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Saliva And Salivary Glands Flashcards

1
Q

3 pairs of major salivary glands

A

Parotid
Submandibular
Sublingual

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2
Q

% of salivary flow by 3 pairs of major glands

A

80%

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3
Q

Minor salivary glands

A

Submucosa of oral mucosa - lips, cheeks, hard and soft palate, tongue

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4
Q

% of salivary flow from minor salivary glands

A

20%

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5
Q

2 distinct types of epithelial cells in salivary glands

A

Acinar cells around ducts

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6
Q

Structure of salivary glands

A

Acinar cells
Ducts- collect to form large duct entering the mouth
Equipped with channels and transporters in the apical and basolateral membranes enabling transport of fluid and electrolytes

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7
Q

2 types of acini

A

Serous acini
Mucous acini

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8
Q

Serous acinus structure

A

Dark staining nucleus in basal third
Small central duct

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9
Q

What do serous acini secrete

A

Water
Alpha amylase- starch digestion

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10
Q

Mucous acinus structure

A

Pale staining - ‘foamy’
Nucleus at base
Large central duct

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11
Q

What do mucous acini secrete

A

Mucous (water and glycoproteins)- mucin for lubrication of mucosal surfaces

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12
Q

Which cells are found in parotid gland

A

Serous acini with ducts interspersed

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13
Q

Which cells are found in submandibular gland

A

Serous and mucus acini (seromucous)

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14
Q

Which cells are found in sublingual gland

A

Serous and mucus acini (more mucus acini)

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15
Q

What does the intralobular duct divide into

A

Intercalated and striated

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16
Q

Intercalated ducts

A

Short narrow duct segments with cuboidal cells that connect acini to larger striated ducts

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17
Q

Striated ducts

A

Striped
Major site for reabsorption of NaCl

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18
Q

How is striated duct adapted for reabsorption

A

Appear striated at basal end
Basal membrane highly folded into microvilli for active transport of HCO3 against concentration gradient
Many mitochondria for ATP generation

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19
Q

Primary saliva

A

NaCl rich isotonic plasma-like fluid secreted by acini

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20
Q

How is the electrolyte composition of saliva modified

A

Duct system
Ducts secrete K+ and HCO3 - and reabsorb Na+ and Cl-
Epithelium of duct doesn’t allow any water movement so final saliva becomes hypotonic

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21
Q

Final saliva

A

Hypotonic

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22
Q

Parotid gland location

A

Superficial triangular outline between zygomatic arch, sternocleidomastoid, ramus of mandible and masseter and med pterygoid
[palpate a finger’s breadth below zygomatic arch]

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23
Q

Parotid duct

A

Stenson’s duct - crosses masseter, pierces buccinator and enters oral cavity at 7/7

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24
Q

Parotid gland structure

A

Horizontally it has a triangular outline with apex on carotid sheath
Parotid capsule very tough

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25
Structures passing through parotid
External carotid artery and terminal branches Retromandibular vein Facial nerve and branches to muscles of facial expression
26
Submandibular glands 2 lobes
Larger superficial lobe Smaller deep lobe in floor of mouth
27
What separates the 2 lobes of the submandibular glands
Mylohyoid muscle
28
Submandibular duct
Wharton’s duct- begins in superficial lobe, wraps round free posterior border of mylohyoid, runs along floor of mouth and empties into oral cavity at sublingual papillae
29
Serous demilunes
Some serous acini arranged as a crescent-shaped groups glandular cells at the bases of mucous acini in submandibular glands
30
Location of sublingual glands
Between mylohyoid muscle and oral mucosa of the floor of the mouth
31
Sublingual duct
No large duct- drains into submandibular duct and/or small ducts that pierce oral mucosa on floor of the mouth
32
Where are minor salivary glands located
Concentrated in the buccal labial, palatal and lingual regions Also found at: Superior pole of tonsils (Weber’s glands) Tonsillar pillars Base of tongue (von Ebner’s glands- underlying circumvallate papillae)
33
Weber’s glands
Superior pole of tonsils
34
Von Ebner’s glands
Base of the tongue
35
Structure of minor salivary glands
All are mucous acini (except serous glands of von Ebner) Lack a branching network of draining ducts- each salivary unit has its own simple duct
36
Parasympathetic stimulation of salivary glands
Causes production of copious flow of saliva
37
Parasympathetic stimulation of parotid gland
Glossopharyngeal nerve
38
Parasympathetic stimulation of submandibular and sublingual glands
Lingual nerve
39
Sympathetic stimulation of salivary glands
Causes secretion of protein and glycoprotein
40
Functions of saliva
Lubrication for mastication, swallowing and speech Oral hygiene- wash, immunity (antibacterial/antiviral/antifungal), buffer Digestive enzyme- aqueous solvent necessary for taste Maintenance of oral pH
41
Oral pH
7.2 [6.2-7.4]
42
How is oral pH maintained
Bicarbonate/carbonate buffer system for rapid neutralisation of acids
43
Aqueous solvent of saliva
Necessary for taste
44
Flow rate of saliva
0.3 - 7 ml per mintue
45
Daily secretion of saliva
800 - 1500 ml in adults from major and minor glands
46
Dysfunction of saliva is associated with
Oral pain Infections Increased risk of dental caries
47
Factors affecting composition and amount of saliva produced
Flow rate Circadian rhythm Type and size of gland Duration and type of stimulus Diet Drugs Age Gender
48
Major contributor to oral health: lubrication
Mucous coat
49
Major contributor to oral health: mechanical cleaning
Flow
50
Major contributor to oral health: buffering salts
Neutralise acid
51
Major contributor to oral health: remineralisation
Ca2+ and (PO4)3-
52
Major contributor to oral health: defensive and digestive functions
Proteins
53
Saliva
Secretion of proteins and glycoproteins in a buffered electrolyte solution
54
Proteins in saliva
Proteomics and peptidomics of whole saliva 3652 proteins and 12,562 peptides detected to date 51% of proteins and 79% of peptides also contained in plasma
55
What inhibits demineralisation
Mucin
56
What has a function of taste in saliva
Zinc
57
Oral Defence provided by
Mucosa Palatine tonsils Salivary glands
58
Defence of mucosa
Physical barrier
59
Oral defence of palatine tonsils
Lymphocyte subsets and dendritic cells- immune surveillance and resistance to infection
60
Oral defence of salivary glands
Saliva washes away food particles bacteria or viruses might use for metabolic support
61
Immunity- salivary glands
surrounded by lymphatic system – linked to thoracic duct and blood Broad range of functional immune cells Oral mucosa and glands have high blood flow rate
62
Which glands are continuously active
Submandibular, sublingual and minor glands
63
Stimulation of parotid glands
No measureable unstimulated secretion but becomes main source of saliva when stimulated
64
Main source of saliva when stimulated
Parotid gland
65
Unstimulated saliva
Dominate by SMG components
66
Whole saliva
Salivary gland secretions, blood, oral tissues, microorganisms and food remnants
67
Clinical Uses of saliva
Diagnostic/ prognostic tool Eg for cystic fibrosis , tuberculosis
68
Salivary gland disease and dysfunction
Obstructive Inflammatory Degenerative Drug side effects Cancer
69
Xerostomia
Dry mouth May be consequence of cystic fibrosis or Sjögren’s syndrome Most common causes- medication and irradiation for head and neck cancers High prevalence of caries and Candida infections
70
Obstruction of salivary glands
Saliva contains calcium and phosphate ions that can form salivary calculi (stones) Most often in submandibular gland (c 80%) Block duct at bend round mylohyoid [X] or at exit at sublingual papillae [X]
71
Where are salivary calculi stones most often found
Submandibular gland (80%)
72
What forms salivary calculi (stones)
Calcium and phosphate ions
73
Inflammatory disease of salivary glands
Infection secondary to blockage Mumps (viral infection) -Fever, malaise -Swelling of glands -Pain especially over parotid because capsule does not allow much enlargement
74
Mumps
Fever, malaise Swelling of glands Pain especially over parotid because capsule does not allow much enlargement
75
Degenerative salivary gland disease
Complication of radiotherapy to head and neck for cancer treatment Sjogren’s syndrome -Mainly post-menopausal females -Also affects lacrimal glands -Rheumatoid arthritis may also be present
76
Sjögren’s syndrome
Mainly post-menopausal females Also affects lacrimal glands Rheumatoid arthritis may also be present
77
Drug side-effects on salivary glands
most common dysfunction you will encounter About 500 prescription drugs have a sympatheticomimetic effect -Act on NA receptors or -inhibit parasympathetic action at ACh receptors
78
Sympatheticomimetic effect
Act on NA receptors or inhibit parasympathetic action at ACh receptors
79
Effects of salivary gland dysfunction
If salivary output falls to < 50% of normal flow – patient experiences xerostomia (dry mouth) Low lubrication – oral function difficult Low (natural) oral hygiene – poor pH control Accumulation of plaque =>Rampant dental caries, gingivitis and periodontal disease Opportunistic infections esp. fungal infections (candida = thrush)
80
Low lubrication
Oral function difficult
81
Low natural oral hygiene
Poor pH control Accumulation of plaque Opportunistic infections
82
What classifies xerostomia (dry mouth)
Salivary output falls to <50% of normal flow
83
Salivary gland cancers
Rare (only about 720 cases per year)
84
Sublingual tumours
Almost always malignant
85
Adenoid Cystic Carcinoma (ACC)
ACC - relatively rare but life-threatening cancer that occurs mainly in salivary glands. Other sites - including the breast, lacrimal gland, lung, vulva, skin. Salivary gland ACC (SGACC) - slow growing, absence of regional metastasis, marked tendency for perineural invasion (PI) and hematogenous dissemination. Late recurrence or rapid progression of cases after long periods of indolent disease are frequently seen – 30 years after initial diagnosis.
86
MYB oncogene
= transcriptional activator = important roles in embryogenesis and homeostasis = haematopoietic linkage determination = many genes regulated by MYB linked to oncogenicity, cell proliferation, survival and differentiation
87
Serous secretion
Alpha amylase for starch
88
Mucous secretions
Mucin for lubrication of mucosal surface
89
Why is final saliva hypotonic
Epithelium of duct doesn’t allow any water movement
90
What activates parotid gland
Thought or smell
91
Sympathetic sensory innervation of the parotid gland
Auriculo-temporal nerve (CN V3, mandibular branch)
92
Sympathetic innervation of sublingual gland
Lingual nerve (branch of the facial nerve)
93
Parasympathetic innervation of sublingual and submandibular glands
Chorda tympani branch of facial nerve
94
2 lobes of submandibular glands
Larger superficial lobe and smaller deep lobe in floor of the mouth
95
What separates 2 lobes of submandibular gland
Mylohyoid muscle
96
Exosomes
Durable, cell specific lipid microvesicles Migrate through vasculature Reside in a number of biofluids including saliva Could be immune response or tumour invasion promoters Target for diagnostic tests?
97
What effect does a higher salivary flow rate have on the ionic composition of saliva
Less acidic as less time for HCO3- to be reabsorbed
98
Which immunoglobulins are found in mucus secretions?
IgA

GI (12 decks)

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