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pathology
test 1
Question | Answer |
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Bulla | circumscribed elevated lesion (blister). is different in size greater than 5mm in diameter usually contains serous fluid. |
Macule | (freckle) flat does not protrude above the survace of normal tissue. Color is ditinguishable from surrounding tissue |
Papule | small lesion smaller than 1cm in diameter elevated or protrudes above the surface of normal surrounding tissue. |
Lobule | a segment or lobe that is part of the whole; these lobes sometimes appear fused together |
Pedunculated | attached by a stemlike or stalklike base similar to that of a mushroom, benign tuomor of epithelial tissue |
Pustule | contains pus |
Sessile | flat broad base (benign tumor of salivary gland tissue) |
Vesicle | small blister; less than 1 cm in diameter (contains serous fluid) |
Nodule | palpable solid lesion up to 1 cm in diameter found in soft tissue; can occur above, level with, or beneath the skin surface. |
Palpation | the evaluation of a lesion by feeling it with the fingers to determine the texture of the area; descriptive terms for palpation are soft, firm, semi-firm, and fluid filled. |
Colors of lesions | red, pink, salmon, white, blue-black, gray, brown, and black describe most oral lesions |
Erythemia | abnormal redness of gingiva and mucosa |
Pallor | paleness of skin or mucosal tissue |
Size of lesions | centimeters and millimeters |
RADIOGRAPHIC TERMS USED TO DESCRIBE LESIONS IN BONE | COALESCENCE, DIFFUSE, MULTIOCULAR, RADIOLUCENT, RADIOPAQUE, ROOT RESORPTION, SCALLOPING AROUND THE ROOT, UNIOCULAR, WELL CIRCUMSCRIBED |
COALESCENCE | parts of a whole join together, or fuse, to make one |
DIFFUSE | lesions with borders not well defined (may make treatment more difficult) |
MULTIOCULAR | describes a lesion that extends beyond the confines of one distinct area and is defined as many lobes or parts that are somewhat fused together making up the entire lesion sometimes resembles soap bubbles. |
RADIOLUCENT | black or dark areas on an xray ex: pulp |
RADIOPAQUE | light or white areas on a xray (more dense such as crowns, or fillings) |
ROOT RESORPTION | when the apex of the tooth appears shortened or blunted and irregulary shaped occurs as a response to stimuli which can inc. a cyst, tumor, or trauma |
SCALLOPING AROUND THE ROOT | radiolucent lesion that extends between the roots (appears to extend up the periodontal ligament) |
UNIOCULAR | Having one compartment or unit that is well defined or outlined |
WELL CIRCUMSCRIBED | a lesion with borders that are specifically defined, can clearly see the exact margins and extent |
radiographic diagnosis | provides sufficient info to establish the diagnosis. |
ATTRITION | the wearing away of tooth structure during mastication. Involves the incisal, occlusal, and proximal surfaces of teeth (normal wear and tear) will never have a TMJ problem. |
first sign of attrition | the disappearance of the mamelons on incisal teeth and flattening of the occlusal cusps |
BRUXISM | grinding and clenching the teeth together visible on enamel surfaces (stress reliever) |
ABRASION | the pathologic wearing away of tooth structure (results from a repetitive mechanical habit, most commonly seen in exposed roots) -occur from improper brushing techniques |
EROSION | the loss of tooth structure resulting from chemical action. the area of erosion appears smooth and polished (usually occurs on smooth facial or lingual surfaces and proximal and occlusal surfaces) |
Erosion may be seen in individuals | who work in industries in which acid is used, erosion of the facial surfaces of teeth may also occur as a result of frequently sucking on lemons, and chronic vomiting. |
Variants of Normal | Fordyce granules Torus Palatinus Mandibular Tori Melanin Pigmentation Retrocuspid Papilla Lingual Variscosities Linea Alba Leukoedema |
Fordyce Granules | cluster of ectopic secbaceous glands (most commonly observed on the lips and buccal mucosa) they appear as tiny yellow lobules in clusters, are usually distributed over the buccal mucosa or vermillion border of the invlolved lips |
Torus Palatinus | (palatal torus): an exophytic growth of normal compact bone. occur more frequently in women, are asymptomatic, develop gradually, are observed in the MIDLINE OF THE HARD PALATE |
Mandibular Tori | outgrowths of normal dense bone found on the lingual aspect of the mandible in the area of the premolars above the mylohyoid ridge. usually bilateral, lobulated, or nodular, can appear fused together |
Melanin Pigmentation | the pigment that gives color to the skin, eyes, hair, mucosa and gingiva. Melanin Pigmentation of the oral mucosa or gingiva is most commonly observed in dark skinned individuals |
Periapical Abcess | an infection around the roots of a tooth, usually a result of spreading of dental caries. is treated by a root canal and consists of 50% boneloss |
blood is composed of | plasma and cells |
Periapical abcess is composed of | purulent exudate or pus surrounded by connective tissue containing neutrophils and lymphocytes. the inflammatory exudate pus puts pressure on nerves. |
Periapical granuloma | a localized mass of chronically inflamed granulation tissue that forms at the opening of the pulp canal, generally at the apex of a nonvital tooth rooth. (most cases are asymptomatic) can progress to become a cyst. |
Periapical Cyst | also called a radicular cyst: pathologic cavity lined by epithelium. it occurs in association with the root of a nonvital tooth. |
how does a periapical abcess appear in a radiograph | slight thichening of the apical periodontal ligament space. if develops in area of periapical chronic inflammation a distinct radiolucent area is seen at the apex: treatment draining by opening the pulp chamber or extracting the tooth. |
how does a granuloma appear in a radiograph | may vary from a slight thickening of the periodontal ligament space in the area of inflammation to a diffuse radiolucency to a distinct, well circumscribed radiolucency surroundint the apex of the root |
how does a cyst appear in a radiograph | is the same of that as a granuloma. appears radiolucent usually well circumscribed, attached to a tooth root. it is not possible to differentiate a granuloma from a cyst. |
Peripheral | located away from the center; indicates that the location of a lesion is in the soft tissue surrounding a bone. (its in the GINGIVA) |
Central | within the bone (in the gingival area) |
exudate | inflammatory fluid formed as a reaction to injury of tissues and blood vessels |
Purulent | containing or forming pus |
Neutrophils | the first white blood cells recruited into the area of injury in response to chemotactic factors. the funcion is PHAGOCYTOSIS of pathogenic microorganisms and tissue debris. 1st in line of defense (60-70%) of WBC Population. |
The removal of what substances from the site of injury is necessary to allow the process of healing to occur? | lysosomal enzymes contained within vacuoles in the cytoplasm destroy substances after the cell has engulfed them. (removal of pathogenic microorganisms and tissue debris) |
Retrocuspid Papilla | a sessile nodule on the gingival margin of the lingual aspect of the mandibular cuspids. |
Lingual Varicosities | prominent lingual veins, usually observed on the ventral and lateral surfaces of the tongue. |
Linea Alba | a white line that extends anteroposteriorly on the buccal mucosa along the occlusal plane it may be bilateral and can be more prominent in patients who have a clenching or bruxing habit. |
Leukoedema | a generalized opalescence is imparted to the buccal mucosa, most common in black adults. |
Lingual thyroid nodule (a developmental anomaly) | the thyroid glands begin to develop during the first month of fetal life, in normal development the thyroid gland descends to its normal loc. in the neck, when it doesnt descend remnants become entrapped in the tissue that makes up the tongue |
median rhomboid glossitis | appears flat or slightly raised oval or rectangular erythematous area in the midline of the dorsal surface of the tongue, beg. at the junction of the anterior middle thirds and extending posterior to the circumvallate papillae. texture is smooth |
geographic tongue | erythema migrains, benign migratory glossitis is not clear changes shape and location. involves the dorsal and lateral borders of the tongue diffuse areas devoid of filiform papillae; appear as white or yellow patches |
fissured tongue | dorsal surface of tongue appears to have deep fissures or grooves that may become irritated if food debris collects in them. |
Sjogren syndrome | an autoimmune disease that affects the salivary and lacrimal glands, resulting in DRY MOUTH, DRY EYES, AND RHEUMATOID ARTHRITIS. affects salivary and lacrimal glands -salivary glands secrete saliva, lacrimal glands secrete tears |
xerostomia | decreased salivary flow, results in dry mouth |
xerophthalmia | decreased lacrimal flow results in dry eyes |
many patients with sjogren syndrome also have another autoimmune disease which one is it? | rheumatoid arthiritis or systemic lupus erythematosus |
the oral maifestation of sjogren syndrome is | xerostomia (dry mouth) result of decrease in salivary flow, causes the mucosa to become erythematous. lack of saliva causes the mouth to feel sticky, lips are cracked and dry loss of filiform and fungiform papillae occur on dorsum of tongue |
patients with xerostomia are at high risk for the development of | caries, periodontal disease, and oral candidiasis |
erythema multiforme | IRIS or TARGET lesion: occur generally on the skin, occurs alot in people who take penicillin. |
DIABETES INSIPIDUS | CAUSED BY COLLECTIONS OF MACROPHAGES IN THE SELLA TURCICA AREA AFFECTING THE PITUITARY GLAND |
Systemic lupus erythematosus (SLE) | THE CLASSIC BUTTERFLY RASH OCCURS OVER THE BRIDGE OF THE NOSE. |
LUPUS signs and symptoms | rheumatoid arthritis, myalgia andmyositis, retinal vasculitis, psychoses and depression, pericarditis, cardiac arrhythmias and endocarditis and thrombocytopenia |
Tuberculosis | primarily pulmonary disease (infection of the lung) symptoms inc: fever, chills, fatigue, malaise, weight loss, and persistent cough |
at what point in time is a patient with tuberculosis ok to treat? | 2 weeks after beginning treatment |
how TB develops | inhaled droplets containing bacteria lodge in the alveoli of the lungs, after undergoing phagocytosis by macrophages, the organisms are resistant to destruction and multiply in the macrophages. they then disseminate into the bloodstream. |
Miliary Tuberculosis | the bacteria can be carried to widespread areas of the body and cause involvement of organs (kidneys and liver) |
oral lesions occur but are rare in patients with TB: | they appear when organisms are carried from the lungs in sputum and transmitted to the oral mucosa. |
diagnosis of TB | oral lesions are identified by biopsy and microscopic examination of the tissue. characteristic lesions are granulomas. -A skin test is used to determine if there has been exposure or the infection is present by purified protein derivative |
TB granulomas | are composed of areas of necrosis surrounded by macrophages, multinucleated giant cells, and lymphocytes. |
SYPHILIS | caused by spirochete Treponema pallidum disease occurs in three stages: Primary, Secondary, and Tertiary |
Primary (stage 1 of syphilis) | oral lesion: Chancre (painless ulcer)highly infectious forms at the site at which the spirochete enters the body. the leasions heal slowly, painless ulcer at sight of primary inocculation, common on the lips genitals, disease re-enters the body later on |
Secondary (stage 2 of syphilis) | oral lesion: Mucous patch: appear as multiple, painless, grayish-white plaques covering ulcerated mucosa -occurs 6 weeks after primary lesion appears -skin lesions have many forms -HIGHLY INFECTIOUS,disease may remain latent for years (non-infective) |
Latent phase | is a non-infective phase where an individual can remain for the rest of their life. they undergo spontaneous remission, after remission the disease may remain latent for many years. |
Tertiary (3rd stage of syphilis) | oral lesion: GUMMA:non-infectious can occur in the oral cavity most commonly seen in tongue and palate. Appears as firm mass that eventually becomes an ulcer. is a destructive lesion and can lead to perforation of the palatal bone. |
Tertiary phase occurs | years after the initial infection if the infection has not been treated. they chiefly involve the cardiovascular system and the central nervous system, this will kill you! |
papillary syphiloderm would be part of what stage of syphilis? | Secondary |
Gumma erodes _____ and ________ | mucosa and palate |
Gumma affects: | the nervous system, makes you walk funny, pupils become small, causes periocarditis, aneurism, aortic anuerism |
Congenital Syphilis | syphilis can be transmitted from an infected mother to the fetus b/c the organism can cross the placenta and enter the fetal circulation. often causes irreversible damage to the child such as facial and dental abnormalities. |
hutchinsons incisors and mulberry molars are both dental abnormalities caused by | congenital syphilis |
CANDIDIASIS (MONILIASIS/ THRUSH) | THE MOST COMMON ORAL FUNGAL INFECTION: occurs as a result of an overgrowth of the yeastlike fungus candida albicans (yeast infection) -competes with other bacteria which causes secondary infection. |
two types of fungal infections | superficial and deep |
4 causes of candidiasis of vital importance | 1. Antibiotic Therapy 2. Steroid Treatment 3. Undiagnosed or poorly treated diabetes 4. AIDS |