APDN OF THE SALIVARY GLANDS 1.2 (AB)

Question 1

Where is the submandibular gland located?

Answer 1

Within the submandibular triangle.

Question 2

What structures form the superior and inferior borders of the submandibular triangle?

Answer 2

Superior: lower border of the mandible. Inferior: anterior and posterior bellies of the digastric muscle.

Question 3

What are the two lobes of the submandibular gland?

Answer 3

Superficial and deep.

Question 4

What muscle divides the submandibular gland into two lobes?

Answer 4

Mylohyoid muscle.

Question 5

Where does the submandibular (Wharton’s) duct open?

Answer 5

At the sides of the frenulum of the tongue.

Question 6

What arteries supply the submandibular gland?

Answer 6

Facial artery. Lingual artery.

Question 7

What vein drains the submandibular gland?

Answer 7

Facial vein.

Question 8

What nerve supplies the submandibular gland?

Answer 8

Chorda tympani nerve of the facial nerve.

Question 9

What is the smallest of the major salivary glands?

Answer 9

Sublingual gland.

Question 10

Where is the sublingual gland located?

Answer 10

Opposite the lingual frenulum, between the genioglossus and mylohyoid muscles.

Question 11

How many ducts does the sublingual gland have?

Answer 11

8-20 ducts.

Question 12

Where do the sublingual ducts open?

Answer 12

In the floor of the mouth.

Question 13

What duct connects with the submandibular duct?

Answer 13

Bartholin duct.

Question 14

What arteries supply the sublingual gland?

Answer 14

Sublingual artery. Submental artery.

Question 15

What vein drains the sublingual gland?

Answer 15

Sublingual vein.

Question 16

What nerve innervates the sublingual gland?

Answer 16

Chorda tympani branch of the facial nerve.

Question 17

What is the most common cause of viral parotitis?

Answer 17

Mumps.

Question 18

What virus causes mumps?

Answer 18

Paramyxovirus.

Question 19

How is mumps transmitted?

Answer 19

Airborne droplets.

Question 20

What are the typical WBC findings in mumps?

Answer 20

Low WBC. Relative lymphocytosis.

Question 21

What enzyme is elevated in mumps?

Answer 21

Serum amylase.

Question 22

Is mumps a suppurative infection?

Answer 22

No. It is non-suppurative.

Question 23

Where does mumps virus enter the body?

Answer 23

Through the upper respiratory tract.

Question 24

How long is the incubation period for mumps?

Answer 24

2-3 weeks.

Question 25

What follows the viremia stage in mumps?

Answer 25

Localization to salivary glands, germinal tissues, and CNS.

Question 26

What gland is most frequently involved in mumps?

Answer 26

Parotid gland.

Question 27

Is mumps usually bilateral?

Answer 27

Yes. 75% of cases are bilateral.

Question 28

What are common symptoms of mumps?

Answer 28

Glandular swelling. Displacement of pinna. Low grade fever. Malaise.

Question 29

What is the treatment for mumps?

Answer 29

Supportive. Fluids. Anti-inflammatories and analgesics. Isolation.

Question 30

What is a complication of mumps in males?

Answer 30

Orchitis. Testicular atrophy. Sterility.

Question 31

What is a complication of mumps in females?

Answer 31

Oophoritis.

Question 32

What CNS complication can mumps cause?

Answer 32

Aseptic meningitis.

Question 33

What complication of hearing may occur with mumps?

Answer 33

Sensorineural hearing loss.

Question 34

How is mumps prevented?

Answer 34

Live attenuated vaccine. MMR at 12 months with booster at 4-6 years.

Question 35

What is the origin of Acinic Cell Carcinoma according to the multicellular theory?

Answer 35

Acinus

Question 36

What neoplasms originate from the intercalated duct under the multicellular theory?

Answer 36

Pleomorphic Adenoma. Adenoid Cystic Carcinoma. Monomorphic Adenoma. Epithelial-Myoepithelial Carcinoma

Question 37

What tumors originate from the striated duct?

Answer 37

Warthin Tumor. Oncocytoma

Question 38

What tumors originate from the excretory duct?

Answer 38

Mucoepidermoid Carcinoma. Ductal Adenocarcinoma. Epidermoid Carcinoma. Papilloma

Question 39

What is the key idea of the multicellular theory?

Answer 39

Neoplasms originate from a distinctive cell type within the salivary gland mucosa

Question 40

What does the bicellular reserve cell theory propose?

Answer 40

Neoplasms originate from basal cells of either excretory or intercalated ducts

Question 41

According to the bicellular theory, which tumors come from intercalated duct reserve cells?

Answer 41

Pleomorphic Adenoma. Oncocytic Tumors

Question 42

According to the bicellular theory, which tumors come from excretory duct reserve cells?

Answer 42

Squamous Cell Carcinoma. Mucoepidermoid Carcinomas

Question 43

Which histogenesis theory is more widely accepted?

Answer 43

Bicellular Reserve Cell Theory

Question 44

What are risk factors for salivary gland neoplasms?

Answer 44

Radiation. Viral Infections. Genetic Factors. Tobacco Smoking

Question 45

How do benign salivary gland tumors usually present?

Answer 45

Painless. Movable. Slow-growing masses

Question 46

Where do parotid tumors typically appear?

Answer 46

Face

Question 47

Where do submandibular tumors typically appear?

Answer 47

Angle of the jaw

Question 48

Where do sublingual tumors typically appear?

Answer 48

Midline

Question 49

Where are minor salivary gland tumors most common?

Answer 49

Palate

Question 50

What signs may parapharyngeal space tumors present with?

Answer 50

Unilateral aural fullness. Dysphagia. Obstructive sleep apnea. Hot potato voice. Trismus. Medially displaced oropharyngeal wall

Question 51

What examination is needed for oral cavity or oropharyngeal extension?

Answer 51

Bimanual examination

Question 52

What clinical features suggest a malignant salivary gland tumor?

Answer 52

Rapid increase in size. Facial nerve paralysis. Pain. Paresthesia. Cervical lymphadenopathy. Cranial nerve deficits. Fixation to skin

Question 53

Which cranial nerve deficits may occur in malignant salivary tumors?

Answer 53

CN IX to XII involvement. Decreased gag reflex. Aspiration. Asymmetric palate elevation. Hoarseness. Dysphagia. Trapezius weakness. Tongue paresis

Question 54

When is imaging not warranted for salivary tumors?

Answer 54

Small. Well defined. Superficial masses

Question 55

When is imaging warranted for salivary tumors?

Answer 55

Suspicious for malignancy. Deep lobe. Parapharyngeal space. Submandibular. Minor glands

Question 56

What is the imaging modality of choice for salivary tumors?

Answer 56

MRI

Question 57

What is the best alternative imaging modality for salivary tumors?

Answer 57

CT Scan with IV Contrast

Question 58

Name another imaging modality used for salivary tumors.

Answer 58

Ultrasound. PET Scan

Question 59

What is the sensitivity of fine needle aspiration biopsy (FNAB)?

Answer 59

85.5% to 99%

Question 60

What is the specificity of FNAB?

Answer 60

96.3% to 100%

Question 61

What is the most common source of diagnostic error in FNAB?

Answer 61

Inadequate sampling

Question 62

What gauge needle is used in FNAB and why?

Answer 62

25-gauge. Safe and does not affect histologic diagnosis

Question 63

What are potential risks of core biopsy?

Answer 63

Tumor seeding. Capsule rupture. Hematoma