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MIDS 227 (module 1 + 2) > Ch 5 Salivary Glands > Flashcards

Ch 5 Salivary Glands Flashcards

1
Q

Differentiate exocrine + endocrine glands?

A

Exocrine: secretes substances through ducts

Endocrine: secretes substances directly into bloodstream

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2
Q

Are salivary glands exocrine or endocrine glands?

A

Exocrine - they produce saliva through ducts

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3
Q

What are the 3 major paired glands?

A

-Submandibular glands
-Parotid glands
-Sublingual glands

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4
Q

What is the purpose of salivary glands?

A

They secrete enzymes for chewing + digestion

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5
Q

What are some indications on why we would scan the salivary glands?

A

-Painful/swollen
-Palpable mass

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6
Q

What general pathologies could be found in the salivary glands?

A

-Abscesses (due to infection/inflammation)
-Cysts
-Neoplasia (abnormal growth of cells)
-Sialolithiasis

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7
Q

Which salivary gland is the largest?

A

The parotid gland

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8
Q

Where is the parotid gland located?

A

In the parotid space which is anterior + inferior to the ear

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9
Q

Explain the parts of the parotid gland?

A

-The inferior portion (lower 2cm) is called the tail
-There are superficial + deep lobes separated by the facial nerve
-Has a fibrous capsule

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10
Q

What is the role of the parotid gland?

A

Secretes saliva into the oral cavity via the parotid duct (aka stensen duct) at approx the level of the 2nd upper molar

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11
Q

Another name for parotid duct?

A

Stensen duct

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12
Q

Tumors/neoplasms are m/c in which salivary gland?

A

Parotid

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13
Q

List parotid gland variations that can occur?

A

-Accessory glands
-Facial process (anterior extension)
-Ectopic
-Duplication
-Congenital agenesis (uni or bilateral)

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14
Q

What is the sonographic appearance of the parotid gland?

A

-Homogeneous
-Superficial
-Increased echogenicity compared to muscles
-Intraparotid lymph nodes are common to see

(typically the deep posterior lobe is NWS, can try decreasing frequency)

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15
Q

What is the Duct of Rivinus?

A

-A collection of 8-20 smaller excretory ducts that drain the sublingual glands
-Largest + major sublingual duct is called the Bartholin duct

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16
Q

What is the major sublingual duct?

A

The Bartholin duct

(this is the largest of the Rivinus ducts)

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17
Q

What is the SF of sublingual glands?

A

-Echogenic
-Triangular appearance in submental space
-Homogeneous

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18
Q

Where is the submandibular gland (SMG)?

A

Lies medial to the mandible

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19
Q

What is the role of the SMG?

A

-Secretes saliva into the oral cavity via the submandibular duct (aka wharton’s duct), lateral to the frenulum of the tongue

-Produces the majority of the saliva in the mouth (70%)

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20
Q

Another term for submandibular duct?

A

Wharton’s duct

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21
Q

Which salivary gland produces the majority of saliva in the mouth?

A

SMG

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22
Q

Does the SMG have a capsule?

A

Yes! Has a fibrous capsule

(does NOT usually contain lymph nodes)

23
Q

What is the m/c SMG variation?

A

Congenital absence (often accompanied by compensatory hypertrophy)

24
Q

What is the SF of the SMG?

A

-Superficial (anterior to muscles)
-Homogeneous
-More echogenic than muscles

(place the probe under the angle of the mandible, in the submental area, to image the SMG)

25
Q

List 6 specific pathologies we covered that can occur in the salivary glands?

A

-Sialolithiasis (stone)
-Sialadenitis (inflammation)
-Warthin’s tumor
-Pleomorphic adenomas
-Sjogren syndrome (autoimmune condition)
-Mikulicz syndrome (gland enlargement)

26
Q

What is sialolithiasis?

A

-Stones inside the ducts or parenchyma of the salivary glands
-M/c salivary gland disease
-M/c in the SMG (others in the parotid)
-M/c in males aged 30-60

27
Q

What is the m/c salivary gland disease?

A

Sialolithiasis

(m/c in the SMG b/c its secretions are thicker + travel upward towards the mouth, whereas the parotid gland secretions travel downwards to the mouth + are less thick)

28
Q

What is the clinical presentation of sialolithiasis?

A

-Recurrent pain + swelling in the affected area of the gland (often associated with eating due to duct obstruction)

-Can cause infections (bacterial sialadenitis)

-Chronic obstructions can cause the gland to undergo fatty atrophy + become asymptomatic

29
Q

What is the SF of sialolithiasis?

A

-Echogenic linear focus with posterior shadow (small stones may not shadow)
-Dilated duct if obstructed
-Gland enlargement
-If chronic the gland may appear echogenic, fatty + atrophic

(intraoral probes can be used for better vis)

30
Q

What is sialadenitis?

A

Inflammation of the salivary glands due to a variety of potential causes

31
Q

List causes of sialadenitis?

A

-Acute bacterial or viral sialadenitis
-Chronic sialadenitis
-Sialolithiasis (m/c - causing obstructive sialadenitis)
-Miscellaneous causes of acute sialadenitis include immunosuppression + dehydration

32
Q

Differentiate the SF of acute vs chronic sialadenitis?

A

Acute: enlarged, hypoechoic, hyperemic, possibly duct dilatation

Chronic: atrophic, diffusely hypoechoic with irregular margins

33
Q

Another term for pleomorphic adenomas?

A

Benign mixed tumor

34
Q

What is the m/c salivary gland tumor + its m/c location?

A

Pleomorphic adenomas in the parotid gland

35
Q

What are pleomorphic adenomas?

A

-Benign mixed tumor
-M/c salivary gland tumor (70-80% benign)
-M/c in parotid gland 84% (then SMG 8%, minor salivary glands 6%, sublingual glands 1%)
-Occurs in middle age people

36
Q

What are pleomorphic adenomas associated with?

A

Prior neck irradiation

37
Q

SF of pleomorphic adenomas?

A

-Hypoechoic mass
-Posterior enhancement

38
Q

Treatment of pleomorphic adenomas?

A

Surgery (partial or total parotidectomy) due to risk of malignant transformation

39
Q

What is warthins tumor + where does it m/c occur?

A

-Benign tumor (1% malignant transformation)
-M/c from parotid gland + favors the tail

40
Q

What is warthins tumor associated with?

A

Smoking + irradiation

41
Q

SF of warthins tumor?

A

-Bilateral in 10-15% cases
-Well defined, ovoid lesion with multiple irregular cystic areas
-Larger lesions (>5cm) have more cystic components
-Hypervascular

42
Q

Treatment of warthins tumor?

A

-Surgery
-Conservative management

43
Q

Another term for sjogren syndrome?

A

Gougerot-sjogren

44
Q

What is sjogren syndrome?

A

-Autoimmune condition of the exocrine glands that produce tears or saliva
-M/c in females (9:1 ratio) aged 40-50

45
Q

Clinical presentation of sjogren syndrome?

A

-Dry eyes + inflammation (xerophthalmia)
-Dry mouth (xerostomia)
-Bilateral parotid enlargement

46
Q

SF of sjogren syndrome?

A

Early stage: normal or enlarged gland + hyperechoic

Late stage: atrophic gland with multi cystic appearance

47
Q

What is mikulicz syndrome?

A

-On IgG4 related disease spectrum
-Non specific inflammatory enlargement of at least 2 salivary + lacrimal glands

48
Q

Clinical presentation of mikulicz syndrome?

A

-Bilateral painless, symmetrical swelling of the lacrimal + salivary glands
-Xerostomia (dry mouth)
-Xerophalmia (dry eyes)

49
Q

SF of mikulicz syndrome?

A

Enlargement of the lacrimal + salivary glands

50
Q

What causes salivary gland enlargement?

A

Many causes!! Such as obstruction, infection, inflammation, immune, neoplastic, infiltrative + congenial causes

(SF depends on the condition that causes the enlargement)

51
Q

List the duct with each salivary gland?

A

Parotid: stensen’s duct
SMG: wharton’s duct
Sublingual: sublingual ducts (major one is the bartholin duct)

52
Q

What is the thymus gland?

A

-NOT a salivary gland
-Plays a role in immune function
-Releases thymosin (a hormone necessary for T cell production, it will produce all the T cells by the time we reach puberty)

53
Q

Is it normal to see the thymus?

A

In children it is largest, it slowly gets replaced by fast after puberty + is no longer is seen

54
Q

Where does the thymus lie?

A

In the retrosternal area

(can be ectopic or have a cervical extension)

MIDS 227 (module 1 + 2) (14 decks)

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