chapter 1: introduction to preliminary diagnosis of oral lesions

what does bulla mean?

bulbous looking, contains serous fluid

how big is a vescile?

less than 1 cm in diameter

what is a vesicle?

small lesion, containing serous fluid

what is an example of a vesicle?

chicken pox

what is a lobule?

a segment that is part of a whole

how are macules distinguished?

different color from surrounding tissue

what does a macule look like?

flat, same flatness of surface of the normal tissue

what is an example of macules?

freckles

what is a nodule?

a palpable, solid lesion ~1cm in diameter

where can nodules occur?

above, in level, or beneath skin surface

what is an example of a nodule?

warts

what is a papule?

an elevated lesion less than 1cm in diameter

what does pedunculated mean?

describes the base of a lesion as stemlike/stalk-like

what does sessile mean?

describes a flat/broad lesion

what does pustules mean?

contains puss

what size are pustules?

varies in size

what is an example of a pustule?

acne

what does plaque look like?

broad, flat, looks pasted on

what is hematoma?

swelling that is filled with blood from a break of a blood vessel wall

what is an ulcer?

a lesion without overlying epithelium, covered by fibrin membrane

what are ulcers missing?

overlying epithelium

what are ulcers covered by?

fibrin membrane

what is ulceration?

the process of ulcers developing

what is an eroded/atrophic lesion?

lesion with thinned overlying epithelium

what is another name for eroded lesion?

atrophic

what is another name for atrophic lesion?

eroded

what is erosion/atrophy?

the process of an eroded lesion developing

what is pallor?

abnormal paleness of mucosa

what is erythema?

abnormal redness of mucosa

what is erythroplakia?

a smooth red patched or granular red patched lesion

what is erythroplakia used to describe?

clinical term for oral mucosa lesions

what is leukoplakia?

clinical term for a white patch on oral mucosa

can erythroplakia/leukoplakia be diagnosed as a disease?

no

how are lesions measured?

cm or mm

what does corrugated mean?

wrinkled

what does fissure mean?

a cleft/groove, shows prominent depth

are fissures always bad?

no, can be normal

what does papillary mean?

resembles small, finger like projections

how are papillaries found?

in clusters

what does verrucous mean?

warty, rough surface

what does well circumscribed mean?

margins are clearly defined

what does poorly circumscribed mean?

margins are not clearly defined

what are irregular borders?

borders that are jagged, may or may not be well defined

what is coalescence?

the process of parts joining together to form one larger whole

what does diffuse mean?

a lesion with borders that are poorly defined

why are diffused lesions bad?

exact parameters of lesions cannot be detected, harder for treatment

what does multiocular mean?

lesions that extend beyond one distinct area

what does multiocular look like?

many lobes fused together to make a whole lesion

what does radiolucent describe?

black/dark areas on an xray

what does radiopaque describe?

white/light areas on an xray

what does radiopacity/radiolucency tell?

stage of lesion development

what is root resorption?

when the apex of a tooth looks blunted/irregularly shaped

what is root resorption a result of?

stimuli (cyst, tumor, trauma)

what is scalloping around the root?

radiolucent lesion that extends between the roots

what does uniocular mean?

having one well defined part

what does corticated mean?

having a well defined radiopaque border

what is an anomaly?

something that is different from the standard/normal

what is dysphagia?

difficulty swallowing

what is dysphonia?

difficulty speaking

what is dyspnea?

difficulty breathing

what are clinical diagnosis based off?

clinical appearance of the lesion

what are the 5 categories looked at for clinical diagnosis?

1. anatomic location

2. border

3. color and configuration

4. diameter/dimension

5. type

what are radiographic diagnosis?

radiographs provide enough information for a diagnosis

what are historical diagnosis?

information from personal, family, past/present medical/dental, drug histories

what is the most important contribution to diagnostic process?

historical diagnosis

what is a sign?

evidence of disease that can be observed by a health care provider rather than the patient

what is an example of a sign?

hyposalivation (finding of dryness noted by clinician)

what is a symptom?

evidence of a disease or physical disorder that is observed by the patient

what is an example of a symptom?

xerostomia (feeling of dryness)

what is a laboratory diagnosis?

clinical lab tests

what is an example of a laboratory diagnosis?

urinalysis

what is microscopic diagnosis?

information from microscopic exam of a biopsy specimen

what is the main component of the definitive diagnosis/scalpel biopsy?

gold standard procedure

what is surgical diagnosis?

a diagnosis made from information gained during a surgical procedure

what are common conditions that are revealed from therapeutic diagnosis?

nutritional deficiencies

what is a differential diagnosis?

listing of probably causes of a particular disease manifestation

what are the steps to create a differential diagnosis?

1. describe abnormality in clinical terms

2. determine a list of diseases/conditions with similar manifestations

3. eliminate some causes

4. rank remaining causes

5. decide what additional information may be necessary

6. result: definitive diagnosis

what is the sequence of examination?

1. lips/vermillion border

2. oral cavity and mucosal surfaces

3. underlying structures of lips/cheeks

4. floor of the mouth

5. salivary gland function

6. tongue

7. palate, tonsils, oropharynx

what are variants of normal?

1. fordyce granules

2. torus palatinus

3. mandibular tori

4. melanin pigmentation

5. retrocuspid papilla

6. lingual varicosities

7. linea alba

8. leukoedema

what are examples of benign conditions?

1. lingual thyroid

2. median rhomboid glossitis

3. erythema migrans

4. fissured tongue

5. hairy tongue

what is lingual thyroid?

mass of thyroid tissue on the midline dorsal tongue

what is median rhomboid glossitis?

flat/slightly raised oval/rectangle erythematous area in midline of tongue

what is erythema migrans?

areas missing filiform papillae on the tongue with patches surrounded by a white/yellow border

what is erythema migrans AKA?

geographic tongue

what is fissured tongue?

tongue having deep fissures/grooves

what is hairy tongue?

filiform papilla is elongated due to increased keratin

what conditions/disease are found in lips/vermillion border?

fordyce granules

what conditions/disease are found in oral cavity/mucosal surfaces?

linea alba and leukoedema

what conditions/disease are found on the floor of the mouth?

mandibular tori

what conditions/disease are found on the tongue?

1. lingual varicosities

2. median rhomboid glossitis

3. erythema migrans

4. fissured tongue

5. hairy tongue