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BDS3 University of Adelaide Dentistry > Oro-Facial > Flashcards

Oro-Facial Flashcards

1
Q

What are the factors affecting taste perception?

A 
Age
Meals
Hunger 
Smoking
Obesity 
Pregnancy
Cold/Flu/Allergies
Disease
Temperature
Adaptation
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2
Q

What is the main component of umami taste?

A

L-Glutamate

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3
Q

What is the main component of bitter tastes?

A

Alkaloids

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4
Q

Sensory pathways for taste in the epiglottis and larynx is innervated by what cranial nerve?

A

CN X: Vagus

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5
Q

Glossopharyngeal nerve provides taste to what?

A

Posterior 1/3 of tongue and pharynx

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6
Q

Where do taste signals terminate in the brain?

A

Gustatory Cortex (Anterior Insulafrontal Operculum)

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7
Q

What are the two measurements for taste acuity?

A

Detection and Recognition Threshold

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8
Q

T/F Sweet taste is pleasant at low concentrations

A

False

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9
Q

What is the life span of sustentacular + taste cells?

A

1-2 weeks

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10
Q

What is the implication of taste for obese people?

A

Less taste cells > compromised fat sensing system > delays satiety response > excess food intake

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11
Q

What is the difference between ageusia and dysgeusia?

A

Ageusia: total loss of taste
Dysgeusia: partial loss of taste

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12
Q

Damage to the chorda tympani will result in unilateral or contralateral loss of taste?

A

Unilateral loss of taste to anterior 2/3rd of the tongue

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13
Q

What can’t the Gates Control Theory explain?

A

Phantom Pain

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14
Q

T/F: Tonic Receptors are fast adapting

A

F: Slow Adapting

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15
Q

What are 5 things chemoreceptors can detect?

A

Taste / Smell / pH (H+) / Plasma O2 / Osmolality

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16
Q

What do Teleceptors detect and give 2 examples

A

Teleceptors are sensitive to stimuli originating at a distance. Such nerve endings exist in the eyes and ears.

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17
Q

Interoceptors can be found where?

A

Inside the body, in muscles, tendons and joints such as Muscle Spindles or the TMJ

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18
Q

Where in the Dorsal Column do neurons cross over?

A

Decusation of Media Leminscus in the medulla oblongata

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19
Q

Where do neurons cross over in the Spinothalamic Tract?

A

Within the spinal column where the 1st order neuron exists

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20
Q

What sort of sensory input can be found from nerves in the dorsal column?

A

Fine touch + pressure, vibration, position sensations

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21
Q

What sort of sensory input can be found from nerves in the spinothalamic tract?

A

Pain, Temperature, Crude Touch/Pressure, Tickle/Itch, Sexual sensations

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22
Q

What is meant by Somatic Sensory Projection?

A

Body parts represented in the brain is proportional to it’s importance for that species.

Eg: for humans sensory input from fingers + tongue is paramount for speech and fine motor skills

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23
Q

Meissner Corpuscle measure what sensory input?

A

Dynamic Deformation

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24
Q

Hair Follicles measure what sensory input?

A

Light Touch

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25
Q

Pacinian Corpuscle measure what sensory input?

A

Vibration

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26
Q

Merkel Cell measure what sensory input?

A

Indentation & Depth

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27
Q

Ruffini Corpuscle measure what sensory input?

A

Stretch

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28
Q

C-Fibre LTM measure what sensory input?

A

Touch

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29
Q

Mechano-Nociceptor Polymodal Mechano-Nociceptors measure what sensory input?

A

Injuring Forces

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30
Q

What is meant by Tactile Acuity?

A

Two points of contact are felt as two distinct points

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31
Q

Can Tactile Acuity cross the midline?

A

No

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32
Q

What are some examples of Tactile Acuity

A

Tongue, Finger Tip, Nose

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33
Q

What mucosa in the oral cavity can detect both cold and warm?

A 
Dorsum of Tongue (Strong Both)
Ventral Tongue (Moderate Warm/Strong Cold)
Labial Mucosa (Moderate Both)
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34
Q

What is the role of Periodontal Mechanoreceptors?

A

Oral Stereognosis and tactile sensitivity to teeth

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35
Q

What factors affect Oral Stereognosis Ability (OSA)?

A
  • Form, Size and Surface characteristics of the test piece
  • Presentation order of the objects
  • Age
  • Dental Status (poorer with missing dentition, perio, endo treated teeth)
  • Duchenne Muscular Dystrophy
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36
Q

Why is Oral Stereognosis important?

A

For efficient mastication that does not damage hard / soft tissue

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37
Q

Stomatodynia is also known as what?

A

Burning Mouth Syndrome

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38
Q

What are endogenous mediators of pain for nociceptors?

A

Bradykinin, H+, Substance P, Histamine, K+

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39
Q

What fibres result in fast pain?

A

A-Delta Fibres

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40
Q

What is double pain sensation?

A

A-Delta + C Fibres which conduct the impulses at different velocities

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41
Q

In an inflammatory response what does bradykinin do in terms of pain?

A

Activates nociceptors

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42
Q

What is Central Sensitisation?

A

Where the nervous system winds up during a persistent state of high reactivity to pain in order to develop a response to maintain chronic pain. This results in the patient being more sensitive not only to pain but to other sensory input.

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43
Q

What is the role of Substance P during the inflammation of dental pulp?

A 
Vasodilatory Response
Histamine Release
Increase in blood flow + vascular permeability
Increase in blood pressure
Synthesis of proinflammatory cytokines
Chemotaxis of inflammatory cells
Sensitisation of nociceptors
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44
Q

What can modulate pain from ascending pain transmitting tracts?

A

Endogenous Opiates from Inhibitory interneurons in the dorsal horn

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45
Q

Are A-Beta fibres part of a pain response?

A

No.

They are large myelinated fibres involved with touch, pressure and proprioception

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46
Q

What are Von Ebner’s Glands and where are they found?

A

Serous salivary secretion glands found on the lateral surface of Circumvallate Papillae

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47
Q

If a patient is clinically observed with a lack of Filliform Papillae and a bold red appearance, what could this be a sign of?

A

Low Iron levels in the blood

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48
Q

Where can minor taste organs be found?

A

Soft + Hard Palate
Pharynx
Larynx
Epiglottis

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49
Q

What is the difference between detection and recongition threshold?

A

Detection Threshold: the ability to distinguish a taste apart from a drop of water

Recognition Threshold: the concentration needed for a solution to be identified as having a certain taste

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50
Q

Why does xerostomia result in poor taste

A

Poor saliva results in insufficient solution to transport

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51
Q

What are 3 main reasons for taste disorders?

A
  1. Transport Loss (Xerostomia)
  2. Sensory Loss (Injury to receptor cells)
  3. Neural Loss ( gustatory afferent nerves + central gustatory pathways)
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52
Q

What are 4 key criteria for the detection of olfactory stimuli?

A
  • Must by volatile - sensitive to changing stimulus
  • Sufficiently water soluble
  • Must be lipid soluble
  • Minimum number of odorous particles must be present for a minimum length of time
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53
Q

What are the 3 phases of the masticatory cycle?

A
  • Opening Phase (Slow > Fast)
  • Closing Phase (Fast > Slow)
  • Occlusal Phase
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54
Q

What masticatory features would you expect to see in a true carnivore?

A
  • Cylindric TMJ for strong biting hinge movement
  • Sharp Teeth
  • Fast Muscles
  • Dominant Temporalis
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55
Q

What masticatory features would you expect to see in a true herbivore?

A
  • Saucer like TMJ for grinding fibrous food
  • Flat Teeth
  • Slow Muscles
  • Dominant Masseter
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56
Q

What is the role of the Orbicularis Oris in mastication?

A

To provide an anterior oral seal around the lips

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57
Q

Accessory muscles of mastication Sternohyoid, Sternothyroid, Omohyoid are innervated by what?

A

C1–C3 Ansa cervicalis

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58
Q

A low innervation ratio for a motor unit is indicative of what?

A

Low levels of control over a muscle

59
Q

What 5 types of receptors are responsible for neural control of neural control of the jaw?

A
  1. Muscle Spindles
  2. Tendon Organ Receptors
  3. TMJ Receptors
  4. Skin / Mucosal Receptors
  5. PDL Mechanoreceptors
60
Q

In which muscles of mastication would we expect to see many muscle spindles?

A

Temporalis, Masseter, Medial Pterygoid Muscle (Jaw Closers) - stretch of muscles is important in maintaining sense of space

61
Q

What are the 2 possible actions of an effector in a reflex arc?

A
  1. Muscle Contraction

2. Gland Secretion

62
Q

What would be a trigger for a jaw-opening reflex?

A

Fishbone wedged in gingiva

63
Q

What would be a trigger for a jaw-closing reflex?

A

During running/jumping

Biting on a nut - adjusted less pressure on close

64
Q

What receptors are responsible for jaw-closing reflexes?

A

Muscle Spindles in jaw-closer muscles (temporalis, medial pterygoid, masseter)

65
Q

What receptors are responsible for jaw-opening reflexes?

A

High-Threshold mechanoreceptors + nociceptors in PDL, gingiva, oral mucosa, tongue, lips, facial skin, nociceptors in tooth pulp

66
Q

Is Jaw Closing reflex bilateral or unilateral?

A

Unilateral

67
Q

T/F Periodontal Reflexes only have reflex inhibition to jaw-closer muscles?

A

False, they have both

  1. Reflex inhibition of jaw-closer muscles - on tapping on a tooth, rapid increase in load force (Protective role: eg stone in sandwich)
  2. Reflex excitation of jaw-closer muscles - o n weak pressure to tooth
    (Help guide food into occlusion, coordinate chewing, crushing of food)
68
Q

With the Peripheral Input + Cortical Input + Central Pattern Generator model for mastication, what is a practical example of when there is a lack of peripheral input?

A

When a patient is eating whilst under LA - Lack of peripheral feedback generates inefficient and dangerous masticatory strokes possibly leading to soft tissue damage

69
Q

Where in the brain is swallowing controlled?

A

The swallowing centre in the pons and medulla oblongata

70
Q

What are the 4 phases of swallowing?

A
  1. Preparatory / Masticatory Phase
  2. Buccal/Oral Phase
  3. Pharyngeal Phase
  4. Oesophageal Phase
71
Q

What is the Buccal/Oral Phase of swallowing?

A

Tongue collects food and pushes it back towards the oropharynx

72
Q

What occurs during the Pharyngeal phase of swallowing?

A
  • Contact of bolus with mechanoreceptors in the pharynx/larynx signals swallowing centre
  • Respiration inhibited
  • Soft Palate Elevated to seal nasal cavity
  • Glottis closes and vocal cords seal entrance to trachea
  • Epiglottis tilts backwards to cover glottis
  • Larynx is elevated prevent entry of food (involuntary movement)
73
Q

What occurs during the Oesophageal Phase of swallowing?

A
  • Pharyngo-oesophageal sphincter opens when food/liquid passes
  • Glottis re-opens and breathing resumes
  • Food then propelled by peristalsis motion down oesophagus
74
Q

What are the 4 suprahyoid muscles?

A

The suprahyoid muscles are four muscles located above the hyoid bone in the neck. They are the digastric, stylohyoid, geniohyoid, and mylohyoid muscles

75
Q

What are the 3 infrahyoid muscles?

A

Thyrohyoid
Sternohyoid
Omohyoid

76
Q

What are the 2 main roles of the digastric muscles?

A
  • Assists Lateral Pterygoid in jaw opening

- Regulating the position of the hyoid bone

77
Q

What does the mylohyoid muscle assist in ?

A
  • Regulating the position of the hyoid bone

- Tongue Movements

78
Q

Which muscle of mastication is most commonly associated with TMD?

A

Temporalis

79
Q

What movements are associated with the Lateral Pterygoid Muscle?

A

Jaw Opening
Jaw Protrusion
Contralateral Jaw Movements

80
Q

What are the 2 heads of the Lateral Pterygoid?

A

Inferior Head of Lateral Pterygoid (IHLP)

Superior Head of Lateral Pterygoid (SHLP)

81
Q

What are the 2 functions of the Medial Pterygoid Muscle?

A

Elevates Mandible

Assists Lateral Pterygoid in moving jaw side-to-side

82
Q

What are the 2 parts of the Masseter Muscle?

A

Superficial and Deep masseter

83
Q

T/F Superficial masseter is more active than Deep Masseter

A

F: Deep Masseter is primarily engaged during mastication + intercuspal open/close excursions

84
Q

What Muscle Fibre Types are more suitable for postural tasks?

A

S-Type (Slow Contracting)

85
Q

What Muscle Fibre Types are more suitable for strong and rapid tasks

A

F-Types (Fast Contracting)

86
Q

What type of muscles of mastication are designed to produce velocity and displacement?

A

Jaw Closers

87
Q

What type of muscles of mastication are designed to produce force?

A

Jaw Openers

88
Q

What is the motion of the temporalis

A

Elevates and retrudes the mandible at the TMJ

89
Q

What are the motions of the Inferior Head of Lateral Pterygoid (IHLP)?

A

Jaw Opening
Jaw Protrusion
Contralateral Jaw Movements

90
Q

When is the superficial part of the masseter most active?

A

During Incisal Clenching

91
Q

T/F: The Superficial Masseter is always more active than the Deep Masseter

A

False, Deep masseter on both sides is always more

active than superficial masseter

92
Q

What are the features of S Motor Units?

A

Slow Contracting

Fatigue-Resistant

93
Q

What are the features of Fine Motor Units?

A

Fast Contracting

Intermediate Fatigable

94
Q

F-Type Motor Units are more suited to what sort of tasks?

A

Strong and Rapid Bite Tasks

95
Q

S-Type Motor Units are more suited to what sort of tasks?

A

Postural Tasks

96
Q

Which muscle fibres are the best for twitch speed?

97
Q

Which muscle fibres are the best for twitch strength?

98
Q

Which muscle fibres are the best for resisting fatigue?

99
Q

Which muscle fibres have the most motoneurons?

100
Q

Which muscle fibres are activated first?

101
Q

Which muscle fibres have the most powerful contractions?

102
Q

What is the significance of hybrid Myosin Heavy Chain fibres?

A

Jaw muscles do a large variety of motor tasks (biting, mastication, swallowing, speech, singing, yawning) &
require a diversity of forces

103
Q

What are 5 factors affecting the fibre-type composition in jaw muscles

A
  • Age
  • Hormones
  • Food - hardness
  • Adaptation behaviours - dentures, edentulousness
  • Craniofacial Morphology (long face, open bite)
104
Q

What are the 5 steps of initiating muscle contraction?

A
  1. ACh released at the neuromuscular junction. Binds to Receptors
  2. Action potential reaches T Tubules
  3. Sarcoplasmic reticulum releases Ca2+
  4. Active site is exposed, Cross-Bridge formation
  5. Contraction begins
105
Q

Precise movement is possibly with what sort of motor neuron?

A

Small Motor Neurons

106
Q

T/F: Larger Motor Neurons are fatigue resistant

107
Q

What mechanoreceptors are primarily involved during chewing?

A

Periodontal Mechanoreceptors (PMRs) generate input to 80% of muscle activity for chewinb

108
Q

What is Fremitus?

A

Fremitus: a vibration perceptible on palpation; in dentistry, a vibration palpable when the teeth come into contact. This is pathological based on occlusal damage from parafunction or bone resorption

109
Q

What are causes of muscle plasticity in jaw function?

A

Tooth extractions
Surgical interventions
Orthodontic interventions

110
Q

How does Poliomyelitis affect motor units?

A

Kills motoneurons in Anterior Ventral Spinal Cord

111
Q

How does Multiple Sclerosis affect motor units?

A

Demyelination of motor axons

112
Q

How does Myasthenia Gravis affect motor units?

A

Blockage of ACh receptors

113
Q

How does Muscular Dystrophy affect motor units?

A

Contraction of muscle fibres inhibited

114
Q

What is an example of reflex inhibition of jaw-closer muscles on a periodontal reflex?

A

Muscle Inhibition on rapid increase in load force: eg biting down on a stone in a sandwich

115
Q

What are 2 examples of Jaw Closing/Jerk reflexes?

A

Maintaining rest position whilst running

Biting on a nut - adjusting for decreased resistance

116
Q

Dentinal Hypersensitivity is mostly caused by what sort of fluid movement?

A

Outward: Air, Drilling, Probing, Osmotic Stimuli (Sucrose: draws water out)

117
Q

What are the 9 components of Neuromatrix pain theory?

A 
Afferent Input
Medullary Descending Inhibition
Pain Perception
Pain Behaviour
Psychosocial/Health Status Factors
Attention
CNS Plasticity
Pathologic Input
Endocrine, Immune and Autonomic System Activity
118
Q

T/F: If the Gate is Closed in Gates Control Theory, there is pain

A

False, if gate is closed there is no pain

119
Q

In Gates Control Theory, stimulus from small fibres results in what?

A

Opens the Gate

120
Q

In Gates Control Theory, stimulus from large fibres results in what?

A

Closing the Gate: no pain (example: massaging the face during LA to stimulate large fibres)

121
Q

A lesion within the ventral trigeminothalamic tract after the midline will result in what sort of sensation loss?

A

Contralateral loss of pain and temperature from the head and face

122
Q

A lesion within the spinotrigeminal tract will result in what sort of sensation loss?

A

Ipsilateral loss of pain and temperature from the head and face

123
Q

What is the tract name for the trigeminal second order axons after they have crossed the midline?

A

Ventral Trigeminothalamic Tract (Trigeminal Lemniscus)

124
Q

Trigeminal nerve innervates the orofacial area. What structure is the relay station for the nerve fibres carrying pain sensations from the maxillary molar tooth?

A

Spinal Nucleus of CN V

125
Q

Subnucleus Oralis, Interpolaris, Caudalis can be found where?

A

Within the spinal nucleus of CN V

126
Q

What can Wide Dynamic Range (WDR) 2nd order neurons respond to?

A

Respond to noxious/non-noxious stimuli including Light Touch, Temperature, Proprioception

127
Q

Where do the neurons crossover in the Spinothalamic Tract?

A

2nd order neuron at the spinal cord associated with the initial sensory input

128
Q

How can Central Sensitisation be avoided when doing a 3rd molar extraction?

A

Use of a long acting analgesic and anti-inflammatory post operatively

129
Q

What 2 things does the release Substance P result in?

A
  1. Inflammation Release (mast cell degranulation, histamine, activation of nociceptors)
  2. Plasma Extravasation
130
Q

In a hot pulp, what does a oedema result in?

A

Additional release of bradykinin and activation of nociceptors

131
Q

What is the role of Calcitonin Gene Related Peptide (CGRP) in a hot pulp?

A

Results in dilation of peripheral blood vessels and creation of oedema

132
Q

What 4 things can activate nociceptors during injury?

A

Damaged Cells: K+
Damaged Vessels: Bradykinin
Damaged Endothelial Cells: Serotonin + Platelets
Mast Cells: Histamine

133
Q

What 2 chemical can sensitise noiciceptors?

A

Damaged Cells: Prostaglandins

Primary Afferent: Substance P

134
Q

What sites of mechanical stimulation can trigger the gag reflex?

A

Faucial Pillar
Base of the Tongue
Soft Palate
Posterior Pharyngeal Wall

135
Q

What is the order of relief of pain?

A
  1. Relief to burning pain (C Fibres)
  2. Temperature and Prickling Pain (A-delta Fibres)
  3. Touch / Pressure sensation (Large A Fibres)
136
Q

Sensitivity of nerve fibres to LA depends on what 3 things?

A
  1. Size of Nerve Fibre: smaller fibres are blocked first
  2. State of Myelination: myelinated fibres are blocked first
  3. Rate of Firing: rapidly firing neurons are blocked first as they have more affinity for LA
137
Q

What fibres are stimulated with FIRST pain?

A

A Beta - transmits impulses quickly

138
Q

What sort of fibres are A-Beta Fibres?

A

Large Myelinated Fibres

139
Q

Patient feels a throbbing type of poorly localised pain after an injury. What fibres are involved with the pain?

140
Q

Unmelinated C Fibres are involved with what sort of pain?

141
Q

What is Allodynia?

A

Pain from a stimulus that doesn’t usually invoke pain. eg Trigeminal Neuralgia

142
Q

What fibres are involved with fast pain?

A

A-Delta Fibres

143
Q

What are the characteristics of fast pain?

A

Sharp Pain
Well Localised
Short Duration
Afferent signals from Thermal + Mechanical Nociceptors

BDS3 University of Adelaide Dentistry (28 decks)

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