SCHOOL OF MEDICINE AND HEALTH SCIENCES

LEOPARDS HILL CAMPUS

LECTURE NOTES IN HISTOLOGY

THE ORAL CAVITY

By

Prof Kasonde Bowa

MSc,M.Med,FRCS,FCS,FACS,DPH,MPH,FCMS(Z)

Programme: MBChB
Course: Human Anatomy
Code: BMHA 121
Module: Module 1 Oral Cavity
Topic: The Histology of the Oral Cavity

Introduction:

The Oral Cavity is the first part of the GIT. These lecture notes provide the teaching
material for this section, which supports the audio power point materials which you
will have listened to already.

The Oral Cavity begins from the lips to the Oral Pharynx. It has 3 parts, which are
1.The Vestibule
2.The Oral cavity proper
3.The Oral Pharynx

This module discusses the Histology of the Oral Cavity and its four main organs.
Upon completion of this second section of module one, you will proceed to the third
section of module 1 which is the Embryology of the Oral cavity

Learning Objectives:

These materials contain the lecture note of the Module 1 course in Histology. They
are accompanied by a power point audio lecture. These materials will supplement
your learning of the audio power point lecture.

Material Outlines:

1
These lecture notes provided some summary notes on the Histology of the four
organs which will have been discussed in the power point audio lecture in Histology
of the Oral Cavity.
These are
1.The Tongue
2.The Teeth
3.The Tonsils
4.The Salivary Glands

Lecture Notes

The Histology of the Oral Cavity

Introduction

In the gross anatomy of the oral cavity 4 main organs were discussed.We will now
discuss how these organs look under the microscope.The way the organs look is
closely related to the function they perform.If you compare the histology of the
Respiratory or Cardiovascular System, you will notice that the epithelium of the
Respiratory system is design for breathing, by having pseudostratified ciliated
columnar epithelium.That of the Cardiovascular system with tunica initma, tunica
media and tunica adventita is designed for transportation of blood through tubular
systems. The digestive systems can be divided as indicated into the oral cavity, the
foregut, the midgut and the hindgut.The mindgut commences the initial mechanical
digestion, and has a mechanical epithelium, which is stratified squamous
epithelium.this is began intial the food may be hard like bone, rough, very hot or
cold.This initial food processing requires a tough wear and tear epithelium.This
epithelium as we will see changes to the more glandular based digestive epithelium
of the columnar epithelium, which we will see is found in the midgut and hindgut of
the GIT system.

The GIT has in general 3 main layers, these are the mucosa layer, the muscular
layer and the serosal layer. Commonly students who fail to understand the general
histology of the GIT fail to grasp the histology of the specific organs of the GIT,
therefore it is essential to understand these general outlines, before, one can hope to
understand the more specific histology of each GIT organ.Secondly, in clinical
practice the system that is most often the basis of general medical practice is the
GIT system, so that for this reason, the system, above all systems, that needs to be
best known and understood by medical students, most of all is the GIT
system.Understanding this system also makes it easier to understand the histology
of other more complex body systems.

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The mucosa Layer
This is covering of the organ.It is composed of 3 to 4 main which are
1.The epithelium
2.Lamina propria
3.The muscularis mucosa
4.The Submucosa

The epithelium is the first layer which is protective.In the oral cavity it is stratified
squamous epithelium, non keratinized.The next layer consists of loose connective
tissue that provides nutrition to the epithelium.Below with is a layer of smooth muscle
which can change the shape of the epithelium as needed.Below this is a further layer
of dense irregular connective tissue called the submucosa.In the submucosa
nerves(Meissners plexus- this easily confused by students with Auberach’s
plexuses- this is the more outer myenteric plexus seen in the next layer) A good
pneumonic is Meissner’s-mucosal Auberach’s –outter).The Meissners plexus helps
with internal peristalsis, while the Auberach’s plexus with external peristalsis).

The Muscular Layer

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This layer usually contains the 2 muscle of the GIT, an inner circular and an outter
longitudinal layers.In between is the nerve plexus called the Auberach ‘s plexus
which has been discussed earlier.In the oesophagus, as we shall see the upper part
is skeletal muscle otherwise the rest is composed of smooth muscle.

The Serosal layer

The serosa is composed of simple squamous epithelium.However in organs not fully
covered by peritoneum, such as the Oesophagus this layer has connective tissue
called adventita only and no external epithelial layer.This makes the surgical repair
of such tissues more difficult because the sutures have no strong tissues to hold or
anchor to.Students often confuse adventita with serosa, both because the are
located at a similar site and they are both found in GIT organs.Therefore Anatomy
teachers will often ask this question in oral and written exams to see if the students
has grasped the difference between th two.

Histology of the Oral cavity

Having understood better the general histology or ultrastructure of the GIT, we can
now commence to learn the microscopic structure of the key organs of the oral
cavity, starting with oral cavity itself.

Vermillion
border

Something the students normally find interesting is the histology of the lip or in
particular of the Vermillion border.This border on the lip between the darker part and
the lighter part of the lip.It is usually also the part enhanced by lip stick in women.The
lipstick exaggerates this margin and gives the lips a larger or pluckered look.This is
perceived to be attractive to the opposite sex.

The lips
The lips can be recognized under the microscope, and the Vermillion border is
recognible as the part of the lip where the epithelium changes from stratified
squamous keratinized to Stratified squamous non keratinise epithelium.

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 Muscle

Vermillion
border

The lower surface has hair follicles and stratified squamous epithelium non
keratinized while the upper surface has no hair follicles and stratified squamous non
keratinized epithelium.The transition point where this change occurs is called the
vermillion border.You can recognize this on yourself in the mirror as the border of the
lips with the mouth.
In addition the mucosa of the oral cavity will have glands, muscle and blood
vessels.The epithelium of the oral cavity is stratified squamous epithelium non
keratinized.This epithelium is lined by mucosal glands which keep the mucosa moist.

The Tongue
This organ is a musclular organ that is responsible for the formation of the food bolus
and taste.It has an epithelium of stratified squamous epithelium was is usually non
keratinized, but may have occasional keratinized areas.It has 4 tatse buds which are
visible under the microscope, these are filiform, fungiform, foliate and valliate
papilla.These are found on the dorsal surface of the tongue and contain senory taste
receptors.The tongue has intrinsic and extrinsic muscles which are visibile under the
microscope.They are many glands which keep the tongue moist and keep the ph
alkaline.

Vallate
papilla

Muscle

Von Ebners

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Vallate Papilla
Taste buds

Groove

Serous Glands
of Von Ebner

The Tonsils
These are aggregrations of mucosal lymphoid tissues which is useful in removing
infectious material from processed food.It would be expected that the histological
appearance would by of squamous epithelium with lymphoid follicles.In addition they
are invaginations or crypts which allow food particles to come into close contact with
Tonsils called tonsillar crypts.This is in contrast to the adenoids which were
discussed in the Nasal cavity whoes epithelium is respiratory pseudostratified
columnar epithelium with goblet cells.In learning one students easily learning the
other, and this simple distinction helps with a clearer understanding of the
nicroscopic structure of these two closely related organs.
The Tonsil Lymphoid
follicle

Tonsilar Crypts

Squamous Cell
Epithelium

Magnified image of the Tonsil

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 Follicle

SSE

The Salivary Glands

There are 3 main Salivary glands.They are all exocrine glands.The Parotid,
Submandibular and Sublingual glands.The have slightly different functions and
secretions, and therefore also a different appearance under the microscope.The
Parotid gland produces mostly digestive fluid which is serous, therefore the main
cells are darkly staining in appearance due to the zymogen granules that contain the
digestive enzyme Salviary Amylase(previous called Ptyalin).The sublingual glands
produce a thick mucoid secretion takes up stain poorly and looks clear.This is a
purely mucinous exocrine gland.The Submandibular glands lie in between the two
glands, and also have a mixed function, having both clear cells (mucinous) and
darkly staining(serous) glands.The have the characteristic cap like apperances of
demilunes(half moon shaped glands).These demilunes sit like a cap on top of the
mucinous glands.Giving the appearance of a old bolding man wearing a sports cap.
Students should distinguish the acinar or flast shaped appearance of the gland , from
the more cuboidal arrangement of the duct, which will aslo have a central
lumen.Apart from the dark staining of the Serous glands the nuclei of the cell tends
to be central, while the clear mucinous glands will tend to have a peripherally placed
nucleus.
Serous Glands
Fat Cells

Duct

The serous Parotid Gland

The Submandibular Gland

This is a mixed seromucinous gland.It has the demilunes as well as salivary gland
ducts.

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The Sublingual Glands
This is a purely mucinous gland.It has thick mucoid secretions and is the most prone
to salivary calculi as a result.This histological appearance is of the pale staining
mucinous gland with an accentric nucleus.The ducts of the gland can also be seen.

The Teeth
The teeth are made mostly of a hard chemical substance, which is harder than
bone.The enamel material is 90% Calcium Hydoxyappatite.This material covers the
exposed part of the tooth.Students can think of it like very hard bone.The second
layer called Dentine is equally non living and is composed of the
glycosaminoglycans and mineral elements of Calcium Hydroxyappatite
(45%).Students can think of it as very hard cartilage.Cementum is another chemical
substance that attaches the tooth to the Alveolar socket.Since all these substances
are chemical in nature there is very little cells or cellular components to see under
the microscope.Therefore, what tends to be shown, in a histology lab of the tooth,
will be the developing tooth.This has the cellular elements that form the 3 chemical
substances.These are the Ameloblasts that form enamel, the Odontoblast that form
Dentine and the Cementoblasts that form cementum.
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In the histology lab students will be required to identify these 3 key cell types from
the top to the bottom.The Ameloblasts growth line which form Enamel leave growth
lines called Striae of Retzius.Equally the Ondontblasts create lines called the dentine
lines or Von Ebners lines.