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46 Cards in this Set

  • Front
  • Back
What is the name for a cyst that forms due to blockage of a salivary duct?
What does a mucocele need to be distinguished from? (not in notes)
basal cell carcinoma
What does a mucocele look like histologically?
space lined by granulation tissue & histiocytes
What does the luman of a mucocele contain?
mucus & macrophages
Where do >70% of mucoceles occur?
on the lower lip
Over what age do people typically develop mucoceles? What gender is more commonly develops mucocels?
>40 years old
What causes mucoceles?
results from trauma to ducts of minor salivary glands
What are 2 variations of mucoceles?
1) mucous retention cyst - (partial duct obstruction)
2) ranula - floor of mouth (sublingual gland) - blockage of duct of sublingual gland
What is the name of a white patch of the oral mucosa that cannot be characterized clinically or pathologically as any other disease?
What is leukoplakia due to & why is it worrisome? (not in notes)
Leukoplakia is due to hyperkeritosis (thickening of keratin) & is pre-neoplastic condition
What are 4 appearances leukoplakia might have?
1) homogenous
2) verrucous (warty)
3) white w/ erythematous areas, errosions, fissures
4) Erythematous base with white patches
What are 4 etiologies of leukoplakia?
1) smoking
2) alcohol
3) irritants
4) dentures
At what age is the typical onset of leukoplakia & what is the male:female ratio of occurance?
Onset @ >40 years; Peak <50 yrs
Male:Female 2-3:1
Where in the oral mucosa are 3 typical locations for leukoplakia?
1) buccal mucosa
2) commisures
3) Uncommon on alveolar ridge, soft palate, gingiva
What are 3 characteristics of the hislotogy of leukoplakia?
1) hyperkeratosis
2) epithelial hyperplasia
3) +/- dysplasia (carcinoma next step)
gross pic - clouds in the sky
What type of leukoplakia is a white lesion, homogenous keratinised, slightly elevated? What is the malignant risk?
Leukoplakia simplex
Lowest malignat transformation
What type of leukoplakia has a red, velvety appearance?
What is the malignant risk?
Highest risk of malignant transformation
90% severe dysplasia or carcinoma
What sign & what symptom in patients w/ chronic oral leukoplakia should raise suspicion?
sign: erythematous component
symptom: discomfort
What is done when dysplasia is found histologically in a leukoplakia lesion?
b/c there is a risk of malignancy when dysplasia is found, surgical removal is indicated
What forms of leukoplakia (besides reddness) are associated w/ a high risk of malignant transformation & must be aggressively treated?
proliferative verrucuous (warty) forms
Are patients w/ mild dysplasia or patients w/out any dysplasia still @ risk for malignant transformation?
yes for both
What is the name of a malignacy of the oral cavity?
squamous cell carcinoma
What is the incidence of squamous cell carcinoma? What gender is most affected? What race? What age?
3-4% of all cancers
incidence increases with age (often overlooked in elderly)
What is the survival rate in five years if Dx with squamous cell carcinoma?
overall <50% five years (low survival rate)
What are the 5 most common sites according to the diagram?
1) lower lip (prognosis better)
2) lower part of mouth
3) tongue
4) palate
5) back of tongue
What is the risk of alcohol & smoking on squamous cell carcinoma?
individually risk of alcohol or smoking is 2-4X risk
alcohol & smoking combined, risk increases to 7X
unknown risk chew or snuff
What are 7 additional risk factors for squamous cell carcinoma (besides alcohol & smoking)?
1) HPV infection
2) sun exposure/radiation
3) low socioeconomic status
4) poor dentition & diet
5) employment in textile industries
6) chronic infections
7) Plummer Vinson
What is the Plummer Vinson trid?
1) Esophageal webs
2) Iron deficient anemia
3) atrophic glossitis
What are 8 sites of Squamous cell carcinoma from most to least common?
1) lower lip - 38% - most common
2) tongue - 22%
3) floor of mouth - 17%
4) gingiva - 6%
5) Palate - 5.5% (almost all on soft palate)
6) Upper lip 4%
7) buccal mucosa 2%
8) Uvula 0.5%
What are 4 possible characteristics of squamous cell carcinoma found on the lip?
1) exophytic (tumor grows out from surface of lip)
2) ulcerating
3) verrucous - wartylike
4) usuall well differentiated - slow growth
Are sqamous cell carcinoma found on the upper lip more or less aggressive?
more aggresive
What is the cure reate of squamous cell carcinoma found on the lower lip?
90% cure rate
What are 3 locations on the tongue where squamous cell carcinoma occurs & what is the differentiation & prognosis of each?
1) lateral border of middle 1/3
2) 75% on oral (mobile) portion of tongue - well differentiated (better prognosis)
3) Posterior 1/3 of tongue poorly differentiated, poor prognosis
What particular population of people have an increasing incidence of squamous cell carcinoma of the tongue w/ no apparent risk factors?
young women
As you go farther back in the oral cavity w/ squamous cell carcinoma, how does the prognosis change?
farther you go back in the oral cavity w/ squamous cell carcinoma, poorer the prognosis
Squamous cell carcinoma of the floor of the mouth is most common in what population & where does it occur on the floor of the mouth?
midline or lateral to frenulum of tongue
List 2 characteristics of the spread squamous cell carcinoma found on the floor of the mouth?
often advanced when diagnosed
metastases to cervical nodes later than tongue
What are 3 functions of salivary glands?
1)moistens mucous membranes (750-1000)
2)prepares food for digestion (amylases)
3)controls bacterial flora of mouth
What are salivary glands derived from embryologically?
Develops as thickenings of epithelium of stomodeum
What germ layer are each of the 3 salivary glands derived from?
1)Parotid - oral ectoderm (larges gland, serous, CN IX glossopharyngeal)
2)Submandibular - oral endoderm (mixed, mainly serous, CN VI Facial)
3)Sublingual - oral endoderm, mucous, CN Facial)
Where are myoepithelial cells & what stimulates them to contract?
myoepithelial cells are in the acinus between epithelial cells & basement membrane
parasympathetic nervous system (mainly) stimulates them to contract
What are 3 cell types in salivary glands?
1) mucous - clear
2) serous (protein) - pink
3) myoepithelium
What are 2 functions of mucous secretions?
1)surface lubricant
2)block epithelial binding sites for bacteria
What type of granules do serous cells contain & what are 3 things in these granules? (include functions)
zygomen granules
1)amylase/ptyaline: split starch into water soluble CHO
2)lactoferrin: antibacterial
3)lysozyme: antibacterial
Where are myoepithelial cells located & what are 2 functions?
lie between epithelium & basement lamina
1)contractile (speed flow of saliva)
2)participate in elaboration of basal lamina
What is the main role of saliva?
lubricate food so it can get down to the esophagus