Anatomy Test #8 Gingiva & Orofacial Structures

Front 1

Attached Gingiva

Back 1

tightly adheres to bone
no submucosa
lamina propria overlies bone (mucoperiosteum); many rete pegs, so stippling

Front 2

Interdental Gingiva/Papilla

Back 2

between adjacent teeth;
col concave, non-keratinized,
more prominent on posterior teeth

Front 3

Free Gingival Groove

Back 3

separates attached gingival from marginal gingival; corresponds with depth of sulcus;
more prominent in mand. anterior and premolar

Front 4

Marginal or Free Gingiva

Back 4

forms a cuff; lacks stippling; continuous with attached gingival

Front 5

Dentinogingival Junction Tissue

Back 5

lines the sulcus and attaches gingival to tooth. Includes sulcular epithelium and junctional epithelium

Front 6

General gingiva

Back 6

part of masticatory mucosa; thicker parakeratinized epithelium over highly vascularized lamina propria (provide nutrients and pathway for WBC)

Front 7

Clinical considerations

Back 7

Inflammation brings swelling, so red tissue, edema reduces attachment and stippling. Gingival hyperplasia: overgrowth of interproximal gingival (drugs, poor oral care)

Front 8

Recession

Back 8

Stillman’s cleft, frenum attachment, brushing, abfraction (movement of teeth), piercings

Front 9

Dentogingival Junctional Tissues

Back 9

unite tooth surface and soft tissue. Loosly packed; crevicular (and bacteria) fluid in & out, no keratin.
2 components: secular epithelium, junctional epithelium

Front 10

Sulcular Epithelium

Back 10

lines sulcus, non-keratinized, smooth interface, in health, depth is 0.5-3mm. Filled with crevicular fluid (from lamina propria), which flows slowly in health, contains WBC

Front 11

Junctional Epithelium

Back 11

lines floor of the sulcus, and is attached to the root surface by hemidesmosomes. Loosly packed with intercellular spaces that allow passage of WBC and fluid. Non-keratinized stratified squamous, lying parallel to the tooth. Wider coronally, tapers apically. Cell division takes place at apical end. In health, very strong and water-tight seal. Cells do not mature

Front 12

Clinical considerations for Dentogingival Junction Tissues

Back 12

Inflammation causes 3 things:
Swelling (pseudopocket),
Increased Vascularity,
GCF is increased (with more WBC). Fluid provides minerals for subgingival calculus. Calculus can also cause irritation and attachment for bacteria

Front 13

Continuous swelling of Dentogingival Junction

Back 13

superficial fiber of PDL damaged, then destroyed; then bone resportion of alveolar crest. Apical migration of JE (perio pocket)

Front 14

Long-term perio

Back 14

chronic; gingival and JE micrate apically at same time, producing recession (w/o perio pocket)

Front 15

Short-term perio

Back 15

acute; rapid, and JE migrates apically faster than bone or gingival(perio pocket). Increased bleeding and swelling. Most common, easier to treat than recession

Front 16

Gland

Back 16

structure that produces a chemical secretion

Front 17

Kinds of Glands

Back 17

exocrine (by way of duct)
endocrine (no duct, diffusion)

Front 18

Different kinds of secretions

Back 18

Serous (watery with proteins and enzymes, breakdown of food).
Mucous (thick with carbohydrates).
Mixed (both serous and mucous at the same time).

Front 19

Both serous and mucous saliva contain

Back 19

minerals, electrolytes, buffers, enzymes, IgA, metabolic wastes

Front 20

Functions of Salivary Glands

Back 20

mastication, enzymes, taste perception, lubricates, pH, rinse food debris, inhibit some microbes, minerals for remineralization

Front 21

Histology of salivary glands

Back 21

epithelial and CT.
Epithelial line ducts and secrete saliva.
CT surrounds and protects epithelium, and supplies nerves and blood vessels

Front 22

Mucous secretory cell

Back 22

cloudier cytoplasm, cells surround side lumen

Front 23

Serous secretory cell

Back 23

clear cytoplasm, cells surround narrow lumen

Front 24

Acini

Back 24

cluster of secretory cells (epithelium). Cuboidal cells around a lumen. Each is completely serous, mucous, or mucoserous (mucous cells with serous demilunes “bonnet”)

Front 25

Myoepithelial cells

Back 25

line the outside of acini. Cell body with 4-8 cytoplasmic processes (like 1-eyed octopus on a rock) contractile function

Front 26

Intercalated ducts

Back 26

Smallest, connect individual acini. Single layer cuboidal cells. Many ducts found in each lobe.

Front 27

Striated ducts

Back 27

connect intercalated ducts. Found in lobules. Lined by columnar (non-secretory)

Front 28

Excretory ducts

Back 28

connect striated to oral cavity. Located in septum. Lined by stratified squamous. Usually only ducts with a proper name (ie parotid)

Front 29

Development of salivary glands

Back 29

invaginate from stomodeum’s ectoderm 6-8 weeks. Ectodermal cells differentiate into secretory/duct cells. Mesenchyme (influenced by neural crest cells) forms septum and capsule. Ducts form first, and branch and develop until acinis. Within acini, cells differentiate into mucous/serous cells. Myoepithelial derived from neural crest cells. CT proper, nerves, vessels form first around acini, then capsule forms around gland

Front 30

Parotid Salivary Gland

Back 30

largest. Encapsulated by fibrous CT. provides 25% of saliva. Mainly serous (enzymes). Near the ramus of mandible. Parotid duct (Stenson’s duct) opening (Stenson’s/Parotid Paillae) on buccal mucosa adjacent to 1st- Max. molar

Front 31

Submandibular Gland

Back 31

second largest. Encapsulated. Provides 60-65% of saliva with mixed (serous and mucous). Submandibular fossa. Wharton’s duct, and exits sublingual caruncle

Front 32

Sublingual Gland

Back 32

smallest. Unencapsulated. Many smaller ducts open on sublingual fold or combine to form sublingual duct or Bartholin’s duct, which exits at sublingual caruncle

Front 33

Minor Salivary Glands

Back 33

smaller, but more numerous. Found in mucosa, soft palate, lateral of hard palate, floor of mouth. Von Ebner’s (circumvallate papilla) more serous

Front 34

Complications with Salivary Glands

Back 34

xerostomia, sialolith, mucocele, ranula, nicotinic stomatitis

Front 35

Sialoth

Back 35

stone formation in duct

Front 36

Mucocele

Back 36

blocked salivary duct

Front 37

Ranula

Back 37

large mucocele (blocked duct) on floor of mouth

Front 38

Nicotinic Stomatitis

Back 38

irritation of duct openings on palate (hot liquids or smoke). Dialate, produce red dots.

Front 39

Thyroid Gland

Back 39

largest endocrine gland; empties thyroxine directly into blood; anterior and lateral regions of neck. Can be palpated, especially when swallowing. Parathyroid located lateral gland

Front 40

Histology of thyroid

Back 40

CT in the form of a capsule. Each lobule contains follicles (irregular spheroidal cells that surround a cavity filled with colloid, the medium where the thyroxine is stored)

Front 41

Development of Thyroid Gland

Back 41

endoderm invaded by mesenchymal cells. Forms at base of tongue and later moves down neck through thyroglossal duct. Foramen cecum is depression left on tongue where the opening was.

Front 42

Lymphatics

Back 42

part of immune system. Lymphatic vessels connect nodes throughout the body. Travel similar route as blood vessels, but larger than blood vessels.

Front 43

Lymph

Back 43

tissue fluid found in lymph vessels

Front 44

Lymphatic ducts

Back 44

actually empty into venous system. Smaller vessels empty into larger ducts. Different on each side of the body.

Front 45

Lymph nodes

Back 45

like a kidney (shape and filtration). Bean shaped. Filter. In health, they are small, mobile, and cannot be palpated. Can be classified as primary or secondary.

Front 46

Afferent vessels

Back 46

lymph flows to the lymph nodes

Front 47

Efferent vessels

Back 47

lymph flows away from or out of the lymph node

Front 48

Histology

Back 48

CT encapsulates node and divides node via trabeculae. Separates into nodules or follicles.

Front 49

Germinal center

Back 49

center of each lymphatic nodule where immature lymphocytes re located (b-cells)

Front 50

Tonsilar Tissue

Back 50

located in the lamina propria of oral mucosa. Non-encapsulated mass of lymphoid tissue.

Front 51

Palatine Tonsils

Back 51

located between pillars. Contains fused lymphatic nodules, and epithelial invaginations (tonsillar crypts)

Front 52

Lingual Tonsils

Back 52

diffuse lymphoid tissue at base of tongue

Front 53

Anatomy of Nasal Cavity

Back 53

nares (flare) and septum. Nasal conchae (3 projecting structures on lateral wall). Between conchae are openings in which paranasal sinuses and nasolacrimal ducts connect/communicate with nasal cavity

Front 54

Histology of Nasal Cavity Musoca

Back 54

respiratory mucosa (pseudostratified ciliated columnar). Goblet cells secrete mucin and fluid to keep moist, humid, and trap foreign materials. Lamina propria very vascular to warm incoming air. Olfactory mucosa located on roof of nasal cavity

Front 55

Para-nasal sinuses

Back 55

air-filled cavities in bone. Include (paired) frontal, sphenoid, ethmoid, maxillary sinuses. Lighten the skull, sound resonating, mucus for nasal cavity

Front 56

Histology of Paranasal Sinuses

Back 56

pseudostratified ciliated columnar epithelium (respiratory mucosa). Fewer goblet cells and thinner epithelial cells. Thinner lamina propria (CT)

Front 57

Development of paranasal sinuses

Back 57

outgrowths of the wall of nasal cavity late in fetal life and continue through puberty.

Front 58

Paranasal Sinus: maxillary

Back 58

small at birth, grow during puberty, and completed when all perm. Teeth have erupted.

Front 59

Paranasal sinus: ethmoid

Back 59

do not start to grow until 6-8 years

Front 60

Paranasal sinus: frontal

Back 60

NOT present at birth, start growing at age 2, and continue into puberty. Formed from ethmoid sinuses.

Front 61

Paranasal sinus: sphenoid

Back 61

formed from ethmoid sinuses and develop similar to frontal