Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

4th yr- CMS- The Oral Cavity > Salivary gland disease > Flashcards

Salivary gland disease Flashcards

(128 cards)

Start Studying
1
Q

How do we examine the salivary glands

A
  1. Inspect from the front side and behind the patient

2. Palpate the salivary glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the minor salivary gland innervated by

A

Greater petrosal nerve which is a branch of cranial nerve VII
Chorda tympani which is a branch of cranial nerve VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the submandibular gland innervated by

A

Chorda tympani which is a branch of cranial nerve VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the sublingual gland innervated by

A

Chorda tympani which is a branch of cranial nerve VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the parotid gland innervated by

A

Lesser petrosal nerve which is a branch of cranial nerve IX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the greater petrosal nerve a branch of

A

Cranial nerve VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Chords tympani nerve a branch of

A

Cranial nerve VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the lesser petrosal nerve a branch of

A

Cranial nerve IX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many minor salivary glands are present in the oral mucosa

A

Approximately 450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where are minor salivary glands found

A

They are distributed throughout the mucosa, including lips, cheeks, palates, floor of mouth and retro molar pad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is saliva made up of

A
  1. 4% water

0. 6% minerals and proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

State a normal saliva flow rate in a non stimulated patient

A

0.3-0.4 ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

State a normal saliva flow rate in a stimulated patient

A

4-5 ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 categories minerals and proteins in saliva fall under

A
  1. Inorganic
  2. Organic
  3. Macromolecules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the inorganic part of saliva made up of

A
  1. Sodium
  2. Potassium
  3. Chloride
  4. Bicarbonate
  5. Hydrogen
  6. iodine
  7. Floruide
  8. Thiocynate
  9. Calcium phosphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the organic part of saliva made up of

A
  1. Urea
  2. Uric acid
  3. Amino acid
  4. Glucose
  5. Lactate
  6. Fatty acids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name the macromolecules found in saliva

A
  1. serum proteins,
  2. glycoproteins, peroxidases,
  3. amylase,
  4. lysozyme,
  5. lipase,
  6. kallikrein,
  7. IgA/G/M,
  8. lipids,
  9. blood group substances,
  10. hormones and carbohydrates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can we investigate for salivary gland disease

A
  1. Sialometry
  2. Plane film radiography
  3. Ultrasoudns
  4. Bloods
  5. MRIs
  6. Biopsies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is it indicated to take a venous blood sample

A

In reports of dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does a sjogrens screen involve

A
  1. FBC
  2. U&E and LFTs
  3. HbA1C
  4. Serum ACE levels
  5. ANA screen
  6. Serum immunoglobulins and electrophoresis
  7. Hepatitis C serology and HIV serology if clinically suspicious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is ultrasonography

A

The use of high frequency sound ways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can we identify through ultrasonography

A
  1. Solid lesions
  2. Cysts
  3. Textural changes in Sjogren’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What can radiographs of salivary glands identify

A

Radio opaque calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is retrograde sialogrpahy

A

A radiographie examination of the ductal system using radio iodide as a contrast medium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what can retrograde sialogrpahy help us identify
1. Strictures 2. Sialectasia (ductal dilatation) 3. Filling defects 4. Localised, e.g. calculi, mucus plugs 5. Punctate sialectasis – typical of Sjögren's Syndrome
26
What are MRIs of salivary gables good at showing
Better demonstrate soft tissue detail
27
How do we take a biopsy of minor salivary glands
Excisional done from an intra oral approach
28
How do we take a biopsy of major salivary glands
Incisional and can be done intra or extra orally
29
How do we describe salivary gland swellings
1. Localised or generalised 2. Unilateral or bilateral 3. Persistent or transient
30
How do we describe salivary glands
1. Swellings 2. Pain 3. Discharge 4. Decreased saliva 5. Increased saliva
31
List salivary gland disease we need to know
1. Obstructive Salivary gland disease 2. Xerostomia 3. Sialorrhoea 4. Sarcoidosis/HIV/GvHD related salivary gland disease 5. Cancers 6. Benign neoplasias e.g. pleomorphic adenoma and Warthin’s tumour 7. Benign cysts/pseudocysts 8. Acute/chronic sialadenitis 9. Frey ’s syndrome 10. Developmental abnormalities e.g. atresia or hypoplasia 11. Primary and Secondary Sjogren’s syndrome
32
What is obstructive salivary gland disease due to
Calculi, strictures or infections
33
What does sialadenitis mean
Inflammation of the salivary glands
34
What does sialadenitis need to be further classified into
Infective or obstructive
35
Name the most common cause of obstructive
sialadenitis
36
What is sialadenitis described as
hard sludge
37
What are strictures caused by
Nearly always acquired usually following trauma rot duct following fibrosis
38
How can localised strictures be treated
Balloon dilation
39
What is acute obstruction caused by
Usually calculus or mucous plug
40
What can acute obstruction lead to
If chronic damage occurs gland can become more and more damaged and produce less saliva
41
What is obstructive sialadenitis caused by
Usually calculus or mucous plug
42
What is obstructive sialadenitis characterised as
Recurrent pre prandial painful swelling of a major salivary gland
43
How do we treat asymptomatic calculi
Leave it alone
44
How do we treat symptomatic calculi
If small and proximal: remove via incision of the duct and relaxing the stone If large and more distal: Can be retrieved endoscopically, via lithotripsy
45
What are the risk associated with removal of the submandibular gland
1. Damage to marginal mandibular nerve 2. Damage to lingual nerve 3. Damage to hypoglossal nerve
46
What can damage to the marginal mandibular nerve lead to
Diminished motor innervation of muscles that depress and evert the muscles that elevate the lower lip
47
What can damage to the lingual nerve lead to
Leads to diminished somatic sensory sensations to the lingual tissue3
48
What can damage to the hypoglossal nerve lead to
Leads to diminished motor function to tongue causing tongue to deviate to affected site
49
What are the risk associated with removal of the parotid gland
Damage to the facial nerve
50
What can damage to the facial nerve lead to
Unilateral facial weakness of all branches
51
What is xerostomia
technically means the subjective perception of dry mouth
52
What is hyposalivation
An objective reduced saliva production
53
What can xerostomia be caused by
1. Diabetes mellitus 2. Iatrogenic damage due to medication 3. Anxiety related 4. Mouth breathing 5. Dehydration 6. Irradiation to the salivary glands 7. Acute infections 8. Recreational drug use 9. endogenous salivary gland disease
54
How many drugs are known to have dry mouth as a side effect
500+
55
How do some medications lead to dry mouth
1. Central effects in the brain 2, Anti-muscarinic effects 3. Symphathomimetics
56
Give examples of prescribed drugs that can cause xerostomia
1. Tricyclic depressants 2. Antihistamines 3. Diuretics 4. Antipsychotics 5. Antiparkinsonian
57
What advice can we give to patients with dry mouth
1. Smoking cessation 2. Minimise alcohol intake e 3. Increase plain water consumption via small frequent sips 4. Avoid caffeinated drinks 5. Sugar free chewing gum 6. Use of high fluoride concentration toothpaste and mouthwash 7. Avoid cariogenic food 8. Discourage mouthbreathign 9. ohi
58
List some saliva substitutes and oral lubricants we can give
1. glandosane 2. BioXtra 3. Saliva Orthana
59
What are the disadvantages of glandosane
Is acidic so only use in edentulous patients to prevent tooth erosion
60
What are the disadvantages of BioXtra
Is made from cows milk proteins so may be unsuitable for patients for due to religion or dietary needs
61
What are the disadvantages of Saliva Orthana
It is produced from porcine proteins so may not be acceptable for Muslim or Jewish patients
62
What is Ptyalism
Too much saliva
63
What type of sialorrhoea do most patients have
Psychogenic usually secondary to anxiety or phobias
64
What is true Ptyalism due to
1. Parkinsons, cerebral palsy, ALS 2. Acute viral infection 3. Rabies 4. Pregnancy 5. Teething 6. New dentures 7. Pancreatitis 8. Poisoning with mercury, copper, arsenic
65
How do we manage sialorrhoea
1. Anti-muscarinis 2. Botulinum toxin A (Botox) can be injected into the salivary gland to reduce ACh release and therefore inhibit salivation 3. Surgical management
66
What is sarcoidosis
Chronic multisystem, non-caseating granulomatous inflammatory disease of unknown cause
67
What can sarcoidosis cause
Salivary gland swelling or xerostomia
68
What is a rare complication of sarcoidosis
Heerfordts syndrome
69
How does Heerfordts syndrome present
1. Chronic pyrexia 2. Salivary and lacrimal gland swelling 3. Uveitis 4. LMN facial nerve palsy
70
What does HIV salivary gland disease involve
Uni/ bilateral parotid gland swelling
71
How can HIV affect salivary glands
Can cause cystic changes
72
Which gland is most affected in hIV salivary gland disease
Parotid
73
What does HIV salivary gland disease histologically appear like
developmental lymphoepithelial salivary gland cysts
74
What is grant versus host disease (GvHD) caused by
Consequence of transplants eg bone marrow transplantation
75
Describe grant versus host disease (GvHD)
Is a systemic condition with high mortality and morbidity | Lymphocytes from the donor recognise the recipient cells as foreign and so graft cell attacks the host
76
How does grant versus host disease (GvHD) present
1. Xerostomia 2. Oral lichenoid lesions 3. Generalised mucosal inflammation 4. Candidoses 5. Oral hairy leukoplakia
77
How common are salivary gland cancers
Uncommon They only account fro 2-4% of head and neck tumours
78
Give examples of salivary gland cancers
1. Benign neoplasm | 2. Malignant neoplasm
79
What does benign neoplasm include
1. Pleomorphic adenomas | 2. Warthin’s tumour
80
What does malignant neoplasm include
1. Primary tumours such as lymphoma 2. Mucoepidermoid 3. Adenoid cycstic carcinomas
81
What does secondary neoplasms include
Deposits from renal lung cancers
82
When is radiotherapy required
May be required for various head and neck primary or secondary malignancies
83
Which cells are most susceptible to radiotherapy damage
Serous cells more than mucus cells
84
What can happen to cells damaged by radiotherapy
Saliva production drops and the saliva has a thick tenacious quality with altered biochemistry and properties
85
Name the most common benign neoplasia
Pleomorphic adenoma (80%)
86
Which salivary gland is most affected by benign neoplasia
Parotid
87
How are war thins tumours managed
Surgical excision
88
What are Mucoceles
A cyst of a minor salivary gland
89
Where do cysts of the major salivary glands form
Present as a radula in the floor of the mouth
90
How do Mucoceles present
As recurrent or persistent fluctuant swellings which transilluminate in the lower lip or buccal mucosa
91
Where on the lips is it suspicious if a Mucoceles forms
Upper lip
92
Why is a Mucoceles on the upper lip a red flag
As they are very rare and mostly turn out to be s form salivary gland neoplasia
93
What are the risk of surgical excision of Mucoceles
Risks damage to adjacent minor salivary gland
94
What is a ranula
It is used to describe a sialocyst arising in the floor of the mouth from one of the sublingual glands
95
How do ranulas present
Some are confined within the sublingual gland capsule | Most are unilateral and may raise the tongue
96
How do we manage ranula
Marsupialisation | Or rarely excision
97
What can mumps cause
dramatic, self-limiting, swelling of glandular tissue with an associated transient xerostomia
98
Which gland is affected by acute sialadenitis
mostly parotid
99
Which gland is affected by chronic sialadenitis
Mostly submandibular
100
How do we manage acute bacterial sialadenitis
1. Antibiotics 2. Hydration and anti pyretics 3. Maintain oral hygiene to reduce the chances of further infection
101
Describe chronic bacterial sialadenitis
Chronically inflamed gland that becomes progressively more fibrosed Intermittent episodes of pain Occasional expression of pus
102
What Is freys syndrome also known as
Gustatory sweating or “auriculotemporal syndrome”
103
When do patients develop Freys syndrome
Common after parotid surgery
104
What is Freys syndrome a result of
Surgical damage to the autonomic nerves supplying salivary glands and skin sweat glands
105
What can happen in Freys syndrome
Mastication can lead to inappropriate stimulation of sweat glands and skin This is localised facial sweating and flushing
106
How can we manage Freys syndrome
Botox injections
107
How does Freys syndrome present
Inappropriate facial sweating and flushing in the distraction of the auriculotemporal nerve
108
Name some developmental abnormalities of the salivary glands
1. Atresia | 2. Hypoplasia
109
What is atresia
Total absence
110
What is hypoplasia
Shrunken appearance
111
What is sjogrens syndrome
An autoimmune exocrinopathy
112
What does sjogrens syndrome affect
Affects internal exocrine tissues in the pancreas, bowel, kidneys and hepatobiliary
113
What is the incidence rate of sjogrens syndrome
0.5-2%
114
list the systemic features seen in sjogrens
1. Generalised fatigue 2. Inflammatory vascular disease 3. Skin, muscle, joints, serosa, CNS/PNS 4. Raynaud’s phenomenon 5. Thyroiditis 6. Anaemia
115
List soem subjective symptoms in patients with sjogrens syndrome
1. Difficulty swallowing 2. Sensitivity to spicy food 3. Altered salty bitter metalic taste 4. Burning mucosa 5. Lack or diminished taste 6. Salivary gland swelling/ pain 7. Cough 8. Voice disturbance 9. Nocturnal discomfort 10. Altered quality of saliva
116
Describe the tongue in sjogrens syndrome
Dry red lobulated and loss of papilla
117
Describe the teeth in sjogrens syndrome
Increased caries experience, failed restoration | Frequent tooth/ restoration fractures
118
Describe the salivary glands in sjogrens syndrome
firm on palpation if swollen
119
Describe the oral mucosa in sjogrens syndrome
dry, atrophic, wrinkled, ulcerated, increased debris, sticky when trying to move mirror around the mouth, frothy saliva, lack of pooling of saliva in the floor of the mouth
120
How do we classify sjogrens syndrome
How many of these signs or symptoms the patietn has: 1. Ocular symptoms 2. Oral symptoms 3. Occular signs 4. Histopathology 5. Salivary gland involvement 6. Autoantibodies
121
How is primary sjogrens syndrome categorised
Presence of any 4 out of 6 items on the diagnostic criteria list (as long as item IV or VI are present) OR Presence of any 3 of II, IV, V or VI
122
How is secondary sjogrens syndrome categorised
Well defined CT disease and presence of item I or II plus any 2 forms of III, IV, V
123
What is SICCA syndrome
A term used to describe patients who complain of dry eyes and/or dry mouth BUT: 1. Do not fulfil criteria for sjogrens syndrome 2. Do not have another recongnised explanation for their symt[poms
124
How do we manage sjogrens syndrom
1. Palliative measures 2. General health looked after by Rheumatology, Opthalmology and GMP 3. Therapeutic measures
125
What is palliative management for sjogrens syndrom
1. Increase lubrication 2. Maintain oral and dental health 3. Review candida status
126
What is sialosis
Painless enlargement of the major salivary glands
127
Describe how sialosis presents
1. Usually bilateral and symmetrical 2. Usually parotid gland afffected 3. Soft to palpate 4. No xerostomia 5. No fever 6. No trismus
128
What can sialosis be associated with
1. Alcoholism 2. Pregnancy 3. Diabetes 4. Thyroid disorders 5. Anorexia or bulimia

4th yr- CMS- The Oral Cavity (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions