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ENT > Head and Neck - Salivary Glands > Flashcards

Head and Neck - Salivary Glands Flashcards

1
Q

What are the 3 major salivary glands?

A

parotid
submandibular
sublingual

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2
Q

How many minor salivary glands are there?

A

600-1000 located beneath the mucosa of the upper aerodigestive tract

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3
Q

Which nerve runs through the parotid gland?

A

Facial nerve

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4
Q

What are the branches of the facial nerve?

A 
Temporal 
Zygomatic 
Buccal
Mandibular 
Cervical
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5
Q

What other structures run through the parotid gland?

A

Reteromandibular vein
External carotid artery which divides
Secretemotor fibres
Sympathetic fibres

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6
Q

What structures lie within the submandibular gland?

A

mandibular branch of facial nerve
secretemotor fibres
sympathetic fibres

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7
Q

Look at anatomy pics of glands

A

:(

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8
Q

What stimulates saliva?

A 
smell
taste - esp acid, sugar, salt, sweet 
psychic stimuli - sight of food 
chewing and mastication
parasympathomimetic drugs
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9
Q

What are the common causes of a dry mouth?

A 
Depression 
Anxiety 
Drugs - ant muscarinic activity and with sympathetic activity 
Sjogrwen syndrome 
Radiotherapy to head and neck
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10
Q

What are some causes of non salivary swellings?

A

Hypertrophy of the masseter
Ageing - absorption of adipose tissue
Neuromas, aneurysms and cysts
Lymphadenopathy secondary to otitis externa
Dental infections, lymph nodes
Mandibular tumours
Mastoiditis causing a subperitoneal abscess

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11
Q

What are the viral causes of parotitis?
Presentation?
Treatment?

A

Viral - mumps, acho, coxsachie (treat with hydration and analgesics)
HIV- diffuse enlargement and multiple cysts

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12
Q

What are the bacterial causes of parotitis?
Presentation?
Treatment?

A

staphylococcal infection - debilitated, may be on anticholinergics, dehydrated, treat with sialogogues, massage or drain pus if present

TB - drug treatment

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13
Q

What are the fungal causes of parotitis?

A

rare
candidiasis
immunosuppressed

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14
Q

What is sialectasis?

A

dilation, stenosis, and necrosis of acini forming cysts cause unknown initial event in sialolithiasis

Investigate with xray and sialogram
Remove callus
Gland may need to be excised

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15
Q

What are the symptoms of Sjogrens syndrome?

A

dry eyes, dry mouth, keratoconjuctivitis, glossitis, secondary candiasis, stomatitis

40% will have enlarged parotid
20% will show enlargement

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16
Q

Where do most salivary tumours occur?

A

Parotid

17
Q

What percentage of salivary tumours are benign?

A

80%

18
Q

What is the most common type of benign salivary tumour?

A

Pleomorphic adenomas

19
Q

How are salivary swelling investigated?

A

fine needle aspiration cytology

ultrasound or CT

20
Q

How are benign salivary swellings treated?

A

superficial parotidectomy/ tumour excision with complete cuff of normal tissue / total parotidectomy

21
Q

What are the examples of malignant tumours of the salivary glands?

A 
adenoid cystic carcinoma 
adenocarcinoma
lymphoma 
metastases
carcinoma ex pleomorphic adenoma
22
Q

What are the important questions to ask in a history of a salivary swelling?

A 
age, sex
unilateral or bilateral swelling 
is the swelling constant or intermittent 
pain? constant or intermittent?
foul taste in mouth?
sudden change?
facial weakness?
dry eyes, mouth, arthritis?
23
Q

How should you examine a salivary swelling?

A 
welling 
whole neck in structured method
think mets
oral cavity and bimanual palpation 
cranial nerves
24
Q

What investigations should be carried when looking at a salivary swelling?

A 
routine bloods
virology, ACE
SSA and SSB
x ray plain, sialogram, CT sialogram, CXR 
USS high definition and Doppler 
MRI 
Schmer's, carlsson-crittenden

FNAC
Bipsy gland
sublabial biopsy for non neoplastic disease

25
Q

What are the two operations used for salivary swellings?

A

partial superficial parotidectomy

submandibular gland excision

ENT (6 decks)

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