The vestibule is the space between the teeth and lips or cheeks. It is divided into the labial vestibule next to the anterior teeth and the buccal vestibule next to the posterior teeth.
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What is the vestibular fornx and where is it located?
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The vestibular fornx is the lowest part of the vestibule next to the mandible or the highest part next to the maxilla.
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What are the main reasons for studying oral mucosa?
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To understand different regions of the mouth, to help understand injury, and to promote health.
What are the key characteristics of the lining mucosa?
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Soft surface texture, moist surface, ability to stretch and be compressed, acts as a cushion to underlying structures
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List the components of the lining mucosa.
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Buccal mucosa, labial mucosa, alveolar mucosa, floor of mouth, ventral surface (bottom) of tongue and soft palate
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What type of epithelium is the lining mucosa?
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Non-keratinized stratified squamous epithelium
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How does the interface between the epithelium and lamina propria differ in the lining mucosa compared to other epithelia?
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The interface is smooth with less pronounced rete pegs/ridges and connective tissue papillae
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What makes the lining mucosa more movable?
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Elastic fibers in the connective tissue
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What is the submucosa and what does it allow?
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The submucosa is the layer deep to the lamina propria that overlies the muscle. It allows for a movable base and compression of superficial tissue.
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Why are sutures necessary for surgical incisions in the submucosa?
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Sutures are necessary because of tissue movement in the submucosa.
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What are Fordyce's Granules or Spots?
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Small, yellowish elevations on the surface of the labial and buccal mucosa.
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Where are Fordyce's Granules or Spots typically found?
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In the labial and buccal mucosa.
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What do Fordyce's Granules or Spots correspond to?
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Misplaced sebaceous glands in the submucosa.
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What type of epithelium is found in the masticatory mucosa?
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Keratinized stratified squamous epithelium
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How is the interface between the epithelium and connective tissue in the masticatory mucosa described?
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Highly interdigitated
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What is the significance of the rete ridges/pegs and connective tissue papillae in the masticatory mucosa?
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They increase the surface area during mastication, enhancing strength
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What is the term for the intermediate layer in lining mucosa?
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Spinosum or prickle layer
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Which layer is absent in lining mucosa?
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Granular layer
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What is the equivalent layer in lining mucosa to the keratin layer in masticatory mucosa?
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Superficial layer
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What are the key characteristics of the Stratum basale?
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Basal layer of cuboidal/columnar stem cells, site of most cell divisions, contains Merkel cells and Melanocytes.
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Which layer of the oral epithelium is adjacent to the lamina propria?
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Stratum basale.
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What are the key characteristics of the Stratum spinosum/ prickle layer in keratinized epithelium?
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Larger ovoid/spherical keratinocytes with desmosomes aka intercellular bridges, and Langerhans cells.
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How does the Stratum spinosum/ prickle layer compare in thickness to the Stratum basale in the oral epithelium?
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The Stratum spinosum/ prickle layer is thinner in lining vs masticatory mucosa.
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What is the Stratum corneum and what is its function?
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The Stratum corneum is the final stage of keratinocyte maturation and development. It is made up of squamous cells without nuclei and organelles, forming a barrier between the outside environment and deeper layers.
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What is the role of keratinocytes in the oral epithelium?
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Keratinocytes at the basal layer of oral epithelium are proliferative. As cells mature up layers, they slowly lose proliferative potential and undergo programmed cell death.
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What is the most common form of epithelium in the oral cavity?
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Non-keratinized stratified squamous epithelium
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Where is non-keratinized stratified squamous epithelium found in the oral cavity?
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Labial mucosa, buccal mucosa, alveolar mucosa, mucosa lining of the floor of the mouth, ventral surface of the tongue, and soft palate
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What are the three layers of non-keratinized stratified squamous epithelium?
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Basal, Intermediate, Superficial
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What is the alternative name for the basal layer?
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Stratum basale
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What is the alternative name for the intermediate layer?
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Stratum intermedium
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What is the alternative name for the superficial layer?
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Stratum superficiale
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What are keratinocytes and what is their role in the epithelium?
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Keratinocytes are cells responsible for creating keratin, which is produced naturally or in response to trauma.
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What are the functions of non-keratinocytes in the epithelium?
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Non-keratinocytes include melanocytes (involved in pigmentation), white blood cells (PMNs are the most common), Merkel cells (involved in sensory information), and Granstein/Langerhans cells (involved in immune response).
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What are the three types of resident non-keratinocytes mentioned in the slide?
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Langerhans cells, melanocytes, and Merkel cells
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Which two types of non-keratinocytes are dendritic in nature?
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Langerhans cells and melanocytes
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What are the two other non-keratinocytes that appear in the epithelium during inflammation?
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Lymphocytes and leukocytes
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What is the immunologic function of Langerhans cells?
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Langerhans cells have an immunologic function via antigen trapping and processing, and they can activate T-lymphocytes by presenting antigens.
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Where are Langerhans cells typically found?
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Langerhans cells are typically found in the Stratum spinosum.
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What is the migratory nature of Langerhans cells?
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Langerhans cells are migratory and can move from the epithelium to lymph nodes in response to antigens.
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What is the function of Langerhans cells in the immune system?
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Langerhans cells trap and process antigens, activating T-lymphocytes by presenting antigens.
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What are the characteristics of Merkel cells?
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Merkel cells are non-dendritic, tactile sensory cells.
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What is the role of Melanocytes in the skin?
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Melanocytes synthesize melanin pigment granules and transfer them to surrounding keratinocytes.
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What is the difference between non-keratinized and keratinized tissue?
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Non-keratinized tissue does not have superficial layers that are keratinized, while keratinized tissue does.
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Where is hyperkeratinization commonly found on the buccal mucosa?
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Hyperkeratinization is commonly found on the linea alba of the buccal mucosa.
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What is the potential outcome if the irritant causing hyperkeratinization is removed?
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If the irritant is removed, hyperkeratinization can be reversed, although it may take time.
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What is hyperkeratinization?
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A large, white, rough, raised lesion.
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What are some factors associated with hyperkeratinization?
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Nicotine stomatitis on the hard palate, heat from smoking, spit tobacco in the vestibules, and hot fluids.
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What is the least common form of epithelium in the oral cavity?
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Orthokeratinized Stratified Squamous Epithelium
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Where is Orthokeratinized Stratified Squamous Epithelium found?
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Hard palate and attached gingiva
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What is the Prickle Layer named for?
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artifact in microscopic slide preparation
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What happens to the cells in the Prickle Layer?
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Cells are dehydrated, but still maintain desmosomal junctions
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What is the Prickle Layer considered to be?
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Bulk of orthokeratinized epithelium
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What are keratohyaline granules and what do they stain as?
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Keratohyaline granules are found in nucleated cells of the granular layer and stain as dark spots.
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How many layers thick are the cells in the granular layer?
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The cells in the granular layer are 3-5 layers thick.
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What is the most superficial layer of the oral epithelium?
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Keratin Layer
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What is the term used to describe the varying thickness of the keratin layer?
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varies
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What is the characteristic of the cells in the keratin layer?
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flat, no nuclei, filled with keratin
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What are the key characteristics of keratin?
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Keratin is a soft, opaque, waterproof material.
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What components form keratin?
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Keratin is formed from keratohyaline granules and intermediate filaments from cells.
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What protective functions does keratin serve?
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Keratin protects from physical, chemical, microbial attack, and dehydration.
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What is the main difference between parakeratinized and orthokeratinized stratified squamous epithelium?
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Cells of the keratin layer contain nuclei in parakeratinized epithelium.
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Where is parakeratinized stratified squamous epithelium found?
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It is found in the masticatory mucosa of the attached gingiva and the specialized mucosa of lingual papillae on the dorsal surface of the tongue.
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What is the lamina propria of oral mucosa?
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A specialized type of connective tissue
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What is the main fiber group in the lamina propria?
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Collagen
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How many layers does the lamina propria have?
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Two layers: Papillary and Dense
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What is the Papillary Layer?
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The superficial layer consisting of loose connective tissue, blood vessels, nerve tissue, and fibers, cells, and intercellular substance.
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What is the capillary plexus?
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A network of capillaries that provides nutrients to the papillary layer.
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What is the function of fibroblasts in the lamina propria?
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Fibroblasts synthesize proteins and intercellular substances.
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List the types of white blood cells found in the lamina propria.
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PMN's, macrophages, lymphocytes, and mast cells.
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Is non-keratinized stratified squamous epithelium the most common epithelium in the oral cavity?
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True
85
What type of epithelium is the most common in the oral cavity?
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Non-keratinized stratified squamous epithelium
86
What is the definition of labial and buccal mucosa?
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The mucosa that lines the lips and cheeks.
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What is the definition of alveolar mucosa?
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The mucosa that covers the alveolar ridge and the crest of the alveolar process.
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What is the definition of ventral surface of the tongue and floor of the mouth?
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The underside of the tongue and the bottom of the mouth.
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What type of epithelium is found in the labial and buccal mucosa?
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Non-keratinized epithelium
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What are the key characteristics of the labial and buccal mucosa?
What is the clinical appearance of the alveolar mucosa?
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Reddish-pink with blue vascular areas, shiny, moist region, extremely mobile, lines vestibule
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What is the classification of the alveolar mucosa?
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Lining mucosa
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What is the clinical appearance of the ventral surface of the tongue and floor of the mouth?
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Reddish-pink with vascular blue areas, moist, shiny, and compressible
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What is the classification of the ventral surface of the tongue and floor of the mouth?
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Lining mucosa
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What is the histological appearance of the ventral surface of the tongue and floor of the mouth?
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Extremely thin non-keratinized epithelium with extensive vascular supply
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What is the clinical appearance of the soft palate?
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Deep pink, yellowish hue, moist surface, compressible, elastic
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What is the histological appearance of the soft palate?
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Thin non-keratinized epithelium, thick lamina propria, distinct elastic layer for mobility, submucosa, adipose tissue, minor salivary glands
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What is the term for the dental radiograph shown on the left?
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Bitewing radiograph
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What is the term for the dental radiograph shown on the right?
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Periapical radiograph
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What is the clinical appearance of attached gingiva?
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Covers alveolar bone of dental arches, opaque pink, dry, dull, firm and immobile, with stippling resembling an orange peel.
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What is the mucogingival junction?
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The point where the attached gingiva meets the alveolar mucosa.
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What is the classification of attached gingiva?
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Masticatory mucosa.
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What are the clinical appearances of the hard palate?
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Lighter pink, immobile and firm, palatal rugae, median palatine raphe
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What is the classification of the hard palate mucosa?
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Masticatory mucosa
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What is the sulcus terminalis?
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A V-shaped line that divides the tongue into the anterior 2/3 and posterior 1/3.
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What distinguishes the anterior 2/3 of the tongue from the posterior 1/3?
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The anterior 2/3 has tightly packed muscle bundles, while the posterior 1/3 has more adipose tissue and is less mobile.
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What are Lingual Papillae and where are they found on the tongue?
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Lingual Papillae are structures on the tongue that include taste buds. They are found on the lateral and dorsal surfaces of the tongue.
108
List the four types of Lingual Papillae and which ones are associated with taste buds?
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The four types of Lingual Papillae are Filiform, Fungiform, Foliate, and Circumvallate. The Fungiform, Foliate, and Circumvallate types are associated with taste buds.
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What are taste buds?
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Barrel-shaped organs of taste derived from the epithelium.
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How many spindle-shaped cells are in a taste bud?
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30-80
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What is the approximate cell turnover time in taste buds?
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10 days
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What are the two types of taste bud cells?
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Supporting cells and Taste cells
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What is the function of supporting cells in taste buds?
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Provide structural support to the outer portion of the bud
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Where are taste cells located in taste buds?
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In the central portion of the bud
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What are the four basic tastes?
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Sweet, sour, salty, and bitter
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What is umami?
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A savory, fatty acids (meaty) taste
117
What is the specialized mucosa covering the anterior 2/3 of the tongue?
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Specialized mucosa
118
How many types of papillae are there on the tongue's specialized mucosa?
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4
119
List the four types of papillae on the tongue's specialized mucosa.
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Filiform, Fungiform, Foliate, Circumvallate
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What are the clinical appearances of filiform lingual papillae?
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Fine-pointed cones of 2-3 mm, tipped towards the pharynx, giving the velvety texture.
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Where are filiform lingual papillae located on the tongue?
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Dorsal surface of the tongue.
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What type of epithelium do filiform lingual papillae have?
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Orthokeratinized or parakeratinized epithelium
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What is the increased amount of keratin at the surface of each filiform lingual papillae responsible for?
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Whiter color
124
Do filiform lingual papillae contain taste buds?
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No
125
What is the clinical appearance of fungiform lingual papillae?
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Reddish dots, raised mushroom shape in 1 mm diameter, not by sulcus terminalis
126
What is the histological appearance of fungiform lingual papillae?
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Mushroom-shaped, thin layer of ortho/para, highly vascularized, taste buds on superficial layer
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What is the function of fungiform lingual papillae?
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taste sensation
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What is the histological appearance of circumvallate lingual papillae?
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Mushroom-shaped with ortho/para
129
What is the function of circumvallate lingual papillae?
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Taste sensation
130
What is the term for the layer of cells that line the inside of the tooth and form the dentin?
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Dentin
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What is the function of the dentinal tubules in the dentin?
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Conduct heat and cold sensations to the pulp
132
What is the pigment responsible for changing the color of the oral mucosa from brown to brownish black?
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Melanin
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Where are melanocytes located in the oral mucosa and what do they do?
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Melanocytes are located in the basal layer. They produce melanin and inject neighboring cells with melanosomes, which migrate superficially.
134
What is the turnover time for the skin in the mouth?
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27 days
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Which mucosal area has the shortest turnover time?
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Junctional epithelium
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How does the turnover time of non-keratinized mucosa compare to keratinized mucosa?
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Faster
137
What is the first step in the repair process after an injury?
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Moist clot from blood forms
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What happens after the clot breaks down?
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Repair is complete
139
What is the term for the tissue formed by fibroblasts during repair?
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Granulation tissue
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What are the characteristics of granulation tissue?
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Fewer fibers and increased blood vessels, soft, bright red tissue that bleeds easily
141
What are Fordyce's granules?
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Small, yellowish, pea-sized structures found on the oral mucosa, particularly on the lips and buccal mucosa.
142
What is xerostomia?
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A condition characterized by a lack of saliva, leading to a dry mouth.
143
What happens to the thickness and number of rete's pegs in the epithelium during aging?
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They diminish
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How does the degree of keratinization change with age?
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It decreases
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What is the effect on the ability to repair oral mucosa with age?
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It is reduced, and the time to do so is increased
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What is the mission of California Northstate University?
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To advance the science and art of health through education, service, scholarship, and social accountability