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D1 Spring - Histopathology > Week 8 - Oral Mucous Membranes II > Flashcards

Week 8 - Oral Mucous Membranes II Flashcards

1
Q

When does gingival pigmentation vary?

A

due to differences in melanocyte activity in the basal cell layer. Melanin granules vary in density person to person

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2
Q

What is attached gingiva?

A

(tissue directly attached to alveolar bone)
thickness
- some pts have significant amounts of attached gingiva

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3
Q

What does it mean if someone has less attached gingiva?

A

More non-keratinized unattached gingiva

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4
Q

What does the lip contain?

A

Capillary loops (close to the surface, and especially close to vermillion border)
Thin para-keratinized layers
Mucous secreting glands

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5
Q

What is the vermillion border?

A

line between keratinized and non-keratinized tissue on the inside of the lip

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6
Q

What does the vermillion border have increased amounts of?

A

Capillary loops

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7
Q

What is filiform papillae?

A

“Hair-like” papillae
Most numerous
Highly keratinized

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8
Q

Where is filiform papillae located?

A

over the entire dorsal surface of the tongue

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9
Q

What is fungiform papilale?

A

“Fungus-like” papillae
Small round, red surface projections (color is due to highly vascular connective tissue core)
Tend to contain taste buds

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10
Q

Where is fungiform papillae located?

A

At the tip of the tongue

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11
Q

What does fungiform papillae best respond to?

A

Salt and sweet stimuli

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12
Q

What is foliate papillae?

A

“’Leaf-like” papillae
**Contain lymphoid nodules with germinal centers
Tend to contain taste buds

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13
Q

What does foliate papillae form part of?

A

Waldeyer’s ring

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14
Q

What is waldeyer’s ring?

A

(lymphoid pathway that consists of 1. palatine tonsils, 2. pharyngeal tonsils and 3. lingual lymphoid nodules on the foliate papillae)

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15
Q

Where is foliate papillae located?

A

posterior lateral margins of the tongue

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16
Q

What does foliate papillae show bias to?

A

Sweet stimuli

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17
Q

What is circumvallate papillae?

A

“Walled” papillae
Generally only about 6-8 per tongue
Lightly keratinized
Contain taste buds

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18
Q

How are circumvallate papillae cleared of taste stimuli?

A

by serous salivary glands of Von Ebner

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19
Q

Where are circumvallate papillae located?

A

Located just anterior to the sulcus terminalis on the posterior dorsal tongue surface

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20
Q

What are circumvallate papillae sensitive to?

A

Bitter compounds

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21
Q

Where are taste buds located?

A

line inside of papillae and usually contain glands of Von Ebner’s

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22
Q

What are the functions of von ebner’s glands?

A

Sit inside crevice and pump out fluid to wash away stimulus from taste bud so you can continue to taste over and over again

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23
Q

What are taste cells?

A

neuroepithelial cells, specialized epithelial cells that can detect different taste sensation

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24
Q

Where do taste fibers from all three nerve converse in?

A

Tractus solitarius in the brain stem

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25
Q

What CN is responsible for anterior 2/3 of the tongue?

A

CN VII (Facial) via chorda tympani branch

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26
Q

What CN is responsible for posterior 1/2 of the tongue?

A

CN IX (Glossopharyngeal)

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27
Q

What CN is responsible for the soft palate?

A

CN VII (Facial) via the greater petrosal branch

28
Q

What CN is responsible for the walls of the pharynx and epiglottis?

A

CN X (Vagus)

29
Q

What occurs when the tongue has coffee coating?

A

foliate papillae are coated

30
Q

What is drug induced linchenoid reaction?

A

can be ulcerative (seen), leukoplakic (contain white plaques), or hypertrophic (thickening of skin)

This one is ulcerative
31
Q

What is lichen planus?

A

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

32
Q

In lichen planus, ulceration/loss of tissue above the basal cell later is seen due to?

A

lymphocyte attraction from Langerhans cells

33
Q

What is treatment for lichen planus?

A

steroids are given to decrease immune response. Can be stress induced

34
Q

What is candidiasis caused by?

A

Candida albicans
Fungal infection

35
Q

What is treatment for candidiasis?

A

Anti-fungal agents
- typically asymptomatic
- can be wiped off

36
Q

What is fissured tongue?

A

thickened tongue, multiplied epithelial layers causes swelling and deep fissures

37
Q

What is fissured tongue connected to?

A

Age related (seen more in older patients) and connected to xerostomia patients

38
Q

What is hairy tongue?

A

abnormal growth of the filiform papillae and delayed shedding of the keratin layer

39
Q

What is treatment for hairy tongue?

A

can be remedied with tongue scraper

40
Q

What is normal variant geographic tongue?

A

Benign inflammation and desquamation of filiform papillae

41
Q

What is the treatment for geographic tongue?

A

Asymptomatic
Doesn’t need treatment
- Idiopathic, could be stress, nutritional, and genetically induced

42
Q

What is hyperkeratosis?

A

thickening of stratum corneum often with aberrant keratinization. Once keratin gets wet, it usually turns white

43
Q

What is leukoplakia?

A

white plaque of the oral mucous membranes that cannot be removed by scraping and cannot be classified histologically as another disease entity
- considered precancerous (should biopsy)

44
Q

What is the most common oral cancer?

A

Squamous cell carcinoma

45
Q

Who does squamous cell carcinoma affect?

A

o The highest incidence is in middle aged African American males
o Male to female gender ration = 3:1

46
Q

Where is the most common site for squamous cell carcinoma?

A
  • posterior lateral border of the tongue
  • Floor of the mouth and ventral tongue surface are also common sites
47
Q

What does squamous cell carcinoma have a strong relationship with?

A

tobacco smoking, chewing tobacco, alcohol consumption, phenol exposure, oncogenic viruses (HPV), immunosuppression (AIDS), oncogenes and tumor suppressor genes

48
Q

What is the histopathology of squamous cell carcinoma (is characterized by)?

A

The lesion arises from dysplastic surface epithelium and features alterations in size, shape, and organization of the cellular components, including nucellar pleomorphism

49
Q

What does a squamous cell carcinoma lesion exhibit?

A

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 (due to blood supply being cut off from immune response)

50
Q

How is abnormal production of keratin seen in squamous cell carcinoma?

A

form of keratin pearls (round focus of concentrically layered keratinized cells) is a frequent finding

51
Q

What is mucosal pemphigoid?

A

autoimmune disease, issue with adhesion of connective tissue and epithelium

52
Q

What does the antigen do in mucosal pemphigoid?

A

Antigen attacks lamina lucida which contains pemphigoid receptors

53
Q

What is the antigen in mucosal pemphigoid?

A

Antigen is the adhesion protein epiligrin found in the lamina lucida

54
Q

What is mucosal pemphigoid characterized by?

A

linear accumulations of IgG and C3 along the basement membrane

55
Q

Who does mucosal pemphigoid affect?

A

o Affects older adults nearing 50-60 age range
o Females are affected more often than males by a 2:1 ratio

56
Q

What is cicatrical?

A

form of mucosal pemphigoid involving scarring (derived from the word cicatrix which means “scar”)

Bengin mucous pemphigoid
57
Q

What is cicatrical characerized by?

A

Characterized by BMMP involvement of the conjunctiva of the eye results in scaring (symblepharon)

58
Q

When is nikolysky’s sign positive?

A

positive if there is separation from the epithelial layer from connective tissue underneath

59
Q

What are examples of a nikolysky’s sign being positive?

A
60
Q

What is ectodermal dysplasia?

A

syndrome involving abnormal lack of development of ectodermal structures such as hair, eyebrows, eyelashes, and teeth

61
Q

What is the genetics of ectodermal dysplasia affect?

A

Typically X-linked receive

62
Q

What are clinical features of ectodermal dysplasia?

A

o Patients commonly have hypohidrosis (don’t have sweat glands, tend to overheat very quickly because they cannot regulate own body temperature
o Clinical features: depressed ridge of the nose, pronounced supraorbital arches, severe xerostomia, and lack of development of teeth

63
Q

What is peripheral ossifying fibroma?

A

considered to be reactive (non-cancerous/non-neoplastic)
- The lesion is thought to represent the maturation of pyogenic granuloma

64
Q

Where is peripheral ossifying fibroma present exclusively?

A

On the gingiva

65
Q

What is the occurrence of ossifying fibroma?

A
  • Predominantly a lesion of teenagers and young adults with peak prevalence between ages of 10 and 19 years (due to hormonal changes during this time frame)
  • 60-65% of cases occur in females
66
Q

What is treatment for ossifying fibroma?

A

surgical excision (will reoccur if not cut out all the way)

67
Q

What is the histology of ossifying fibroma?

A

reveals a gingival mass with islands of calcified material (derived from periosteum)

D1 Spring - Histopathology (14 decks)

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