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salivary gland diseases Flashcards

1
Q

Parotid gland is serous/mucous acini

A

Serous

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2
Q

Location of parotid gland

A

Posterior aspect of the masseter, below the ear. Wraps around posterior border of mandible

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3
Q

What cranial nerve is related to parotid gland

A

Superficial/deep lobe divided by CN7 facial nerve

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4
Q

Describe Stenson’s duct and its opening

A

Duct for parotid gland.

6cm in length. Lies on masseter, turns medially at anterior border and pierces buccinator into oral cavity

Opening adjacent to maxillary second molar

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5
Q

Secretion of parotid gland controlled by

A

CN9

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6
Q

Sign of infection of parotid gland

A

Ear lobe raised

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7
Q

Size of submandibular gland

A

Walnut

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8
Q

Submandibular gland location

A

Partly superficial partly deep to the mylohyoid myscle

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9
Q

Relations and opening of duct for submandibular gland

A

Wharton’s duct

5cm
Opens into floor of mouth lateral to lingual frenum
Lingual nerve loops under Wharton’s duct

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10
Q

Submandibular gland is serous/mucous

A

Mixed

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11
Q

Histological appearance of submandibular gland

A

Serous demilunes

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12
Q

Size of sublingual gland

A

Almond

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13
Q

Location of sublingual gland

A

Superior surface of mylohyoid muscle

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14
Q

Sublingual gland open into

A

8-20 ducts open into floor of mouth or into submandibular duct

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15
Q

Innervation of sublingual and submandibular gland

A

CN VII through chorda tympani

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16
Q

Sublingual gland serous/mucous

A

Predominantly mucous

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17
Q

Blockage of sublingual gland ducts result in formation of

A

Ranula

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18
Q

Minor salivary glands found at

A 
Buccal mucosa
Labial mucosa
Lingual mucosa
Soft palate
Floor of mouth
Lateral portions of hard palate
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19
Q

Minor salivary gland function

A

Each cluster of minor salivary glands has an individual duct that leads to surface of mucosa, keeping mucosa moist with mucous saliva

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20
Q

Plain films of minor salivary glands can be used to show

A

Calcifications and stones

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21
Q

Sialogram: a portion of the duct does not show the dye

A

Stricture of duct, narrow and fibrosed hence not getting any dye. Clinically would get constant swelling of the gland

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22
Q

Sialogram appearance for Sjogren’s

A

T cells attack salivary gland. Acini dead, dye goes to the end of each acini. Fruit laden branchless tree appearance

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23
Q

What is sialadenitis

A

Salivary gland infection (acute/chronic)

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24
Q

Cause of sialadenitis

A

Viral or bacterial or fungal or mycobacteria; bacteria usually Staph Aureus (staph from skin/nasal cavity inoculated and transmitted to mouth lead to ascending infection)

Fluid balance changes eg dehydration

Blocked ducts; stones can cause recurrent sialadenitis

Decreased salivary flow eg dehydration, Sjogren’s, drugs

–> retrograde spread of bacteria through ductal system

25
Mumps is caused by
Paramyxovirus (acute)
26
Mumps is common in
children 3-8 years old
27
Mumps is characterised by
Painful swelling of parotid/submandibular glands Pain over affected glands Fever, chills, headache Begin 16-18 days after exposure, last 5-12 days
28
Mumps is transmitted by
Urine, saliva, respiratory droplet
29
Mumps patients are contagious from
Contagious from day 1 before clinical appearance of symptoms until 14 days after clinical resolution
30
Complications of mumps
Meningitis, pancreatitis, nephritis, sterility
31
MMR vaccine should be given at
infancy
32
Treatment for mumps
Symptomatic care eg analgesics, antipyretics, hydration
33
Treatment for acute bacterial sialadenitis
Symptomatic and supportive care -- IV fluid hydration Culture causative organism and give appropriate antibiotics
34
Histologic feature of mycobacteria sialadenitis
Acid fast bacilli
35
What is sialolithiasis and cause
Obstructive salivary gland disease; calcified structures develop within ductal system Arise from deposition of calcium salts around nidus of debris
36
Age range for sialolithiasis
Young and middle aged adults (never in children!)
37
Which gland is sialolithiasis more common in and why
Submandibular gland because mucous and thicker Duct has to loop over lingual nerve --> kink
38
Sialolithiasis result in episodic pain in affected gland especially at
mealtimes
39
What does sialoendoscopy do
Endoscopic transluminal of ductal system can remove stones up to 4mm diameter Bigger stones have to be fragmented with Holmiun laser
40
Cause of mucocele
Trauma --> rupture of salivary duct --> mucin spills into surrounding soft tissue
41
Clinical presentation of mucocele
Bluish fluctuant swelling Lower lip, ventral tongue, cheek
42
Principle of excision of mucocele
Excision should include adjacent minor salivary glands
43
Source of mucin spillage that causes ranula
Sublingual gland, wharton's duct, minor salivary glands
44
Ranula occurs in what demographic
Children and young adult
45
Treatment for ranula
Marsupialisation
46
Clinical presentation of neoplasm of salivary gland
Painless/dull ache Firm to rubbery texture
47
Parotid tumours are mostly benign or malignant
80% benign (pleomorphic adenoma)
48
Large malignant tumour at parotid gland, how to excise
Remove whole gland with sacrifice of facial nerve | avoid enucleation and tumour spill
49
Demographic of pleomorphic adenoma
4th-6th decade | F>M
50
Behaviour of pleomorphic adenoma
Rarely, can get transformation to carcinoma ex pleomorphic adenoma
51
Most common salivary gland neoplasm is
Mucoepidermoid carcinoma
52
Demographic for mucoepidermoid carcinoma
3rd to 8th decade (peak at 5th) | F>M
53
Low vs high grade mucoepidermoid carcinoma
Low: a lot of mucous cells, slow growing, painless High: a lot of epithelial cells, rapidly growing, painful
54
Where does adenoid cystic carcinoma mainly occur
Parotid gland and minor salivary glands
55
Demographics for adenoid cystic carcinoma
5th decade | M>F
56
Clinical presentation of adenoid cystic carcinoma
``` Slow growing Expansile Dull pain Paresthesia Facial weakness (perineural invasion) ```
57
Classic histologic appearance of adenoid cystic carcinoma
Cribiform swiss cheese appearance
58
Treatment for adenoid cystic carcinoma
Complete local excision | Sacrifice of facial nerve due to tendency for perineural invasion

Oms (24 decks)

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