88.Salivary Glands

Question 1

Important anatomy near parotid gland

Answer 1

facial nervemaxillary and temporal arteriesinternal maxillary vein regions surrounding the external acoustic meatus and the stylomastoid foramenmandibular salivary gland

Question 2

What is the blood supply to the parotid gland

Answer 2

parotid artery, a branch of the external carotid artery

Question 3

what two of the main 4 salivary glands exit into the oral vestibule

Answer 3

zygomatic–caudal aspect of the last molarparotid–level of upper PM 4

Question 4

minor salivary glands

Answer 4

buccallabiallingualtonsillarpalatinemolar (well developed in cats)

Question 5

openings of the mandibular and sublingual salivary duct

Answer 5

sublingual caruncle (lateral to the lingual frenulum)the sublingual gland empties just caudal to mandibular duct

Question 6

which salivary glands share a capsule

Answer 6

monostomatic sublingual and mandibular salivary glands share a common capsule just ventral to parotid salivary gland

Question 7

what landmark is used to determine where the polystomatic portion of sublingual salivary gland is

Answer 7

lingual nervepolystomatic sublingual salivary glands run rostral to the lingual nerve

Question 8

functions of saliva

Answer 8

–lubricate ingesta–facilitate packing bolus–thermoregulation–oral cavity cleansing–buffers (rich in HCO3 and K)–reduces bacT growth–protects surface epithelium

Question 9

T/Fsalivary alpha amylase plays a significant role in CHO digestion in small animals

Answer 9

FALSEsalivary alpha amylase DOES NOT play a significant role in CHO digestion in small animals

Question 10

mucus or serous production of which salivary glands

Answer 10

parotid and mandibular—serouszygomatic and sublingual —mucinous

Question 11

two phases of saliva production

Answer 11

1. acinus: absorb Na/H20 –sodium rich saliva2. intralobular duct: reabsorb Na and secrete HCO3 and Kresultant saliva in oral cavity is rich in HCO3 and K

Question 12

innervation to salivary glands is under what control

Answer 12

autonomic nervous systemPARASYMPATHETIC via facial and mandibular nerves: increases saliva production

Question 13

most common gland affected by sialadenosis

Answer 13

mandibular glandnoninflammatory swellingnon painfultx: GCC, Ab, +/- surgery +/- phenobarbital

Question 14

define sialocele

Answer 14

collections of saliva within subcutaneous tissuesaliva filled cavities are lined by inflammatory connective tissue NOT true cystsMOST COMMON SOURCE: sublingual salivary glandmost common manifestation: cervical sialocele

Question 15

causes of sialoceles

Answer 15

–iatrogenic –sialoliths–foreign bodies–trauma–neoplastic–IDIOPATHIC

Question 16

signalment sialoceles

Answer 16

POODLEGerman Shepherd DogsAustralian Silky TerriersDachshundsno sex predisposition

Question 17

clinical signs associated with the location of sialoceles

Answer 17

1. exophthalmos —zygomatic2. labored breathing–pharyngeal 3. dysphagia–sublingual (ranula)

Question 18

diagnostics for salivary disease

Answer 18

FNA (cytology, culture)radiographs +/- contrast (sialography)USCT/MRIbiopsy

Question 19

cytology of sialocele

Answer 19

viscous, clear, or blood tinged fluid non-degenerative cellshomogenous pink to violet staining mucus (periodic acid shift stain)macrophages may contain foamy cytoplasm

Question 20

treatment for pharyngeal sialocele

Answer 20

can cause labored breathing and/or airway obstructionaspirate or preferably LANCEmarsupializeremove mandibular and sublingual salivary glands

Question 21

treatment for ranula (sublingual sialocele)

Answer 21

marsupializeremove mandibular and sublingual salivary glands (especially rostral!)

Question 22

cervical sialocele

Answer 22

fluctuant, nonpainful, may change in sizeremove mandibular and sublingual salivary glands on the affected side

Question 23

main differential for cervical sialocele

Answer 23

–neoplasia–abscess–granuloma–branchial cleft cysts** (HISTOPATH has a true secretory epithelial lining)

Question 24

recurrence of cervical sialocele with removal of sublingual and mandibular salivary glands

Answer 24

<5%

Question 25

complications of cervical sialocele following surgery

Answer 25

--seroma (placing a drain does not seem to decr risk)--infection--recurrence (<5%)--sublingual swelling--bleeding

Question 26

sialoliths

Answer 26

raremost often affect parotid duct but can affect othersmay be proteinaceous material and NOT a true stone

Question 27

surgical options for sialolith tx

Answer 27

--gland and duct removal--duct ligation--duct R&A--marsupialization of the dilated duct into the oral cavity--incision over stone for removal with primary duct repair

Question 28

salivary gland neoplasia

Answer 28

mostly epithelial origin tumors--adenocarcinoma--acinic carcinomamostly affect mandibular and parotid salivary glandstherapy aimed at initial cytoreductive surgery following by adjuvant therapy +/- sentinel LN removal

Question 29

dissection of the rostral portion of the sublingual salivary gland continues until what anatomic structure is seens

Answer 29

lingual nerve(may or may not go dorsal to digastricus muscle---especially if ranula is present and need to get more rostral tissue)

Question 30

anatomic structure to avoid when removing the parotid salivary gland

Answer 30

FACIAL NERVE near external horizontal ear canal