Salivary glands

Question 1

What are the three major pairs of salivary glands?

Answer 1

Parotid (serous), Submandibular (mixed), Sublingual (mucous).

Question 2

How many minor salivary glands are there?

Answer 2

800–1000 located throughout the oral mucosa.

Question 3

Which nerves control salivary gland parasympathetic innervation?

Answer 3

Facial nerve (CN VII) and Glossopharyngeal nerve (CN IX).

Question 4

Which receptors and neurotransmitters are involved in PNS salivary stimulation?

Answer 4

M3 muscarinic receptors via acetylcholine.

Question 5

What is the effect of sympathetic stimulation on salivary glands?

Answer 5

Decreased blood flow and saliva, increased protein secretion via α/β receptors.

Question 6

What is xerostomia?

Answer 6

Dry mouth due to salivary gland hypofunction.

Question 7

List 4 soft tissue consequences of xerostomia.

Answer 7

Fissured tongue, inflamed gingiva, candidiasis, dry lips.

Question 8

List 3 hard tissue consequences of xerostomia.

Answer 8

Caries, bone loss, risk from S. mutans, Actinomyces, Lactobacillus.

Question 9

How does xerostomia affect denture wearers?

Answer 9

Reduces retention, increases friction, risk of Candida infection.

Question 10

How does xerostomia impact quality of life?

Answer 10

Causes eating, swallowing, sleeping, and taste difficulties.

Question 11

Name 3 drug classes commonly causing xerostomia.

Answer 11

Antidepressants (SSRIs), antihypertensives (beta-blockers, ACEi), diuretics.

Question 12

What is ptyalism?

Answer 12

Excessive salivation or sialorrhoea.

Question 13

List 3 causes of ptyalism.

Answer 13

Oral trauma/infection, nausea/reflux, neurological disorders (e.g. Parkinson’s, stroke).

Question 14

What are common symptoms of salivary gland disease?

Answer 14

Swelling, pain, xerostomia, ptyalism, systemic signs, nerve involvement.

Question 15

What is a sialolith?

Answer 15

Salivary stone (calcium salts) causing duct obstruction, usually in the submandibular gland.

Question 16

How is sialolithiasis managed?

Answer 16

‘Milking’, lithotripsy, or surgical removal under LA.

Question 17

What is a mucocele?

Answer 17

Soft tissue cyst caused by ruptured minor salivary gland duct, common on the lower lip.

Question 18

What is a ranula?

Answer 18

Mucocele in a major salivary gland on the floor of the mouth.

Question 19

List 3 treatment options for mucoceles.

Answer 19

Excisional biopsy, laser ablation, cryotherapy.

Question 20

What is sialadenitis?

Answer 20

Infection of the salivary glands (e.g. parotid).

Question 21

What are common causes of suppurative sialadenitis?

Answer 21

Staph. aureus, Strep. spp., often in xerostomic patients.

Question 22

How is suppurative sialadenitis treated?

Answer 22

Antibiotics and supportive care.

Question 23

Which virus causes mumps?

Answer 23

Paramyxovirus, typically causing bilateral parotitis.

Question 24

How is HIV-associated sialadenitis different in adults vs children?

Answer 24

Children: chronic parotitis. Adults: cystic parotid swelling with lymphadenopathy.

Question 25

What is Sjögren’s syndrome?

Answer 25

Autoimmune disease causing dry mouth and dry eyes due to salivary/lacrimal gland destruction.

Question 26

What is the difference between primary and secondary Sjögren’s?

Answer 26

Primary: isolated. Secondary: associated with other autoimmune diseases like RA or SLE.

Question 27

Name 3 diagnostic methods for Sjögren’s syndrome.

Answer 27

Labial gland biopsy, sialometry, serology (autoantibodies).

Question 28

What immune cells are typically involved in Sjögren’s?

Answer 28

CD4+ lymphocytes infiltrating ducts and acini.

Question 29

How does radiation affect salivary glands?

Answer 29

Destroys stem cells and acini, leading to irreversible xerostomia and fibrosis.

Question 30

What is the most common benign salivary gland tumour?

Answer 30

Pleomorphic adenoma.

Question 31

What is the most common malignant salivary gland tumour?

Answer 31

Mucoepidermoid carcinoma.

Question 32

Where are benign tumours most commonly found?

Answer 32

Parotid gland (70–80% of tumours here are benign).

Question 33

What is the characteristic histology of adenoid cystic carcinoma?

Answer 33

Swiss cheese appearance, perineural invasion.

Question 34

What is sialosis?

Answer 34

Non-neoplastic, non-inflammatory salivary gland enlargement, often bilateral (e.g. in diabetes or alcoholism).

Question 35

What is acute necrotising sialometaplasia?

Answer 35

Self-limiting, ulcerative lesion of minor palatal glands, often mimics oral SCC.