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Salivary Glands Diseases Flashcards

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1
Q

What is Sialorrhea?
What is Sialolithiasis?
What is Sialography؟
What is Sialagogue?

A

Excessive salivation.
stone in salivary gland duct.
x-ray of the salivary gland.
drug stimulates salivary gland secretio

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2
Q

What is Aplasia (agenesis) of salivary glands?

A

Congenital absence of one or more of the major or minor salivary glands.
Causing xerostomia

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3
Q

Define Atresia in the context of salivary glands.

A

Congenital occlusion or absence of one or more of the major salivary gland ducts.ducts

Rare formation of a retention cyst or produce a relatively
sever xerostomia

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4
Q

What is Aberrancy concerning salivary glands

A

Presence of ectopic salivary gland tissue normal at an abnormal anatomical position. Static bone defect.

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5
Q

List some causes of temporary xerostomia.

A

Obstruction of salivary ducts by sialolith
, acute or chronic infections or inflammation, medications, mouth breathingتبخر اللعاب , smoking, water/metabolite loss, and psychogenic disorders

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6
Q

List some causes of permanent xerostomia.

A

Salivary gland Aplasia,
local radiation therapy
, Sjogren`s syndrome,
Vitamin deficiency (A and B),
Aging, Diabetes mellitus, Sarcoidosis, and HIV infections

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7
Q

Describe the appearance of the mucosa in a patient with xerostomia.

A

residual saliva appears either foamy or
thick.
Difficult mastication and swallowing .
Mucosa appears dry, and examining gloves stick.
Tongue appears fissured with atrophy of the filliform papillae.
Increased prevalence of oral candidiasis
Difficulty with artificial dentures and can not be tolerate
‏ great risk of dental caries

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8
Q

How can permanent xerostomia be treated

A

Artificial saliva, continuous sips of water, sugarless candy, Sialogogues (like systemic Pilocarpine), frequent dental visits, daily fluoride applications, and good oral hygiene.

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9
Q

How can permanent xerostomia be treated?

A

Artificial saliva, continuous sips of water, sugarless candy, Sialogogues (like systemic Pilocarpine), frequent dental visits, daily fluoride applications, and good oral hygiene.

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10
Q

What causes Sialolithiasis?

A

Obstruction of a duct due to a salivary stone (sialolith).

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11
Q

What is the etiology of sialolithiasis?

A

Deposition of calcium salts around a nidus of debrisقد يشمل (viscous mucin, bacteria, epithelial cells, foreign bodies) within the duct lumen.

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12
Q

What is the most common site for sialolithiasis?

A

The ducts of the submandibular glands (80% of cases).

The ductal obstruction leads to chronic sialadenitis of the affected gland

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13
Q

What are the classical symptoms of sialolithiasis?
Age
Six

A

Pain and swelling, especially at meal-times.

Adults are mainly affected with males twice as often as females.2:1

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14
Q

How do sialoliths appear on x-ray examination?

A

They appear as radiopaque masses, but not all stones are visible depending on their calcification degree.

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15
Q

Describe the histopathological appearance of sialoliths.

A

Round or oval hard masses, white or yellow, with concentric laminations around a nidus of amorphous debris.

The rough surface may cause the
duct lining to undergo squamous metaplasi

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16
Q

How is a small and large sialolith treated?

A

Gentle massage of the gland to push it out of the duct.

Larger stones may need surgical removal. If the gland is damaged by recurrent infection and fibrosis, it must be excised.

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17
Q

What is a Mucocele?(Mucous extravasation cyst )

A

A common lesion resulting from trauma to a salivary duct, leading to spillage of mucin into the surrounding connective tissue.

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18
Q

What is the histopathology of a mucocele?

A

Saliva leaks into the tissue, causing inflammation and the formation of a granulation tissue wall around the mucin. It has no epithelial lining, making it a pseudo-cyst.

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19
Q

How are mucoceles treated?

A

Surgical removal with the related gland to prevent recurrence.

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20
Q

What is a Ranula?
And Site

A

A mucocele that occurs specifically in the floor of the mouth.

Sublingual glands, and less commonly from the submandibular glands

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21
Q

Describe the clinical features of a ranula.
And هستو

A

A large blue dome-shaped fluctuant swelling, elevate the tongue, interfering with speech and mastication.

similar to a mucocele

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22
Q

How is a ranula treated?

A

Marsupialization and removal of the related gland to prevent recurrence.

a. Marsupialization is the removal of the roof
of the ranula

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23
Q

What is the difference between a Mucous Retention Cyst and a Mucocele?

A

A Mucous Retention Cyst is a true cyst lined by epithelium, while a mucocele is a pseudo-cyst with no epithelial lining.

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24
Q

What is the etiology of a Mucous Retention Cyst?

A

It may represent ductal dilatation due to duct blockage by a sialolith or an impinging tumor, obstructing salivary flow.

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25
In which age groupand site are Mucous Retention Cysts more common?
Older people. major (parotid) or minor salivary gland
26
Describe the histopathology of a Mucous Retention Cyst.
Retained mucin is surrounded by compressed ductal epithelium مضغوط (cuboidal or columnar cells), giving a cystic appearance. There is no surrounding chronic inflammatory reaction as the mucous is contained in the duct.
27
How are Mucous Retention Cysts treated?
Removal of the cyst and associated minor salivary glands. If in a major gland, partial or complete removal of the gland may be necessary.
28
What is Necrotizing Sialometaplasia?
A benign condition typically affecting the palate, which can be misdiagnosed as malignancy.
29
What is the etiology of Necrotizing Sialometaplasia?
Initiated by salivary gland ischemia caused by local trauma, surgical manipulation, or local anesthesia, leading to tissue necrosis and squamous metaplasia of ductal remnants.
30
Describe the clinical features of Necrotizing Sialometaplasia. Site شكلها ‏مده الشفاء
Spontaneous appearance, most commonly at the junction between hard and soft palate. Initially a tender swelling with erythematous mucosa, then a sharply demarcated deep ulcer with a yellowish-grey base. The ulcer is persistent and heals slowly (6-8 weeks).
31
What is the histopathology of Necrotizing Sialometaplasia?
Necrosis of salivary glands and squamous metaplasia of salivary duct epithelium . Preservation of the lobular architecture helps distinguish it from neoplasia.الاهم Ductal squamous metaplasia shows no atypia,
32
What is the treatment for Necrotizing Sialometaplasia?
It is a benign, self-limiting process that does not require surgical intervention; correct diagnosis based on biopsy, serology, and culture is necessary.
33
How does radiation affect salivary glands?
Salivary tissue is highly sensitive to radiation. Therapeutic radiation can cause irreversible destruction of acini and replacement by fibrous tissue if included in the field.
34
Which acini are more severely affected by radiation, serous or mucous?
Serous acini are severely affected, while mucous acini are more resistant.
35
What is Mumps? Site Cased by Epidemiology
Acute infectious sialadenitis primarily affecting the parotid glands, caused by a paramyxovirus infection. the most common of all salivary gland diseases.
36
What is the incubation period for mumps?
Usually 16 to 18 days, with a range of about 2 to 4 weeks.
37
When are patients contagious with mumps?
From 1 day before the clinical appearance of infection to 14 days after its clinical resolution بعد الشفاء (الحل )
38
Is mumps only a localized infection? Age
No, it is a systemic infection with widespread involvement of glandular and other tissues, including liver, pancreas, kidney, and nervous system 30‎%‎ no septum. Children and young adults
39
What are the prodromal signs of symptomatic mumps?
Sialadenitis which causes: Low-grade fever, headache, malaise, anorexia, and myalgia. Swelling : Bilateral or unilateral swelling of involved salivary glands. The parotid gland is involved most frequently but the sublingual and submandibular also can be affected. ( 3 ) Sever local pain and tenderness : It is often noted especially on movement of the jaws in talking and chewing. ( 4 ) Redness and enlargement of the papillae at the orifice of Stensen`s or Wharton`s ducts ( 5 ) Stenson's duct may become partially occluded as the gland swells, with sharp pain secondary to the stimulation of the secretory mechanism by food or drink
40
What is the? ( ii ) Orchitis: التهاب الخصيه
it is the second most common finding in mumps and occurs in about 25% of post-pubertal males. التاني بعد التهاب الغدد في اعراض mumps
41
What are some other less common complications of mumps in post-pubertal females?
Oophoritis and mastitis. التهاب المبايض
42
What are some potential complications of mumps?
Ocharitis, ovaritis, meningoengalitis, cerebellar ataxia, hearing loss (permanent deafness), pancreatitis, arthritis, nephritis, decreased kidney function, heart inflammation.
43
Describe the histopathology of mumps.
Swollen and edematous acinar and ductal cells with chronic inflammatory cell (lymphocytes + plasma cell) infiltrate.
44
What is the treatment for mumps?
Treatment is palliative, including non-aspirin analgesics and antipyretics, bed rest for males to minimize orchitis, and avoidance of sour foods and drinks.
45
How does most bacterial sialadenitis arise?
As a result of ductal obstruction or decreased salivary flow, allowing retrograde spread of bacteria.انتشار رجعي
46
What can cause blockage (obstruction) of the salivary duct of bacteria of infection
Sialolithiasis, congenital strictures, or compression by an adjacent tumor. Dehydration, debilitation, or medications that inhibit secretions.
47
When is Acute Suppurative Parotitis commonly seen? Surgical mumps or post-operative mumps.اسماء مختلفة Cause Ethology
After recent surgery, especially abdominal surgery, where the patient has been kept without food or fluids and received atropine.ادويه بتسبب جفاف الفم staphylococcus aureus, but they also may arise from streptococci
48
What are the typical signs and symptoms of Acute Suppurative Parotitis?
Painful swelling, low-grade fever, malaise, and headache. The involved gland is extremely tender, with possible erythematous Pus (a purulent discharge) often is observed from the duct orifice when the involved gland is gently massaged.
49
What is the most common site for Acute Suppurative Parotitis?
The parotid gland (mostly unilateral, but can be bilateral in 10-25% of cases).
50
Describe the histopathology of Acute Suppurative Parotitis.
Infiltration of salivary gland tissues (acini and ductal system) with acute inflammatory cells (PMNLs). Cavities within the lesion represent purulent discharge.المهم
51
What is the treatment for Acute Suppurative Parotitis?
Eliminate the causativemicroorganism, coupled with rehydration, and drainage of pus if present.
52
What can lead to Chronic Sialadenitis?
Recurrent or persistent obstruction, most commonly by sialoliths.
53
What is the common site for Chronic Sialadenitis?
The submandibular gland, though it can occur in minor glands.
54
What are the signs and symptoms of Chronic Sialadenitis?
Unilateral recurrent, periodic swelling and pain within the affected gland, usually developing at meal-time.
55
What does Sialography reveal in cases of Chronic Sialadenitis?
Sialectasia (ductal dilatation) proximal to the area of obstruction. توسيع الغده
56
Describe the histopathology of Chronic Sialadenitis.
Atrophy of acini and dilatation of ducts. Scattered or patchy infiltration by chronic inflammatory cells (lymphocytes). Fibrosis may be present if fibrosis named (chronic sclerosing sialadenitis).
57
What is the treatment for Chronic Sialadenitis?
Removal of the sialolith or obstruction in early cases. Surgical removal of the whole gland if there is significant inflammatory destruction.
58
What is Sjogren's Syndrome?
A chronic, systemic autoimmune disorder that principally involves the salivary and lacrimal glands, expressing a generalized exocrinopathy.
59
What is the suspected etiology of Sjogren's Syndrome?
Autoimmune origin, which may be limited to exocrine glands or include systemic connective tissue disorders.
60
In which age group and sex is Sjogren's Syndrome predominantly seen?
Middle-aged adults (peak age 50), predominantly females (9:1 ratio).
61
What salivary gland is predominantly affected in Sjogren's Syndrome, and what are the signs?
The parotid gland, with diffuse, firm enlargement (often bilateral, slightly painful, intermittent or persistent).
62
What are the two types of Sjogren's Syndrome?
Primary Sjogrens syndrome (Sicca syndrome) and Secondary Sjogrens syndrome.
63
What is Primary Sjogren`s Syndrome (Sicca syndrome)?
Involves principally the salivary and lacrimal glands, resulting in xerostomia (dry mouth) and xerophthalmia (dry eye), with no other autoimmune disorder present.
64
What is Secondary Sjogren`s Syndrome?
The patient has Sicca syndrome in addition to another associated autoimmune disease, most commonly rheumatoid arthritis.
65
What are the most common symptoms in both types of Sjogren's Syndrome?
Severe tiredness, xerostomia, xerophthalmia, and arthralgia.
66
What are the ocular changes seen in Sjogren's Syndrome (keratoconjunctivitis Sicca)?
Reduced tear production, pathologic effect on ocular surface epithelial cells, scratchy/gritty sensation or feeling of a foreign body in the eye, blurred vision, and sometimes aching pain.
67
Describe the histopathological features of involved major glands in Sjogren's Syndrome.
Lymphocytic infiltration initially around intralobular ducts, replacing affected lobules and damaging acini. Proliferation of ductal epithelium and myoepithelial cells forming "epimyoepithelial islands." Fully developed lesion shows lymphoid cells surrounding epimyoepithelial islands, replacing salivary gland lobules.
68
What are some common laboratory findings in Sjogren's Syndrome?
Positive Rheumatoid factor (75% of cases), elevated erythrocyte sedimentation rate (ESR), diffuse elevation of serum immunoglobulin levels, Antinuclear antibody (ANA) and precipitating antinuclear antibodies (anti-SS-A/Ro and anti-SS-B/La).
69
What pattern does Sialography reveal in Sjogren's Syndrome?
A "fruit-laden branchless tree" pattern due to lack of normal branching of ducts, caused by ductal and acinar damage.
70
How is Sjogren's Syndrome mainly treated?
Treatment is mostly supportive. Dry eyes are managed with artificial tears and techniques to conserve tear film (sealed glasses, sealing lacrimal punctum). Dry mouth is managed as previously mentioned for xerostomia.
71
Xerostomia, xerophthalmia and rheumatoid arthritis are the manifestation of …………………….
Sjogren`s syndrome.
72
………………….. is one of the salivary gland diseases that could be misdiagnosed as malignancy both clinically and microscopically.
Necrotizing sialometaplasia.
73
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Oral pathology (16 decks)

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