This document provides a classification and overview of various disorders that can affect the tongue. It discusses inherited/congenital disorders like partial ankyloglossia, variations in tongue movement, and macroglossia. It also covers diseases of the lingual mucosa such as geographic tongue and hairy tongue. Finally, it summarizes disorders that affect the body of the tongue and tumors that can develop on the tongue.
Periodontitis is a chronic, slowly progressing disease which mainly results in the destruction of tooth supporting apparatus. Earlier it was classified as Chronic and Aggressive periodontitis with different clinical features and etiology. Current classification ( 2017) of periodontal disease involves periodontitis with is further divided into 4 stages and 3 grades depending on severity and rate of disease progression respectively. Diabetes meelitus and smoking are the validated risk factors for the progression of periodontitis.
for undergraduate dental students this presentation includes essential & common disorders which related to the tongue very briefly. Though this may be very helpfull to you to as a start for further readings & studying.
Periodontitis is a chronic, slowly progressing disease which mainly results in the destruction of tooth supporting apparatus. Earlier it was classified as Chronic and Aggressive periodontitis with different clinical features and etiology. Current classification ( 2017) of periodontal disease involves periodontitis with is further divided into 4 stages and 3 grades depending on severity and rate of disease progression respectively. Diabetes meelitus and smoking are the validated risk factors for the progression of periodontitis.
for undergraduate dental students this presentation includes essential & common disorders which related to the tongue very briefly. Though this may be very helpfull to you to as a start for further readings & studying.
Introduction
Development of tongue.
Anatomy of tongue
Arterial supply & nerve supply of tongue.
functions of the tongue.
Pathologic consideration of tongue.
Conclusion.
References
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. INTRODUCTION
Tongue is a muscular organ situated in the floor of
mouth.
It aids in chewing, swallowing, speech and taste.
It is organ of location of taste.
The tongue may be affected as part of oral disease
or as a signs of systemic diseases.
4. CLASSIFICATION OF TONGUE
DISORDERS
A)Inherited, congenital and developmental
anomalies:
a) Minor variations:
1 .Partial ankyloglossia
2.Variations in tongue movement
3.tongue thrusting
4.fissured tongue
5.patent thyroglossal duct and cyst
6.lingual thyroid
7.median rhomboidal glossitis
5. b) Major variations:
1.Cleft, lobed, bifurcated and tetrafurcared tongue
2.aglossia, hypoglossia and macroglossia
3.hamartoma and dermoid
4.bald and depapillated tongue
5.papilomatous changes
6. B)Disorders of the lingual mucosa:
a)changes in the tongue papillae:
1.geographic tongue
2.coated or hairy tongue
b)Non-keratotic lesions:
1.thrush
2. white sponge nevus
3.vesiculobulous and other desquamative disorders
11. Partial ankyloglossia:
Partial ankyloglosia refers to congenital shortness of the
lingual frenum or a frenal attachment that extends nearly
tip of tongue,binding the tongue to floor of mouth and
restricting its extention.
Clinical features:
Restricted tongue movements
Feeding problums
Speech defects: lisping, inability to pronounce words such
as ta, te, time, water, cat etc.
Tongue biting
14. Variation in tongue movement
Ability to curl up the lateral borders of tongue into a
tube is noted in 65% of caucasians and is inherited as a
n autosomal dominant trait.
Unusual extensibility of tongue, both farward to touch
tip of nose(gorlin sign)and backword into the pharynx
occurs in Ehlers-danlos syndrome.
The tongue in tuberous sclerosis-long and narrow
The mobility of tongue is also restricted in
epidermolysis bullosa as a result of fibrous scars
secondrry to blister farmation.
15. Tongue Thrusting
Tongue thrust is a forward placement of the tongue
between the anterior teeth and against the lower lip
during swallowing, speaking or at rest.
It is an infantile swallowing pattern.
It may be associated with macrogllosia.
And:
16. 1. Proclination of anteior teeth
2. Anterior open bite
3. Bimaxillary protrusion
4. Posterior open bite in case of lateral tongue thrust
5. Posterior cross bite
17. Fissured Tongue:
Also called as scrotal tongue,plicated tongue,and
lingua dissecta.
Characterised by furrows, one extending
anteroposteriorly and others lateraly over the entire
anterior surface.
Patterns: plication, central longitudinal fissuring,
double fissures, transverse fissuring, lateral
longitudinal.
Bacteria and debris retained in the fissures causing
irritation or burning sensation.
19. Patent Thyroglossal Ducts and
Cysts
Thyroid gland develops from an analogue of
endothelial cells in the midline of the floor of the
pharynx, between the first and second brachial arches,
just posterior to tubercular impar.
These cells sink into the base of developing tongue
,descent into the neck and proliferate below the larynx
to form thyroid gland.
Remnant of the epithelium along this path are reffered
as thyroglossal duct.
Cystic degeneration of it is called as duct cyst.
20. In 70% of those with heterotopic thyroid ,the thyroid
gland is contained entirerly within the tongue.
Enlagement of the lingual thyroid , cystic changes, or
malignancy may be first recognised due to symptoms
of an enlarging tongue, dysphagia or less
commonly,hypoglossal palsy.
Dysphagia with firm cystic mass in midline of neck
will give clue to the diagnosis.
The cysr is lined by columner,respiratory or stratified
squamous epithelium.
Management: surgically excised or enucleated.
21. Median Rhomboid Glossitis:
‘central papillary atrophy of tongue’
Developmental defect resulting from an incomplete
descent of tuberculum impar and entrapment of a
portion between fusing lateral halves of the tongue.
It is benign lesion.
Characterised by rhomboid or oval in shape, changes
occur in the tongue mucosa in the midline, just
anterior to the foramen caecum.
Some authers suggest fungal infection as etiology.
22. c/f: m>f
Generally asymptomatic
The surface is dusky red and completely devoid of
filiform papillae and usually smooth.
Kissing lesion-soft palate erythema may be seen where
the lesion of median rhomboid glossitis touch the
palate.
Management: antifungal agents,
Long standing cases:cryosurgery, excisional biopsy
23.
24. Cleft,Lobed, Bifurcated and
Tetrafurcated Tongue:
Seperation of the dorsal surface of tongue into 2 or 4
by deep grooves.
Associated with orofacial-digital syndrome,fetal face
syndrome,meckel’s syndromes.
Management:regular cleaning of tongue.
25. Aglossia,Hypoglossia
Aglossia: complete absent of tongue at birth.
Hypoglossia: small rudimentary tongue.
c/f: difficulty in eating,speaking
High arched palate,narrow constricted mandible
Airways problums
Associated with hypoglossia-hypodactylia
syndrome,hypomelia, Pierre Robin syndrome.
26.
27. Macroglossia:
Tongue enlargement-leads to functional and cosmetic
problems.
Etiology:
1.Congenital-hemangioma,lymphangioma, lingual
thyroid, cretinism, down syndrome, neurofibromatosis
and multiple endocrineneoplsia type2B.
2.Inflammatory: syphilitic gumma,ranula,
postoperative edema.
3.Neoplastic:granular cell tumer,neurofibroma, lipoma
,carcinoma.
4.Metabolic:myxedema,amyloidosis,acromegaly.
28. C/F:noisy breathing,drooling of saliva, difficulty in
eating, speech and airways problums.
Recurrent upper respiratory tract infection.
Displacement of teeth ,malocculusion
Crenation of lateral border of tongue
Associated with beckwith’s syndrome
Management: surgical, orthodontic, speech therapy
29.
30. Hamartomas and Dermoids:
The tongue may be enlarged or distorted by the
persence of variety of tumerlike growthsof
developmental origin(hamartomas-
neurufibroma,hemangiomas)
or by epithelial inclusion cysts(dermoids,branchial
cleft cysts).
31. Bald or Depapillated tongues:
An erythematous , edematous and painful tongue that
appears smooth because of loss of filifirm papillae
and sometime fungiform papillae secondary to certain
nutrional deficiency .
Atrophy or loss of papillae may be caused by a
congenital anomaly ,or develop as a secondary features
32. Local causes:
Eosinophilic granuloma
Traumatic injuries-jagged teeth,rough margins of
restorations and inadvertent contact of tongue with
dental medicaments such as eugenol.
Allergic stomatitis: monomer of denture,
mouthwash, chewing gum, and lipstick.
Facial hemiatrophy
33. Systemic causes:
Iron deficiancy anemia: first appears at tip,lateral
border of tongue with loss of filiform papila. In
extreme cases , the entire dorsum becomes smooth
and glazed. Very painful either pale or fiery red.
Plummer vinson syndrome: sideropenic anemia
shares atrophic glositis, angular cheilitis, generalised
atrophic oral mucosa, oral ulceration and secondary
candidiasis
Pernicious anemia: atrophy of filiform &fungiform
papilae.
Niacin deficiency:
34. Folic acid deficiency: tongue is fiery red and atrophy
of filiform & fungiform papilae. Tongue is swollen and
small cracks may appear on dorsal surface.
Sceroderma: tongue shrinks, losing its mobility and
papillary pattern. Color of the tongue changes to a
vivid appearance due to circulatory disturbances. In
the end stages, the tongue lies as a stiff, reduced body
in the floor of mouth.
Dermatomyositis: in early stages, tongue is markedly
swollen and later becomes harder. In the late phase,
tongue is atrophic.
35. Diabetes: central papilary atrophy of the dorsum in
which low flat papillae are noticed just ant. to row of
circumvallate papillae.
Syphilis: depapilation of tongue usually occurs in
secondary and tertiary syphilis. Single or multiple
mucous patch on the tongue. A more difusse, chronic,
nonulcerating, iiregular induration, with an
asymmetrical pattern of grooves and atrophic field
covering the entire dorsum.
Zoster infection:numerous vesicles occur on ventral
surface of tongue.
Atrophic gastritis:
36. Peripheral vascular disease: decreased nutritional
of the lingual papillae as a result of vascular changes
affecting the subpapillary dorsal capillry plexus.
Using fluorescence-enhanced capillary microscopy in
humans have documented variations in the fungiform
papillae associated with age, sex, and the number and
shape of terminal vessels in the papillae.
Infarcts of the tongue may be associated with
shrinkage of the affected side of tongue and atrphic
changes in the overlying mucosa.
37.
38.
39. Deficiency:
Vitamin-A
Vit-B1
Vit-B2
Pantothenic acid
Vit-B6(niacin)
Vit-B2,B6,B12,niacin
Folic acid,vit-B6,zinc
Symptoms:
Poor sense of taste
Furrowed tongue
Purplish or magenta
tongue
Beefy enlaged tongue
Scarlet red tongue
Burning sore tongue
Ulcer on tongue
40. Papillomatous changes:
In several congenital disorders the surface of tongue is
covered with multiple papilomas. When extensive this
abnormalities is known as pebbly tongue.
Lesions of this type is associated with congenital
lingual lymphangiomas, neurufibromatosis and the
Anderson-Fabry syndrome and Meckel’s syndrome.
Management:
41.
42. Geographic Tongue:
Also called as benign migratory glositis,wandering rash,
glossitis areata exfoliativa, and erythema migrans
It refers to irregularly shaped reddish areas of depapillation
and thinning of the dorsal epithelium which is surrounded
by a narrow zone of regenerating papillae that are whiter
than the surrounding tongue surface.
Etiology:
Hypersensitive patient: h/o-asthma, hay fever, eczema.
Other factors:immunological reaction, emotional strees ,
hereditary factors, nutrional deficiencies.
43. C/F- common in young & middle age.
Female predilection
Commonly on dorsal surface & lateral border
Asymptomatic but patient may complain of burning
sensation, stinging, pain
Initially appears as a smsll erythrmatous, non-
indurated, atrophic lesion, bordered by a slitaly
elevated distinct rim that varies from gray to white to
light yellow.
Loss of filiform papillae pink to red smooth shiny
surface , fungiform papillae persist in desqumated
areas as small elevated red dots.
44.
45. The condition may persist for weeks to months and
then regress spontaneously only to occur at later date.
The lesion is not always restricted to tongue and
similar irregular or circinate lesions occur elsewhere in
the oral cavity and are called as ectopic geographic
tongue or erythema circinate migrans or annulus
migrans.
46. Diagnosis: clinically
Biopsy shows loss of filiform papillae with
hyperparakeratosis and acanthosis.
D/D-
Psoriasis
Reiter’s syndrome:skin,occular,urethral lesion +
Licken planus:absense of raised whitish yellow rim.
Use of strong mouth wath-h/o
Anemic condition:hematological study and absense of
raised yellowish white border.
47. Management:
For control of burning-topical local anaesthetic agents
like lidocaine, dyclonine hydrochloride, or
diphenhydramine can be given.
Topical therapy: topical corticosteroids and topical
application of salicylic acid and tretinoin(retinoic
acid)
Psychological assurance
48. Hairy Tongue:
Lingua villosa, lingua nigra, black hairy tongue
An overgrowth of filiform papillae on the dorsum of
tongue , giving the tongue a superficial resemblance as
that of hairiness.
There is marked accumulation of keratin on the
filiform papillae.
49.
50. Etiology:
Fungal and bacterial overgrowth:
Use of certain drugs: sodium perborate, sodium
peroxide, and antibiotics like penicillin and
Aureomycin
Poor oral hygiene
After surgery
Lowered ph-blocks the normal desqumation of
epithelial cells covering the filiform papillae
51. In Debilitated, dehydrated, terminally ill patients can
lead to very thick, leathery coatings on the tongue that
are reffered to as earthy or encrusted tongue.
C/F: papillae may reach a lenth of 2cm which
occasionally brush the palate and may produce
gagging or bad taste.
The hyperplastic papillae then become pigmented by
the colonisation of chromogenic bacteria,which can
impart a variety of colors ranging from green to brown
to black to yellow.
52. This gives it a coated or hairy appearance and retains
debris and pigments from substances from food,
tobaco, smoke, madicines.
Management:
Maintenance of oral hygiene
Elimination of predisposing factors
Topical keratolytic application- podophyllum in
acetone or alcohal suspention
53. Thrush:
Acute pseudomembranous candidiasis
Often appears as pearly white , pinhead size flecks scattered over
the dorsal surface.
Etiology:overgrowth of Candida albicans in patient taking
antibiotics, immunosuppressants drugs,or having a disease that
supresses the immunity.
C/F: f> m
Prodromal symptoms like rapid onset of bad taste, discomfort on
spicy food, burning sensation
White patches are easily wiped out
54. d/d-
Plaque form of licken planus
Leukoplakia
Gangrenous stomatitis
Chemical burn
55.
56. Management:
Topical application of clotrimazole cream-2-3 times
daily for 3-4 weeks.
Ketoconazole 200-400 mg od for 2 weeks
Fluconazole 50-100mg od for 2-3 weeks
57. White sponge nevus:
Congenital anomaly in which the surface of tongue as
well as other parts of oral mucosa are involved by white
spongy plaques without significant hyperkeratosis.
c/f- children are most commonly affected
Friction may strip superficial keratotic area leaving
zone of normal looking epithelium or raw area.
No treatment
58.
59. Vasiculobullous and other
Desquamating disorders
Desqumating disorders are often mistakenly identified
as white lesions because coalscence of whitish
desquamating epithelium with areas of papillary
atrophy and scarring.
Patches of regenerating papillae may also be
interspersed, giving red and white areas in a marble
like pattern.
60. Licken planus:
Oral licken planus is defined as a common chronic
immunological mucocutaneous disorder that varied in
appearance from keratotic to erythematous and
ulcerative.
Lacelike , erosive and bullous variety of this disorder
may affect the tongue in addition to the cheeks, lips,
and gingiva.
Etiology: unknown
Immune systum has primary role in development of
this disease.
61. Other facters: stress, habits, hypertention, diabetes
c/f- oral lesions are characterized by radiating white
and gray valvety thread like papules in linear, angular
or retiform arrangement.
Tiny white elevated dots rae persent at the intersection
of white lines, called as Wickham’s striae.
In some cases superimposed candidial infection
64. Management:
Removal of cause
Steroids –topical and systemic
Topical application of antifungal agents
Retinoids
Psychotherapy
65. Leukoplakia:
It is whitish patch or plaque that can not be
characterised, clinically or pathologically, as any other
disease and which is not associated with any other
physical or chemical causative agent except the use of
tobaco.
It can occur anywhere in the oral cavity but tongue is
one of the commonest site.
If it occurs on tongue ,it is called as ‘chronic superficial
glossitis’
66. Etiological factors are classically known as 6 S
….smoking, syphilis, sharp tooth, sepsis, sprit, and
spices.
Alcohal-facilitates the entry of carcinogen into
exposed cells and thus alters the oral epithelium and
its metabolism.
Vitamin deficiency
67.
68. c/f- confied to ant. 2/3 rd of tongue,dorsum and lateral
border.
The affected area show milky-white patches with
fissure and cracks.
Some patient may complain of burning sensation
69. Management:
Stop habits
Conservative treatment-
Use of beta carotenes, lycopene, L-ascarbic acid, vit.E,
retinoic acid,
Surgical treatment: cold knife surgical excision, laser
surgery
70. Pigmentation:
Tongue may exhibit various patterns of racial melanin
pigmentation.
Joundice may be apparent on ventral mucosa
Exogenous pigmentation of the filiform papillae of the
normal and coated or hairy tongue is very common
and results from microbial growth and metabolic
products, food debris, and dyes from candy, beverages,
and mouth rinses.
Pigmentation by chemotherapeutic agent, doxorubicin
hydrochloride
71. Extravasation of red cells around lingual varicocities
may give a patchy, bluish red discoloration, usually on
ant. Ventral surface of tongue.
72.
73. Ucers and infectious diseases:
Quite severe ulcers, which are more in nature of
lacerations and contusions, are produced by sudden
biting trauma, either during epileptic seizure or as a
result of a sudden blow to the jaw while tongue lies
b/w upper and lower teeth.
Rough surface of restorations and jugged, brocken
cusps rapidly cause ulceration of the tongue.
Lateral margins and ventral surface of tongue are also
frequently damaged by contact with rapidly revolving
burs, discs, or other dental equipment.
74. Ulcers on lingual frenum in neonates with natal lower
incisors rae reffered as Riga’s ulcer or Riga-Fede
disease.
Shallow but persistant tontue ulcers , especially along
the posterior ventral surfaces, are common in patients
with licken planus, various nutritional deficiencies,
and hematological problums.
The lateral margins and tip of tongue are frequently
involved in sevsere episode of recurrent aphthous
ulcers.
75. Vesiculobulous disorders also may involve lingual
mucosa.
Tuberculosis-post. ventral surface
The ant. 1/3rd of the tongue may also be site of an
extragenital chancre in primary syphilis.
In primary herpes simplex gingivostomatitis, the
dorsum, ventral and lateral margin may be ulcerated.
In infections with erythrogenic, toxin producing
Streptococcus pyogens (scarlet fever), the sign of
strawberry tongue.
76.
77.
78. The most effective treatment to get rid of tongue ulcer
is to increase your body's immunity power by taking B-
complex tablets and vitamin tablets.
Glycerin: Rinsing your mouth and tongue with glycerin
on the affected parts of tongue is the best way to
alleviate the pain caused by ulcers under tongue and
throat. Rinsing your mouth with glycerin also controls
the wounds or lesions further spreading and
expanding inside the mouth and throat.
Topical application of lignocaine
79. Superficial vascular changes:
Lingual varicosities are evident as prominent purplish
blue spots, nodules, and redges, usually on the anterior
ventral surface of the tongue and around the
submandibular-sublingual gland orifices.
But they are rarely symptomatic
They represent a normal age change
Petechial hemorrhages and telangiectases also can
demonstrated on vetral surface
Hemangiomas are relatively common on tongue.
80.
81. Amyloidosis:
Involvement of the tongue is described in both the
primary and secondary forms of amyloidosis.
The characteristic fibrous glycoprotein of this disease
is deposited in the submucosa as well as in deeper
muscular layers of tongue.
Generalised enlargement of the tongue(macroglsia)
and fungating swelling may result.
82.
83. Neuromuscular disorders:
Neuromuscular disorders of central, peripheral, or
muscular origin may produce symptom of dysphagia
and choking as well as disordered mastication and
speech problems.
Repetitive , uncontrolled movement of the tongue,
head, and jaws, depapillation, burning sensations and
traumatic ulcers of tongue are common in
buccolingaul-facial dyskinesia, parkinsonism, and the
tardive dyskinesia.
Weakness of tongue can occur in polymyositis,
multiple sclerosis and Duchenne’s muscular dystrophy.
84. Damage to hypoglossal nerve, leads to hypoglossal
palsy.
If bilateral, the tongue can not be extended
If unilateral, the tongue deviates to the unaffected side
when extended.
85. Sleep Apnea Syndrome:
Sleep apnea is a disorder characterized by a reduction
or pause of breathing (airflow) during sleep.
It is common among adults becoming more common
in children
Obstructive sleep apnea is caused by the collapse of
the airwayduring sleep.
Obstructive sleep apnea is diagnosed and evaluated by
history, physical examination and polysomnography
(sleep study).
One of the most common signs of obstructive sleep
apnea is loud and chronic (ongoing) snoring.
86. Sleep apnea is treated with lifestyle changes,
mouthpieces, breathing devices, and surgery.
Medicines typically aren't used to treat the condition.
The mouthpiece will adjust your lower jaw and your
tongue to help keep your airways open while you sleep.
87. Vascular disease of the body of
the tongue:
The lingual artery is very susceptible to the
development of atherosclerotic changes.
The extent of the lingual atherosclerosis increases with
age, but age does not bring ischemic comlications
secondary to atherosclerosis.
Infarcts of tongue are fairly rare
88. Angioneurotic Edema:
Angioneurotic edema is one form of acute
anaphylactic reaction representing an immediate
hypersensitivity response allied to urticaria, allergic
rhinitis, and asthma.
Antigenic stimuli are-respiratory allergens, food such
as shellfish, chocolate, nuts, various drugs and
occasionally cold and physical trauma to tongue.
Medications used to treat angioedema include:
Antihistamines
Anti-inflammatory medicines (corticosteroids)
Epinephrine shots (people with a history of severe
symptoms can carry these with them)
Inhaler medicines that help open up the airways
89. Benign tumors of tongue:
A benign mouth tumor is an abnormal growth located
in the mouth or tongue.
The growths are not cancerous and very rarely spread
to other body parts.
The condition is most common in adults over the age
of 60.
The risk of developing an abnormal growth within the
mouth is greater increased in smokers.
90. c/f:
bleeding lump –
Mouth dentures don't fit
difficulties swallowing
lump in any part of the mouth
poor pronunciation
sore lump - mouth
92. Fibroma:
A fibroma is a benign, tumor-like growth made up
mostly of fibrous or connective tissue.
Tumor-like growths such as fibroma develop when
uncontrolled cell growth occurs for an unknown
reason, or as a result of injury or local irritation.
Fibromas can form anywhere in the body and usually
do not require treatment or removal.
Usually painless
Surgical exicision
93.
94. Papiloma:
Papilloma is a general medical term for a tumor of the
skin or mucous membrane with finger-like
projections.
Papillomas are either pedunculated or sessile growth
on any surface of oral mucous membrane.
Multiple papillomae are occur in cowden’s syndrome,
down’s syndrome.
Surgical excision.
95.
96. Hemangioma:
Hemangioma is a benign tumor of dilated blood vessels.
It is also known as port-wine stain, strawberry
hemangioma, and Salmon patch.
They are characterized by hyperplasia of blood vessels,
usually veins and capillaries, in a focal area of submucosal
connective tissue.
Surgical or invasive treatment of oral hemangiomas has
evolved. Complete surgical excision of these lesions offers
the best chance of cure, but, often, because of the extent of
these benign lesions, significant sacrifice of tissue is
necessary. For example, lesions of the tongue may require
near-total glossectomy
97.
98. Lymphangioma:
Lymphangiomas are benign hamartomatous tumors of
the lymphatic channels. They are thought to be
developmental malformations arising from
sequestration of lymphatic tissue that do not
communicate with the rest of the lymphatic channels
Oral lesions are most frequently found on the tongue.
Treatment:injection of sclerosing solutions,
cryosurgery, intravascular emovilization with silicon
spheres.
99.
100. Granular cell myoblastoma:
Granular cell tumour, is a relatively uncommon benign
neoplasm, which is more commonly found in females in
the 4th to 6th decades of life even though it can occur in all
ages.
Most of the intraoral lesions occur on the tongue, usually
on the lateral aspect.
Granular cell tumours are slow-growing, painless tumours
with no known cause.
They may start in nerve cells.
They occur mostly on the top of the tongue.
101.
102. Lipoma:
Lipoma is a rare benign tumour of mesenchymal
origin which infiltrates adjacent muscle and tend to
recur after excision
It is prevalently found in the cheek and tongue, but
also in the lip, gingival and floor of the mouth.
Particularly, lipoma accounts for 0.3% of all lingual
tumours
103.
104. Malignant tumors of tongue:
Cancer of the tongue is a malignant tumor that begins
as a small lump, a firm white patch, or a sore (ulcer) on
the tongue.
If untreated, the tumor may spread throughout the
tongue to the floor of the mouth and to the gum
(jaws).
As a tumor grows, it becomes more life threatening by
spreading (metastasizing) to lymph nodes in the neck
and later to the rest of the body
Eg: squamous cell carcinoma,
105. Squamous cell carcinoma:
It is most common oral carcinoma with 60% cases
arising from the ant. 2/3rd of the tongue and reminder
from base of tongue.
Etiology: physical trauma, alcohal, tobacco, smoking,
candidiasis, syphilis, sepsis, chronic dental trauma and
chronic superficial glossitis.
About 80% of all people who develop tongue cancer
are smokers.
106.
107.
108. c/f: middle and later decades, m>f ,
Painless mass or ulcer later becomes painful
Excessive salivation
Offensive smell in mouth occurs due to bacterial
stomatitis.
Sore thraot
Immobility of tongue-causes difficulty in speech.
Hoarseness of voice and dysphagia
It spread by infiltration and invasion.
109. Management:
Early carcinoma of tongue(T1 and small T2) responds
equally well to surgical excision or by radiation.
T1 and T2 with no evidance of lymph node metastasis,
surgical treatment is usually restricted to partial
glossectomy.
If it is T2 or T3 without node involvement ,
prophylactic neck dissection is advised.
110. Treatment of carcinoma of the ant. 2/3rd of tongue
with evidance of node involvement may include
radical neck dissection, partial mandibulectomy, and
intraoral dissection(commando operation) in adition
to glossectomy
Better cure rates obtained with combined
chemotherapy(cis-platinum and bleomycin)-surgery-
radiation aproaches, use of neutron irradiation,
immunotherapy, and transoral laser resection for
accessible early stage carcinoma.