9. salivary glands and lymphoid tissue (lecture)

Question 1

what do secretions of parotid gland enter oral cavity via?

Answer 1

parotid duct (single opening)
Stenson's duct

Question 2

what do secretions of parotid gland enter oral cavity via?

Answer 2

Wharton’s duct

single opening

Question 3

how does sublingual duct open into the oral cavity?

Answer 3

via multiple ducts

Question 4

how do salivary gland stones form?

Answer 4

usually calcium-based

saliva can crystallise and block the salivary ducts

Question 5

which salivary gland is most commonly affected by salivary gland stones?

Answer 5

submandibular duct

Question 6

why is the submandibular duct most commonly affected by salivary gland stones?

Answer 6

it produces saliva that is comparatively thicker than parotid gland, stones may be visible
(sublingual stones vary)

Question 7

how do salivary gland stones normally present?

Answer 7

as pain / swelling of the affected gland at meal times

Question 8

how do you treat salivary gland stones?

Answer 8

small stones may resolve spontaneously

commonly need removal

Question 9

what is Weldeyer’s ring?

Answer 9

made of lymphoid tissue and 4 tonsillar structures

Question 10

what are the 4 tonsillar structures making up Weldeyer’s ring? (superior to inferior)

Answer 10

ATPL
adenoid tonsil
tubal tonsil
palatine tonsil
lingual tonsil

Question 11

what is tonsillitis?

Answer 11

inflammation of the palatine tonsil

Question 12

how do patients with tonsillitis normally present?

Answer 12

sore throat

odynophagia / dysphagia if severe

Question 13

how do tonsils normally appear in tonsillitis?

Answer 13

typically enlarged and erythematous

lots of exudate can appear on the palatine tonsils

Question 14

what are the usual viral infective causes of tonsillitis?

Answer 14

e.g. rhinovirus, adenovirus

accompanied by symptoms of URTI e.g. cough

Question 15

what are the usual bacterial infective causes of tonsillitis?

Answer 15

e.g. ß-haemolytic strep
accompanied by cervical lymphadenopathy, fever, pus
(enlarged cervical lymph nodes)

Question 16

what is peritonsillar abscess known as?

Answer 16

quinsy

Question 17

how does quinsy normally occur?

Answer 17

severe complication of bacterial tonsillitis (normally strep pyogenes)
(other organisms e.g. staph aureus, H. influenza)

Question 18

how do patients with quinsy usually present?

Answer 18

typically systemically unwell with trismus (locked-jaw) or hot potato voice (reduced opening of jaw)
can appear with drooling due to dysphagia (difficulty swallowing saliva)

Question 19

how does quinsy normally affect patients?

Answer 19

often unilateral

uvula can deviate AWAY from the lesion (towards unaffected side)

Question 20

how should you treat quinsy?

Answer 20

immediate (same day) referral to ENT

Question 21

what does palatoglossus contribute to?

Answer 21

palatoglossus:
an extrinsic muscle of tongue (attaches tongue to something else)
contributes to the soft palate