Oral Mucous Membranes- Exam III Flashcards
The main functions or mucous membranes: (3)
- Absorption
- Excretion
- Protection
What are the classifications of oral mucous membranes?
- masticatory mucosa (keratinized)
- Lining mucosa (nonkeratinized)
- Specialized mucosa (contains taste buds)
Masticatory mucosa is ____ mucosa
keratinized
locations of masticatory mucosa:
- gingiva
- hard palate
Lining mucosa is ____ mucosa:
nonkeratinized
locations of lining mucosa:
- alveolar mucosa
- buccal mucosa
- floor of mouth
- ventral surface of tongue
- soft palate
Specialized mucosa is mucosa containing _____.
taste buds
Location of specialized mucosa:
- dorsal surface of tongue
Classify the mucous membranes present in the image:
What does the blue line represent?
- masticatory mucosa
- lining mucosa
blue line: mucogingival junction
Classify the mucous membrane present in this image:
specialized mucosa
List the microscopic organization of oral mucous membranes:
- Epithelium
- Lamina Propria
- Submucosa
- Periosteum
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
mucoperiosteum
Which component of the microscopic organization of oral mucous membranes may or may not be present?
submucosa
List the tissue layers from top to bottom:
Blue: epithelium
Green: lamina propria
Orange: periosteum
White: Bone
List the tissue layers from top to bottom:
Green: Lamina propria
Orange: Periosteum
White: Bone
What is this image displaying?
submucosa of the palate
Name the zones of the submucosa of the palate:
A: Gingival zone
B: Fatty zone
C: Glandular zone
List the microscopic organization of the epithelium layer (both ways):
- stratum corner
- stratum ganulosum
- stratum spinous
- stratum basal
or
- keratin layer
- granular cell layer
- spinous cell layer
- basal cell layer
List the components of the microscopic organization of the epithelial layer:
Green: Keratin layer
Blue: Granular cell layer
White: Spinous cell layer
Orange: Basal cell layer
What are the arrows pointing to?
Yellow: Epithelial Rete Pegs
Green: Connective tissue papilla
Both the epithelial rete pegs and the connective tissue papilla aid in:
attachment
The stratum basal may also be referred to as:
stratum germinativum
Characteristics of epithelium:
rests on:
a basement membrane
Characteristics of epithelium:
Exhibits:
one or more specialized intercellular attachments
Characteristics of epithelium:
Exhibits one or more specialized intercellular attachments such as:
desmosomes and tonofilaments
Characteristics of epithelium:
The epithelium is _____ and gets all its. nutrients from ____.
avascular; dermis
Characteristics of epithelium:
Exhibits a high degree of ___ and a relatively ____ volume of _____.
cellularity; low; extracellular matrix
Characteristics of epithelium:
The epithelium may exhibit:
polarity
Characteristics of epithelium:
The cells may exhibits ____ borders
apical, basal, and lateral
Characteristics of epithelium:
The polarity of the epithelium is expressed in:
the distribution of cytoplasmic organelles
Terminology related to the stratum corneum:
Refers to the normal keratin formation with clinically normal presentation
orthokeratosis
Terminology related to the stratum corneum:
Refers to the retention of pyknotic nuclei in the the stratum corneum
Parakeratosis
Terminology related to the stratum corneum:
Refers to the abnormal thickening of the stratum corneum. May exhibit aberrant patterns of keratinization
hyperkeratosis
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
Orthokeratosis, Parakeratosis, Hyperkeratosis, and dyskeratosis are all terms relating to the:
stratum corneum
Aconthosis, acontholysis, metaplasia, and dysplasia are all terms relating to the:
epithelial layer
Terminology related to the epithelial layer:
Refers to the hyperplasia of the epithelial layer, i.e., increase in the number of cells
acanthosis
Terminology related to the epithelial layer:
Refers to the loss of intercellular attachments between epithelial cells (keratinocytes)
acantholysis
Terminology related to the epithelial layer:
Describes a reversible change in which one adult cell type is replaced by another:
metaplasia
An increase in the number of cells would be an example of:
acanthosis
Transition of columnar to squamous epithelium in the respiratory tract in response to smoking would be an example of:
metaplasia
Metaplasia is a ____ change in which one adult cell type is replaced by another.
reversible
Terminology related to the epithelial layer:
Refers to a disorderly but non-neoplastic growth of tissue including the epithelial layer:
Dysplasia
Dysplasia refers to a disorderly but _____ growth of tissue including the epithelial layer
non-neoplastic
What condition is characterized by pleomorphism, hyperchromatism and loss of normal spatial orientation?
Dysplasia (epithelial layer)
This image is displaying:
Masticatory mucosa- gingival orthokeratosis
This image is displaying:
Masticatory mucosa- gingival parakeratosis
This image is displaying:
Masticatory mucosa- gingiva hyperkeratosis
This image is displaying:
Buccal lining mucosa- Acanthosis and Parakeratosis
This image is displaying:
Buccal lining mucosa- Hyperkeratosis + Parakeratosis
These images are showing:
Masticatory Mucosa-gingival dyskeratosis: squamous cell carcinoma
This image is showing:
Masticatory Mucosa- gingival dyskeratosis: squamous cell carcinoma
Melanocytes, Langerhans cells, Merkel’s cells, Lymphocytes, are all _____ in the oral epithelium
non-keratinocytes
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
Melanocytes have _____ morphology
Dendritic
Melanocytes are located in the:
Basal cell layer
Melanocytes synthesize ____ pigment granules
Melanin
Melanin pigment granules:
Melanosomes
This image is showing what type of nonkeratinocyte?
Melanocytes
This image is showing what type of nonkeratinocyte?
Melanocytes
What type of cell is this image showing?
Melanocyte
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
Langerhans cells are located in the:
Stratum spinosum
Melanocytes are located in the:
Basal cell layer
What characteristic is typically found in langerhans cells?
Langerhans granules (tennis racquets)
Functions as an antigen trap in epithelium and transfers antigen information to CD4 lymphocytes:
Langerhans Cell
What is this image displaying?
Langerhan’s Cells
What is this image displaying?
Langerhan’s Cell
What is this image displaying?
Langerhan’s granule (Langerhan’s cell)
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
Merkel’s Cells display a ____ morphology
Rounded
Merkel’s cells are located in the:
Basal cell layer
Merkel’s Cells contain characteristic:
Dense core granules
What is a possible function of Merkel’s Cells?
Tactile sensory functions
This image is displaying:
Merkel’s Cells
This image is displaying:
Merkel’s Cell
Describe the morphology of the lymphocyte in the oral epithelium
rounded morphology
Where are the lymphocytes located within the oral epithelium?
found in basal and spinous cell layers
What are lymphocytes within the oral epithelium associated with? (3)
- immune survelince
- antigen message processing
- inflammation (both cellular response and humeral)
What two layers is the basement membrane comprised of?
basal lamina + lamina reticularis
The basal lamina portion of the basement membrane can further be broken down into:
lamina lucida + lamina densa
The lamina Lucida is part of the:
basal lamina
What two main components is the lamina lucida comprised of?
- bulbous pemphigoid antigen
- type VII collagen
What is the function of the type 7 collagen in the lamina lucida component of the basal lamia
anchoring fibrils
The lamina dense is a component of the:
basal lamina
What are the two key components of the lamina dense portion of the basal lamina?
- Type IV collagen
- Type 7 collagen
What is the function of the type 7 collagen within the lamina densa portion of the basal lamina?
anchoring fibrils
THe lamina reticularis is part of the:
basal lamina
What four components make up the lamina reticularis portion of the basal lamina?
- reticulin
- type 1 collagen
- type 3 collagen
- elastin connective tissue
What are the two connective tissue components of the lamina reticularis?
elastin and reticulin
What are the three layers of the basal lamina?
- lamina lucida
- lamina densa
- lamina reticularis
What are the intermediate filaments in the cytoplasm of the cell?
tonofilaments
Tonofilaments are made of what types of keratin?
5 & 14
The intermediate filaments (tonofilaments) of the cytoplasm of the cell include (4):
- actin
- myosin
- talin
- vinculin
The hemidesmosome components of the cell include?
BPAG 1 and 2 & cadherins
What connects the cytoplasm of the cell and all of its intermediate filaments to the lamina lucida?
hemidesmosomes
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
What are the five specialized attachments present in oral mucous membranes?
- desmosomes
- hemidesmosomes
- intermediate junctions
- tight junctions
- gap junctions
Desmosomes in the oral mucous membranes are also called:
macula adherens
Intermediate. junctions of the oral mucous membranes are also called:
zonula adherens
The tight junctions of the oral mucous membranes are also called:
zonula or macula adherens
What are the gap junctions of the oral mucous membranes called?
communication junction
What are the two main protein components of desmosomes?
- E-cadherin (desmogelin)
- P-cadherin (desmocolin)
What occurs to the specialized cellular attachments in the oral mucous membranes in the presence of inflammation?
Loss of cellular attachments
What do the basophils of the lamina propria develop into?
mast cells
List the transient cell populations of the lamina propria:
neutrophils and lymphocytes
secretes collagen and elastin within the lamina propria:
fibroblast
blood borne precursor of functional macrophage within the lamina propria:
monocyte
Phagocytic cell capable of antigen processing within the lamina propria:
macrophage
Secretes inflammatory mediators, E.g., histamine and heparin within the lamina propria:
mast cell
Synthesis of immunoglobulins (antibodies) within the lamina propria:
plasma cell
Phagocytic cell capable of neutralizing antigens and killing bacteria within the lamina propria:
neutrophil
Functions in humoral and cell mediated immune response and located within the lamina propria:
lymphocyte
Functions to line the blood and lymphatic vessels within the lamina propria:
endothelial cell
what are th two inflammatory mediators that may be secreted by mast cells:
histamine and heparin
papilla that are hair-like, most numerous, highly keratinized, and found over the dorsal surface of the tongue;
filiform papilla
Fungus-like papilla, small and round, red surface projections, may contain tastebuds, commonly found on the tip of the tongue:
fungiform papilla
Where are filiform papilla commonly found?
over the entire dorsal surface of the tongue
Where are fungiform papilla commonly found?
commonly found at the tip of the tongue
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
Foliate papilla contains:
lymphoid nodules with germinal centers
Foliate papilla forms part of:
waldeyers ring
Where are foliate papillae commonly found?
posterior lateral margins of the tongue
Walled papilla, generally 6-8 in number, light keratinized, located just anterior to the sulcus terminals on the posterior dorsal tongue surface:
circumvallate papilla
How many circumvallate papilla are typically found?
6-8
Are circumvallate papilla keratinized?
lightly
Location of circumvallate papilla:
anterior to sulcus terminalis on posterior dorsal tongue surface
The papilla sulcus is cleared of taste stimuli by:
serous salivary glands of von ebner
The different papillae respond to all types of taste stimuli but display bias in:
their sensitivity
_____ tend to be more sensitive to bitter compounds:
circumvallate papillae
_____ respond best to salt and sweet stimuli:
fungiform papillae
_____ shows a bias for sweets:
foliate papillae
Tastes cells are specialized _______
epithelial cells
Give an example of a taste cell:
neuroepithelial cells
Nerve supply for taste:
- anterior 2/3 of tongue:
- posterior 1/3 of tongue:
- soft palate:
- walls of pharynx and epiglottis:
- facial nerve (CN7) via chorda tympani branch
- glossopharyngeal nerve (CN9)
- facial nerve (CN7) via greater petrosal branch
- vagus nerve (CN10)
Taste fibers from all 3 nerves (facial, glosspahryngeal, and vagus), all converge in the:
tractus solitarius in the brain stem
Unknown etiology, but T-lymphocyte infiltrates with Langerhans cell hyperplasia are characteristic of:
lichen planus
Cell mediated immune injury to basal cells is a consequence of:
lichen planus
Thickening of the stratum corneum, often with aberrant keratinization:
hyperkeratosis
A white plaque of oral mucous membranes that cannot be removed by scraping and cannot be classified histologically as another disease entity:
leukoplakia
Until proven otherwise, leukoplakia should be considered:
precancerous
Oral cancer that accounts for about 3% of all cancers:
squamous cell carcinoma (SCCA)
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 SCCA is the :
posterior lateral border of the tongue
What are two common sites for SCCA not including the posterior lateral border of the the tongue:
- ventral tongue surface
- floor of mouth
tobacco, alcohol, phenol exposure, ontogenic viruses (HPV), Immunosupression (AIDS), oncogenes and tumor suppressor genes all have a strong relationship with:
SCCA
In SCCA, the lesion arises from ___ and features alterations in size, shape, and organization of the cellular components including nuclear polymorphism:
dysplastic surface epithelium
SCCA lesions exhibit _____ and cords of malignant squamous epithelial cells:
invasive islands
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
In SCCA, abnormal production of ____ in the form of _____ is a frequent finding
keratin; keratin pearls
Round focus of concentrically layered keratinized cells:
keratin pearls
Other names for mucosal pemphigoid include: (3)
- benign mucous membrane pemphigoid
- BMMP
- cicatricial pemphigoid
Mucosal pemphigoid is classified as a ____ disease:
autoimmune
What is the antigen found in mucosal pemphigoid and where is it found?
adhesion protein epiligrin found in the lamina lucida
Characterized by linear accumulations of IgG and C3 along the basement membrane
mucosal pemphigoid
Mucosal pemphigoid is characterized by linear accumulations of ___ and ____ along the _____
IgG & C3; basement membrane
Mucosal pemphigoid tends to affect:
older adults 50-60 years
What is the ratio of affected females to males of mucosal pemphigoid:
females to males 2:1
BMMP involvement in the ____ of the eye results in scaring (symblepharon)
conjunctiva
A syndrome involving abnormal or lack of development of ectodermal structures such as hair, eyebrows, eyelashes, or teeth:
ectodermal dysplasia
Peripheral ossifying fibroma is considered to be _____ rather than _____ in nature
reactive; neoplastic
In peripheral ossifying fibroma, the lesion is thought to represent the maturation o:
pyogenic granuloma
Peripheral ossifying fibroma occurs exclusively on the:
gingiva
Peripheral ossifying fibroma is predominantly a lesion of ____ & _____ with peak prevalence between the ages of:
teenagers and young adults; 10-19 years
60-65% of cases of Peripheral ossifying fibroma occur in:
females
Peripheral ossifying fibroma histologically reveals a gingival mass with islands of _____ derived from ____.
calcified material; periosteum
What is the recommended treatment of Peripheral ossifying fibroma:
surgical excision
Peripheral ossifying fibroma lesions are likely to recur if:
excision is not extensive and complete