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Term 2 > Hi Res (Salivary Glands, Neck & Lymph Nodes) > Flashcards

Hi Res (Salivary Glands, Neck & Lymph Nodes) Flashcards

1
Q

Salivary Glands

A
  • release secretions into ducts that lead to mouth
  • 3 main pairs (parotid, submandibular, sublingual)
  • also numerous sm salivary glands scattered around mouth
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2
Q

Parotid Glands

A
  • each side of face (below external acoustic meatus)

- each one has a parotid duct opening into the mouth at the second molar

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3
Q

Submandibular Glands

A
  • lie on each side of the face under the angle of the jaw

- 2 submandibular ducts open to the floor of mouth (each side of the frenulum of tongue)

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4
Q

Sublingual Glands

A
  • under mucous membrane of the floor of mouth in front of submandibular glands
  • numerous small ducts that open into the floor of mouth
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5
Q

Structure of Salivary Glands

A
  • fibrous capsule
  • lobules made of sm acini, lined with secretory cells
  • secretions are poured into ductules (join to form larger ducts leading to the mouth)
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6
Q

Arterial Supply

A

-branches from the external carotid arteries

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7
Q

Venous Drainage

A

-external jugular veins

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8
Q

Composition of Saliva

A

-combined secretions from salivary glands and mucus secreting glands of oral mucosa

  • water
  • mineral salts
  • digestive enzymes (salivary amylase)
  • mucus
  • lysozyme
  • immunoglobins
  • blood clotting factors
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9
Q

How much saliva is produced each day?

A

1.5 litres

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10
Q

Mumps

A
  • disease of salivary glands
  • acute inflammatory condition of salivary glands (especially parotid)
  • caused by mumps virus
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11
Q

Parotitis

A

-inflammation of parotid gland

May be:

  • viral (mumps)
  • bacterial (develop into abscess)
  • autoimmune (sjogren’s syndrome)
  • calculus
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12
Q

Parotitis on US

A
  • usually bilateral
  • enlarges
  • heterogenous
  • increased vascularity
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13
Q

Reactive lymphnodes (embedded in the parotid gland) are ______ to parotitis.

A

-secondary

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14
Q

Sialtis

A

-inflammation of salivary gland or duct

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15
Q

Sialectasis

A
  • dilation of salivary duct
  • resulting from duct obstruction of parotid or submandibular glands
  • pain and swelling
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16
Q

Parotitis

A

-inflammation of parotid gland

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17
Q

Calculus Formation

A
  • calculi (stones) formed by crystallization of mineral salts in saliva
  • partially/completely block ducts (inflammation, swelling, infection, atrophy)
  • unknown cause
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18
Q

Where do salivary gland stones occur?

A
  • 8/10 in submandibular

- rare in sublingual

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19
Q

Why are stones less common in parotid glands?

A

-parotid glands make thinner saliva

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20
Q

The calculus is easily seen in the ______ duct as it exits the main body of the parotid gland heading medially. Parotid duct calculi are ______.

A
  • Stenson’s

- rare

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21
Q

Parotid Adenoma on US

A
  • well circumscribed

- posterior enhancement

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22
Q

Carcinoma

A
  • malignant tumors most commonly affect the parotid glands
  • have a tendency to infiltrate nerves in the surrounding tissue (causes pain)
  • lymph spread is to cervical nodes
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23
Q

Sjogrens Disease

A

-autoimmune disorder affecting moisture producing exocrine glands (tears, saliva)

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24
Q

2nd Most Common Rheumatic Disorder

A

-sjogrens disease

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25
Most Common Rheumatic Disorder
-rheumatoid arthritis
26
Symptoms of Sjogrens Disease
-dryness of eyes/mouth (sicca syndrome)
27
What can occasionally develop in the parotid glands of the sjogre's patients?
-MALT lymphoma
28
Role of US
- palpable lump in gland/neck - pain - mumps - illness (mouth/dental infections) - mouth dryness - abnormality on previous xray, CT or sialogram - guidance of injection, aspiration or biopsy
29
Assess the gland for...
- size - increased vascularity - abnormality surrounding lymph nodes - duct dilation (use doppler, so you don't mistake a vessel to be a dilated duct)
30
What is between the parotid and submandibular glands?
-kuttner lymph node
31
Appearance of Glands
- hypoechoic | - homogenous echotexture (similar to muscle)
32
What do the intraglandular ducts look like on US?
-small, linear hypoechoic parallel stripes
33
How do you document pathology?
- in 2 planes, with measurements | - measure vascularity as well
34
Submandibular duct (Wharton's duct) is generally no more than ______ in diameter and is often not visible along it's entire length.
2mm
35
Why is the parotid more attentive than the submandibular?
-fat content
36
Are ducts easily visualized?
-only if dilated
37
Are the sublingual glands easy to see?
- very small - can sometimes only see if there is a pathology - obscured anteriorly by mandible
38
Average Size of Normal Sublingual Gland
32 x 12 mm
39
Sublingual Glands on US
- homogenous, hyperechogenicity similar to the parotid gland | - best seen in TRV and SAG planes obtained from the submental position
40
Lymphatic System
-network of tissues and organs that primarily consist of lymph vessels, lymph nodes and lymph
41
What system are the tonsils, adenoids, spleen and thymus part of?
-lymphatic system
42
How many lymph nodes are in the body (filter lymph before it returns to circulatory system)?
-600 to 700
43
Functions of Lymphatic System
- transport clean fluids back to blood - drains excess fluid from tissue - removes debris from body cells - transports fats from digestive system
44
Which way does lymph flow?
- 1 direction - towards neck - into the venous system through the SCV's
45
Where are the lymphatic drainage areas (2)?
- Rt drainage area handles the Rt arm and chest | - Lt drainage area handles the rest of the body (legs, lower trunk, upper Lt portion of chest, Lt arm)
46
Lymphangitis
-inflammation of lymph vessels
47
Lymphadenitis
-infection of lymph nodes
48
Lymphadenopathy
-enlargement of lymph nodes
49
Splenomegaly
-enlargement of the spleen
50
Lymphoedema
-swelling in tissues whose lymphatic drainage has been instructed in some way
51
Normal Appearance of Lymph Nodes
- small - oval - hilum present - moderate echogenicity - sharp margins, no structural changes - soft tissue edema - central vessel on doppler - single vascular pedicle - regular vascular pattern - low impedance
52
What is the difference on US between the appearance of normal and reactive lymph nodes?
-they look the same
53
Reactive Lymph Nodes
- enlargement of the cervical lymph nodes commonly occurs with viral infections - usually sm, firm and non tender - may persist for weeks/months
54
Abnormal Lymph Node Appearance
- lg - rounded - hilum absent - hypoechoic - irregular, angular, blurred margins - structural changes - no edema - peripheral vessels on doppler - multiple vascular pedicles - chaotic vascular pattern - high impedance
55
Lymphoedema
-chronic swelling of limbs caused by accumulation of lymph fluid (if lymphatic system is damaged/not functioning properly)
56
How may lymphoedema develop?
- following cancer therapy (especially breast) - recurrent infections - injuries
57
What parts of the body are involved in lymphedema?
-limbs, face, neck, abdomen
58
Tumors
- may grow into and block lymph vessel/node, obstructing the flow - a lg tumor outside the lymphatic system may cause pressure to stop the flow of lymph
59
Why might lymph nodes be surgically removed?
- cancer cells may spread to them | - to prevent growth of secondary tumors in local lymph nodes and the spread of disease through the lymphatic system
60
Minor Lymphadenitis
-accompany infections (measles, typhoid, cat scratch fever, wound, skin infection)
61
Chronic Lymphadenitis
-follows unresolved acute infections (TB, syphilis, low grade infections)
62
Lymphomas
- malignant tumor of lymphoid tissue | - classified as Hodgkin's or non Hodgkin's lymphomas
63
Hodgkin's Disease
- progressive, painless enlargement of lymph nodes | - superficial lymph nodes in the neck are usually noticed 1st
64
Is Hodgkin's disease malignant or benign?
-malignant
65
What is the cause of Hodgkin's disease?
-unknown
66
Why does Hodgkin's disease cause reduced immunity?
-lymphocyte function is depressed, therefore recurrent infection is common
67
Non Hodgkin's Lymphoma
- tumors - multiple myeloma and Burkitt's lymphoma may occur in any lymphoid tissue and in bone marrow - expanding lymph nodes may compress adjacent tissues/organs - anemia and leukopenia
68
How are non Hodgkin's lymphomas classified?
- type of cell involved | - degree of malignancy
69
What is the most common anomaly of the head and neck?
-thyroglossal (duct) cyst
70
Thyroglossal (duct) Cyst
- cyst beneath the skin of the anterior midline of the neck (below hyoid bone) - moves superior if patient moves their tongue - infected cyst ruptures through skin to drain (thyroglossal sinus)
71
What is the most common benign lymphadenopathy?
-thyroglossal (duct) cyst
72
What is the 2nd most common cause of a neck mass in children?
-thyroglossal (duct) cyst
73
Thyroglosssal (duct) Cyst on US
-low level intraluminal reflectors (due to bleeding/infection)
74
branchial Cleft Cyst
- abnormal persistence of remnant of the branchial apparatus - results in cysts, sinuses and fistulas - cystic neck mass, along the medial border of SCM (upper neck)

Term 2 (19 decks)

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