saliva and salivary glands Flashcards

1
Q

Name the largest salivary gland

A

Parotid Gland

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2
Q

Name the second largest salivary gland

A

Submandibular Gland

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3
Q

Name the third largest salivary glands

A

Sublingual

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4
Q

Name the duct(s) of the parotid gland and where it/they open

A

Stensens duct - just by 2nd upper maxillary molar
( pierces buccinator)

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5
Q

What type of secreation comes from the parotid duct

A

Serous saliva

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6
Q

Is the parotid duct encapsulated

A

Yes

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7
Q

Name the borders of the parotid Gland

A

Superiorly - zygomatic arch
Inferiorly - inferior border mandible
Anteriorly - masseter muscle
Posteriorly - sternocleidomastoid

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8
Q

What divides the parotid into 2 lobes

A

Facial nerve- a superficial and deep lobe are formed

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9
Q

Where is the superficial lobe of the parotid

A

Subcutaneous, anterior to the external ear, between skin and masseter

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10
Q

Where is the deep lobe of the parotid found

A

Inferior to the ear , posterior to mandible ramus

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11
Q

Name 4 structures in the parotid gland

A

2 nerves : Facial nerve
Auriculotemporal nerve

2 vessels : Retromandibular vein forms ( from superficial temporal Vn and maxillary vein )
External carotid artery -( gives off the maxillary artery and superficial temporal Artery here)

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12
Q

What nerve(s) supplies the parotid

A

Glossopharyngeal nerve ( Cn IX)-parasympathetic
Auriculotemporal nerve ( sensory )-branch of V3
Superficial cervical ganglion ( sympathetic )

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13
Q

What artery supplies the parotid gland

A

external carotid artery

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14
Q

What vein supplies the parotid gland

A

Retromandibular vein

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15
Q

What is the lymphatic drainage of the parotid gland

A

Deep Parotid LN

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16
Q

Name 2 illnesses affecting the parotid gland

A

Parotitis ( Mumps ) -
Sialolitiasis ( stones)

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17
Q

What is mumps and how does it present

A

70% unilateral
Painful enlarged tender parotid gland

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18
Q

How is mumps prevention/treatment /complications

A

Prevention - vaccination
Treatment - pain relief
Complications - testicle/ovary swelling ( infertility risk)
-meningitis
- deafness

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19
Q

How could you differentiate mumps from a stone or cancer

A

Mumps- fevers ,red enlarged usually unilateral 70%-
Cancer - unilateral bony hard - non painful until advanced
Sialolithiasis - may see stone in duct or on X-ray

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20
Q

Can you do dental treatment while a patient has mumps

A

No wait 5 days from symptom onset unless urgent

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21
Q

What percentage of saliva does the parotid gland make

A

25%

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22
Q

Where are the minor salivary glands found -

A

All through the mouth but not gingiva or anterior hard palate

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23
Q

What is the duct(s) of the submandibular gland and where do they/it open

A

Whartons duct - open floor mouth at sublingual caruncles

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24
Q

What secretion is from submandibular duct

A

Mixed -serous and mucus

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25
Q

What percentage of saliva does the submandibular gland produce

A

60-65%

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26
Q

is the submandibular gland encapsulated

A

Yes

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27
Q

Is the submandibular gland the largest major salivary gland

A

No - 2nd largest ( parotid largest )

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28
Q

What is the location of submandibular duct

A

In submandibular triangle in the posterior floor mouth -superiorly is the -inferior mandible border
- anteriorly - anterior belly digastric
-posterior - posterior border digastric

2 lobes
superficial -abve the mylohyoid muscle
deep -around posterior part mylohyoid muscle -

29
Q

Name the 2 lobes of the submandibular gland and where found

A

superficial -abve the mylohyoid muscle
deep -around posterior part mylohyoid muscle -

30
Q

What is the arterial supply to the submandibular gland

A

Facial Artery

31
Q

What is the venous drainage of the submandibular gland

A

Facial vein

32
Q

Which major salivary gland is most common to form stones

A

Submandibular

33
Q

What nerve(s) supplies submandibular gland

A

Parasympathetic -chorda tympana ( branch of VII)
Sensory - Lingual nerve( branch of V3)
Sympathetic -superficial cervical ganglion

34
Q

What is the lymphatic drainage of the submandibular gland

A

Submandibular LN

35
Q

Sublingual gland - where is it

A

in anterior floor mouth within sublingual fossa
Between mylohyoid and oral mucosa

36
Q

Is the sublingual gland the largest gland of the major salivary glands

A

Smallest

37
Q

Is the sublingual gland encapsulated

A

No

38
Q

What type of saliva does the sublingual gland make

A

Mostly mucous

39
Q

What is the name of the sublingual duct(S) and where do they open

A

Bartholins - open in the floor of mouth in sublingual caruncles
Rivinus ducts- 8-20 small ducts in sublingual folds

40
Q

What nerve supplies sublingual gland

A

Parasympathetic -Chordae tympani ( off VII)
Sensory- Lingual nerve (branch of V3 )
Sympathetic - superficial cervical ganglion

41
Q

What is the arterial supply to the sublingual gland

A

Sublingual Artery

42
Q

What is the venous drainage of the sublingual gland

A

Sublingual vein

43
Q

What is the lymphatic drainage of the sublingual gland

A

Submandibular LN

44
Q

Name 2 problems of salivary glands and how may tell difference

A

Sialolothiasis ( stones ) block duct so saliva flow blocked - swelling and pain in gland
Can sometimes visualises stolen or palpate it at its opening - or see on X-ray
Pain and swelling post eating - / cause ? created dehydration

Txn : heat massage sour sweets to increase flow saliva

Sjigrens disease -autoimmune - attacks salivary glands and minor salivary glands - xerostomia ( hypo saliva - leads to severe caries as diagnosed late and been no saliva to protect teeth as unable maintain a safe pH >5.5

45
Q

Name a disease of the minor salivery glands

A

Sjögren’s syndrome. autoimmune disease in which cells of a person’s immune system attack the salivary and other moisture-producing glands, leading to dry mouth and eyes.

46
Q

How can salivary lands be classified and under the 2 classifications what are the classes

A

By ductal system
-exocrine ( duct)
- endocrine no duct

Type of secretion
serous- watery thin
mucus - viscous slimy
Mixed -( both above )

47
Q

What is the autonomic control system do to salivary glands

A

Parasympathetic - lots watery saliva ( low amylase levels )
Sympathetic - scant viscous secretions with high amylase levels

48
Q

What is the structure system of saliva glands

A

Group of secretory units( ACINAR CELLS) surrounding a central lumen (= ACINUS) make saliva fluid
then drains into
interconnected ducts
then
into salivary duct
then
into oral cavity

49
Q

Name 3 types of saliva and what they look like and function

A

Serous - watery low amylase - diluting and rinsing
Mucous - slimy lubricating saliva
Seromucous - combination both

50
Q

How many minor salivary glands do we have

A

600-1000

51
Q

How much saliva do the minor salivary glands make

A

10% ( even though there’s a 1000)

52
Q

What type of saliva do the minor salivary glands make

A

Mucous mostly ( Special minor ones at base circumvilliate papilla make serous saliva)

53
Q

Where are the minor salivary glands found

A

All through the mouth EXCEPT gingival and anterior hard palate

54
Q

What is a ranula

A

saliva filled cyst - develops under tongue leaked out of a blocked or damaged salivary gland

55
Q

Name 2 problems of saliva secretion

A

Hypersalivation - medications
Hyposalivation ( decreased saliva )
- lead to problems of dental /oral infections
rampant caries
difficulty swallowing \
eating as food not moistened

56
Q

Name 4 causes of hypo salivation

A

Medications
Radiation
Autoimmune diseases eg Sjogren disease
Salivary gland problem - cystic fibrosis or diabetes (causes gland swelling so less flow )

57
Q

What 2 elements involved in tooth protection

A

Saliva and acquired pellicle

58
Q

What is the function of saliva- name 2 categories and give examples in each and the element

A

Protective
Maintains pH ( buffers- HCO3)
Lubricates/hydrateses ( hypotonic)
Stops demineralisation - contains salivary calcium
Defends host - antibacterial ( lactoferrin)
- anti fungal
-antiviral
Immunological - sIgA

Digestive - Bolus formation
-enzymes ( amylase and lipase )
-taste

59
Q

What is secretory IgA and its function

A

Found in saliva - has 4 binding sites that “ grab and clump” microorganisms preventing innfection

60
Q

What is lactoferrin

A

An iron binding protein in saliva that binds iron so the bacteria can not use it ( bacteriostatic)

61
Q

What is the acquired pellicle

A

A thin protein layer covering all oral exposed teeth surfaces involved I protecting teeth from erosion by concentrate salivary calcium and contains carbonic anhydrase that helps neutralise pH (buffer)

62
Q

What happens if we consume acidic/citric foods

A

pH decreasesin the mouth causing ionisation od salivary calcium causing demineralisation of hydroxyapatite and tooth erosion
Saliva tries to buffer this drop by buffers ( 90% buffering by bicarbonate ) and also carbonic anhydrase in acquired pellicle catalyses carbonic acid neutralising the pH . Pellicle also tries concentrate Calcium

63
Q

What happens as consume citric juices

A

Ph decreases due to 1. acidity
2. citrate in the juice ( chelates the calcium ions ) so decreases calcium
Both lead to dental erosion

Saliva tries to buffer this drop by buffers ( 90% buffering by bicarbonate ) and also carbonic anhydrase in acquired pellicle catalyses carbonic acid neutralising the pH . Pellicle also tries concentrate Calcium

64
Q

What happens as drink fizzy ( carbonated juices )

A

1.Carbohdrates ( sugars )consumed become fermented by bacteria —> decrease in pH

  1. Carbon dioxide reacts with water in mouth forming carbonic acid ( acidic so decreases pH)

Both cause tooth erosion

65
Q

How does the saliva and acquired pellicle try to stop tooth erosion

A

Saliva - buffers 90% by bicarbonate
- washes out some of food /acid and dilutes
-contains salivary calcium ( concentrated in acquired pellicle

Acquired pellicle on teeth
- concentrates salivary calcium so helps hydroxyapatite remineralisation
-contains carbonic anhydrase catalyses carbonic acidd formation so increasing pH )

66
Q

What pH does tooth decay start

A

<5.5

67
Q

What happens to carbohydrate foods ingested

A

Fermented by bacteria lowering pH and increasing tooth decay

68
Q
A

. autoimmune disease in which cells of a person’s immune system attack the salivary and other moisture-producing glands, leading to dry mouth and eyes.( hypo salivation). Ass diagnosed late severe dental caries as mouth been unable to maintain a pH > 5.5 as lack of saliva to help correct the pH