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BDS2 OCB > OCB02-2020 > Flashcards

OCB02-2020 Flashcards

1
Q

What type of gland are salivary glands?

A

Exocrine

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2
Q

What type of disease is Sjogren’s syndrome and what is its dental relevance?

A

Autoimmune

Loss of salivary gland function

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3
Q

What are possible consequences of a lack of saliva?

A

Tongue can become sore and red

Caries (esp in cervical areas)

Dry mouth (xerostomia)

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4
Q

What are the three major salivary glands called?

A

Parotid

Submandibular

Sublingual

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5
Q

Where does the Wharton duct open?

A

Empties at sublingual caruncles (either side of lingual frenum)

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6
Q

What is an alternative name for the submandibular duct?

A

Wharton duct

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7
Q

What gland drains via the Wharton duct?

A

Submandibular gland

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8
Q

Where do the ducts of Rivinus open?

A

Sublingual surface at sublingual folds

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9
Q

What is the name given to the ducts draining the sublingual gland?

A

Ducts of Rivinus

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10
Q

What gland drains via the ducts of Rivinus?

A

Sublingual gland

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11
Q

Where does the Stensen duct open?

A

Next to buccal surface of upper 6/7s

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12
Q

What is the alternative name for the parotid duct?

A

Stensen duct

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13
Q

What gland drains via the Stensen duct?

A

Parotid gland

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14
Q

Briefly describe a salivagram.

A

Imaging of the ductal trees and acini by injecting radiopaque dye into ducts

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15
Q

What is the function of salivary myoepithelial cells?

A

Wrap around acinus and stabilise acinus

Prevents acini cells expanding due to pressure during secretion (allows saliva to move into ducts)

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16
Q

What is the sequence of regions through which saliva travels from the acinus to the mouth?

A

Acinus = acinar cells

Intercalated duct

Striated duct

Excretory duct

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17
Q

Are excretory ducts located in intra- or interlobular areas?

A

Interlobular areas

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18
Q

What ducts are located intralobularly?

A

Intercalated duct

Striated duct

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19
Q

In which histological layer are minor salivary glands found?

A

Submucosa

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20
Q

How large are the secretory units of minor salivary glands?

A

1-2mm

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21
Q

What kind of saliva is produced by minor salivary glands?

A

Sticky/lots of mucins

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22
Q

Which mucosa’s minor salivary glands are most often used for diagnostic purposes?

A

Labial mucosa

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23
Q

Do minor salivary glands receive sympathetic innervation?

A

No

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24
Q

How does saliva from minor salivary glands reach the mouth?

A

Short ducts

Often join to secrete from one duct

25
Q

What pair of salivary glands have been found in the nasopharynx?

A

Tubarial salivary glands

26
Q

What may the function of tubarial salivary glands?

A

Lubrication

Innate immune function

27
Q

Briefly describe the nerve-mediated reflex of salivary secretion.

A

Oral stimuli activate receptors and sensory nerves

Afferent pathway to nucleus tractus solitarius (brainstem)

Interneurons conduct to superior and inferior salivary nuclei or down the thoracic spinal cord

  • salivary nuclei send parasympathetic efferents to major glands
  • thoracic spinal cord sends sympathetic efferents to submandibular and parotid glands
28
Q

What influence do higher centres have on salivary secretion?

A

Modulate salivary nuclei in brainstem (+/-)

Provides the only negative effect on secretion (inhibition)

29
Q

Where are salivary nuclei found?

A

Pontine tegmentum or medulla

30
Q

What oral stimuli may stimulate salivary secretion?

A

Gustatory/taste

Masticatory

Olfactory

Thermoreceptive

Nociceptive

31
Q

Which cranial nerves are involved in the afferent pathway of salivary secretion?

A

Taste:

  • facial nerve (C.VII)
  • glossopharyngeal nerve (C.IX)

Mechano/themoreception:
- trigeminal nerve (C.V)

32
Q

Which autonomic ganglion is involved in parotid gland salivary secretion?

A

Otic ganglion (glossopharyngeal nerve)

33
Q

Which autonomic ganglion is involved in sublingual and submandibular salivary secretion?

A

Submandibular ganglion (lingual nerve of facial nerve)

34
Q

What type of receptor is found at the glands in parasympathetic control of salivary secretion?

A

Muscarinic

35
Q

What type of receptor is found in the ganglia in parasympathetic control of salivary secretion?

A

Nicotinic

36
Q

Describe the role of the thoracic spinal cord in salivary secretion.

A

Receives input from nucleus tractus solitarius via interneurons

Sends sympathetic efferents to parotid and submandibular glands

Synapses in sympathetic ganglia in the superior cervical ganglion region

37
Q

What branch(es) of autonomic innervation supply the salivary glands?

A

Parotid and submandibular = parasympathetic and sympathetic

Sublingual and minor = parasympathetic

38
Q

What parts of the salivary glands do the autonomic nerves affect?

A

Myoepithelial cells = contract

Blood vessels = dilate

Duct cells = increase activity

39
Q

What are the parasympathetic and sympathetic effects on salivary glands?

A

Parasympathetic:

  • evoke most fluid and some protein secretion
  • contract myoepithelial cells
  • cause vasodilatation
Sympathetic:
- collaborates with PS
- causes protein secretion
- contract myoepithelial cells
(no vasoconstriction and rarely fluid secretion)
40
Q

More gland atrophy will be caused by the removal of which branch of the autonomic system from salivary glands?

A

Parasympathetic

41
Q

What part of saliva formation are parasympathetic nerves responsible for? What receptors/transmitters are used?

A

Na and Cl secretion (and therefore water secretion that follows)

Muscarinic ACh receptors

42
Q

What part of saliva formation are sympathetic nerves mainly responsible for? What receptors/transmitters are used?

A

Protein secretion

β-adrenoceptors with noradrenaline

43
Q

What are α-adrenoceptors responsible for in saliva formation?

A

Small amounts of sympathetic salt and water secretion

44
Q

What happens in striated salivary ducts?

A

Na+ and Cl- removed but water remains

Secrete K+ into lumen

Results in hypotonic saliva

45
Q

What is the role of neuropeptides in saliva formation?

A

Stimulate protein secretion in minor salivary glands

46
Q

Give an example of a neuropeptide that may be released for saliva formation and their function.

A

VIP (vasointestinal peptide) = protein secretion

Substance P = fluid and electrolyte secretion

47
Q

Describe what occurs in an acinar cell on stimulation (sympathetic and parasympathetic).

A

Parasympathetic:

  • ACh binds M3 receptors to trigger Gq signalling (PLC and IP3)
  • increase in intracellular calcium (from RER) causing electrolyte and fluid secretion (opening of Cl- channels)

Sympathetic:

  • NA binds β-adrenoceptors to trigger Gs signalling (adenylyl cyclase and cAMP)
  • protein secretion
48
Q

What drugs may impact acinar cell function?

A

Atropine (blocks muscarinic receptor)

Propanolol (blocks β-adrenoceptors)

49
Q

What is the formation of saliva mainly dependent on chemically?

A

Na+ gradient

50
Q

What are the sodium concentrations inside and outside of acinar cells and how is this gradient maintained?

A

Intracellular = 10mM

Extracellular = 143mM

Na-K ATPase basolaterally (activity increases on stimulation)

51
Q

How does an increase in intracellular calcium cause water movement into the lumen during saliva formation?

A

Causes apical Cl- channels to open so Cl- moves into lumen

Lumen becomes electronegative so Na+ follows paracellularly

Osmotic gradient formed by having NaCl in the lumen so water follows paracellularly (and partly by aquaporins)

52
Q

What maintains a higher Cl- concentration in acinar cells?

A

Basolateral Na/K/2Cl transporter

53
Q

How is saliva secretion returned to normal levels after the stimulus is removed?

A

Nerve signalling stops (parasympathetic)

Calcium returned to RER

Chloride channels close

54
Q

Describe the protein secretion of acinar cells.

A

Acinar proteins are stored in granules (amylase, mucinm PRPs, statherin)

Albumin found in small amounts

Plasma cells produce IgA which are picked up by a transporter protein and carried across the cell

NA binding to β-adrenoceptors causes release of stored acinar proteind

55
Q

Describe the types of saliva secreted by each major gland.

A

Parotid = serous (amylase and non-mucin protein)

Submandibular = mixed/seromucous

Sublingual = mucous (mucins)

56
Q

What are the ionic concentrations in isotonic saliva from acini?

A

145mmol Na+

4mmol K+

100mmol Cl-

57
Q

What are the different ionic concentrations in the saliva during unstimulated and stimulated flow rates?

A

Unstimulated:

  • 2mmol Na+
  • 25mmol K+
  • 23mmol Cl-

Stimulated:

  • 36mmol Na+
  • 21mmol K+
  • 28mmol Cl-
  • 30mmol HCO3-
58
Q

Which salivary flow rate produces saliva that is more hypotonic?

A

Unstimulated (low flow rate)

BDS2 OCB (22 decks)

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