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OMS > Salivary Gland > Flashcards

Salivary Gland Flashcards

1
Q

Parotid glands secretly mostly?

A

Serous saliva

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2
Q

Parotid glands are supplied by

A

Parasympathetic fibers from IX

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3
Q

Which is the largest salivary gland?

A

Parotid

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4
Q

What is the relation of the parotid gland?

A

Posterior aspect of masseter muscle, below ear

Wraps around posterior border of mandible

Superficial and deep lobe is divided by facial nerve

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5
Q

What are the relations of the parotid duct?

A

Lies on masseter

At anterior border of mandible, duct turns medially, pierce buccinator muscle and opens adjacent to maxillary 2nd molar

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6
Q

Where is the submandibular duct located?

A

Submandibular triangle of neck

Partly superficial and deep to mylohyoid muscle

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7
Q

Path of submandibular (wharton’s) duct?

A

Opens floor of mouth at punctum lateral to lingual frenum

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8
Q

What is the relation of lingual nerve to submandibular duct?

A

Lingual nerve loops under Wharton’s duct from lateral to medial in the posterior mouth

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9
Q

Location of sublingual duct?

A

Lies on superior surface of mylohyoid muscle

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10
Q

Path of sublingual duct

A

Open into floor of mouth or submandibular duct

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11
Q

What innervates sublingual and submandibular glands

A

VII through the chorda tympani nerve

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12
Q

Sublingual gland produces

A

Mucous saliva

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13
Q

Minor salivary glands produce

A

Mucous saliva?

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14
Q

What are the radiographs taken for salivary glands?

A
  1. Plain films: True occlusal mandible
  2. Sialography
  3. CT scans
  4. MRI
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15
Q

What bacteria causes sialdenitis?

A

Staphylococcus aureus

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16
Q

What is Mumps?

A

Acute infection caused by paramyxovirus

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17
Q

What age is Mumps common in?

A

3-8 years old

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18
Q

What are the symptoms of Mumps?

A

Painful swelling of one or both parotid and submandibular glands

Fever, chill, headaches

Symptoms 16-18 days after exposure and last 5-12 days

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19
Q

Vaccination of MMR should be given at what age?

A

Infancy

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20
Q

Treatment of Mumps

A
  1. Symptomatic care
  2. Analgesics, anti-pyretics, hydration
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21
Q

How did bacteria infection of salivary duct arise?

A

Blocked ducts or decreased salivary flow

22
Q

Treatment of Acute Bacterial Sialadenitis

A
  1. Symptomatic and supportive care: IV fluid hydration
  2. Culture and sensitivity of causative organism
  3. Antibiotics, analgesics
23
Q

List Obstructive Salivary Gland Disease

A
  1. Sialolithiasis
  2. Mucocele
  3. Ranula
24
Q

What is sialolithiasis?

A

Calcified structures that develop within ductal system that arise from deposition of calcium salts around a nidus of debris

25
Q

Which gland is Sialolithiasis more common in?

A

Submandibular gland

26
Q

What can Sialolithiasis cause?

A
  1. Recurrent sialadenitis
  2. Bigger stones can cause episodic pain in affected gland, meal-time symptoms
27
Q

Management of sialolithiasis?

A

Surgical removal of salivary stone

28
Q

What is sialoendoscopy?

A

Endoscopic transluminal of ductal system of major salivary glands which can remove stones up to 4mm diameter

Bigger stones can be fragmented with Holmiun laser

29
Q

Ranula is often a?

A

Mucous retetion cyst

30
Q

Mucocele is often a?

A

Mucous extravasation cyst

31
Q

Treatment of Ranula

A

Marsupialisation

32
Q

Characteristics of Salivary Gland Neoplasms

A
  1. Swelling that is increasing in size
  2. Painless, sometimes dull ache
  3. Firm to rubbery in texture
33
Q

What is the most common of all salivary gland neoplasms

A

Pleomorphic adenoma

34
Q

Treatment of Pleomorphic Adenoma

A

Complete surgical excision of lump and gland

Avoid enucleation and tumour spill

35
Q

What is the histology of Pleomorphic Adenoma?

A
  1. Mixture of epithelial, myoepithelial and stromal components
  2. No true capsule
36
Q

Clinical signs of Warthin Tumour?

A

Slow growing, painless, usually appears in the tail of the parotid gland

37
Q

What is the predisposing factor for Warthin’s tumour?

A

Smoking

38
Q

What is the most common salivary gland malignancy?

A

Mucoepidermoid Carcinoma

39
Q

Which salivary gland is Mucoepidermoid Carcinoma most common in?

A

Parotid gland

40
Q

What age is Mucoepidermoid Carcinoma common in?

A

30-80 years old, peak in 50 years old

41
Q

Clinical sign of Mucoepidermoid Carcinoma

A

Low grade: Slow-growing painless mass

High grade: Rapidly enlarging with or without pain

  1. Well-circumscribed to partially encapsulated/unencapsulated
  2. Solid tumour with cystic spaces
42
Q

What is the histology for low-grade Mucoepidermoid Carcinoma?

A
  1. Mucus cells > Epidermoid cells
  2. Prominent cysts
  3. Mature cellular elements
43
Q

What is the histology for intermediate-grade Mucoepidermoid Carcinoma?

A
  1. Mucus=Epidermoid cells
  2. Fewer and smaller cysts
  3. Increasing pleomorphism and mitotic figures
44
Q

What is the histology for high-grade Mucoepidermoid Carcinoma

A
  1. Epidermoid> Mucus cells
  2. Solid tumour cell proliferation
  3. Mistaken for SCC
45
Q

What is the treatment for Mucoepidermoid Carcinoma?

A

Influenced by site, stage,grade

Stage I and II: Wide local excision

Stage III and IV: Radical excision +/- Neck dissection +/- Postoperative radiation therapy

46
Q

What is the 2nd most common salivary gland malignancy?

A

Adenoid cystic carcinoma

47
Q

Which salivary gland is Adenoid Cystic Carcinoma most common in?

A

50% Parotid 50% Minor Salivary Glands

48
Q

Which age is Adenoid Cystic Carcinoma most common in?

A

50 years old

49
Q

Clinical signs of Adenoid Cystic Carcinoma

A
  1. Slow-growing enlarging mass
  2. Dull pain paraesthesias, facial weakness/paralysis
  3. Perineural invasion
50
Q

What is the histology of Adenoid Cystic Carcinoma?

A

Infiltrative proliferation of basaloid cells arranged in cribriform pattern

51
Q

What is the treatment of Adenoid Cystic Carcinoma?

A

Complete local excision + Facial nerve sacrifice + Postoperative radiotherapy

52
Q

Prognosis of Adenoid Cystic Carcinoma

A

Local recurrence 42%

Distant metastasis to the lung

5 year survival rate 75%
20 year survival rate 13%

OMS (6 decks)

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