvallate papilla keratinized?
lightly
127
Location of circumvallate papilla:
anterior to sulcus terminalis on posterior dorsal tongue surface
128
The papilla sulcus is cleared of taste stimuli by:
serous salivary glands of von ebner
129
The different papillae respond to all types of taste stimuli but display bias in:
their sensitivity
130
_____ tend to be more sensitive to bitter compounds:
circumvallate papillae
131
_____ respond best to salt and sweet stimuli:
fungiform papillae
132
_____ shows a bias for sweets:
foliate papillae
133
Tastes cells are specialized _______
epithelial cells
134
Give an example of a taste cell:
neuroepithelial cells
135
Nerve supply for taste:
1. anterior 2/3 of tongue:
2. posterior 1/3 of tongue:
3. soft palate:
4. walls of pharynx and epiglottis:
1. facial nerve (CN7) via chorda tympani branch
2. glossopharyngeal nerve (CN9)
3. facial nerve (CN7) via greater petrosal branch
4. vagus nerve (CN10)
136
Taste fibers from all 3 nerves (facial, glosspahryngeal, and vagus), all converge in the:
tractus solitarius in the brain stem
137
Unknown etiology, but T-lymphocyte infiltrates with Langerhans cell hyperplasia are characteristic of:
lichen planus
138
Cell mediated immune injury to basal cells is a consequence of:
lichen planus
139
Thickening of the stratum corneum, often with aberrant keratinization:
hyperkeratosis
140
A white plaque of oral mucous membranes that cannot be removed by scraping and cannot be classified histologically as another disease entity:
leukoplakia
141
Until proven otherwise, leukoplakia should be considered:
precancerous
142
Oral cancer that accounts for about 3% of all cancers:
squamous cell carcinoma (SCCA)
143
The highest incidence of SCCA is in:
middle aged African American males
144
The overall male-to-female gender ratio of occurrence of SCCA is:
3:1
145
The most common site for SCCA is the :
posterior lateral border of the tongue
146
What are two common sites for SCCA not including the posterior lateral border of the the tongue:
1. ventral tongue surface
2. floor of mouth
147
tobacco, alcohol, phenol exposure, ontogenic viruses (HPV), Immunosupression (AIDS), oncogenes and tumor suppressor genes all have a strong relationship with:
SCCA
148
In SCCA, the lesion arises from ___ and features alterations in size, shape, and organization of the cellular components including nuclear polymorphism:
dysplastic surface epithelium
149
SCCA lesions exhibit _____ and cords of malignant squamous epithelial cells:
invasive islands
150
In SCCA, there is often a strong ____ or ____ response to the invading epithelium and focal areas of ___ may be present
inflammatory or immune cell response; necrosis
151
In SCCA, abnormal production of ____ in the form of _____ is a frequent finding
keratin; keratin pearls
152
Round focus of concentrically layered keratinized cells:
keratin pearls
153
Other names for mucosal pemphigoid include: (3)
1. benign mucous membrane pemphigoid
2. BMMP
3. cicatricial pemphigoid
154
Mucosal pemphigoid is classified as a ____ disease:
autoimmune
155
What is the antigen found in mucosal pemphigoid and where is it found?
adhesion protein epiligrin found in the lamina lucida
156
Characterized by linear accumulations of IgG and C3 along the basement membrane
mucosal pemphigoid
157
Mucosal pemphigoid is characterized by linear accumulations of ___ and ____ along the _____
IgG & C3; basement membrane
158
Mucosal pemphigoid tends to affect:
older adults 50-60 years
159
What is the ratio of affected females to males of mucosal pemphigoid:
females to males 2:1
160
BMMP involvement in the ____ of the eye results in scaring (symblepharon)
conjunctiva
161
A syndrome involving abnormal or lack of development of ectodermal structures such as hair, eyebrows, eyelashes, or teeth:
ectodermal dysplasia
162
Peripheral ossifying fibroma is considered to be _____ rather than _____ in nature
reactive; neoplastic
163
In peripheral ossifying fibroma, the lesion is thought to represent the maturation o:
pyogenic granuloma
164
Peripheral ossifying fibroma occurs exclusively on the:
gingiva
165
Peripheral ossifying fibroma is predominantly a lesion of ____ & _____ with peak prevalence between the ages of:
teenagers and young adults; 10-19 years
166
60-65% of cases of Peripheral ossifying fibroma occur in:
females
167
Peripheral ossifying fibroma histologically reveals a gingival mass with islands of _____ derived from ____.
calcified material; periosteum
168
What is the recommended treatment of Peripheral ossifying fibroma:
surgical excision
169
Peripheral ossifying fibroma lesions are likely to recur if:
excision is not extensive and complete
