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GI > Saliva And Salivary Glands > Flashcards

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
Q

Structures passing through parotid

A

External carotid artery and terminal branches
Retromandibular vein
Facial nerve and branches to muscles of facial expression

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26
Q

Submandibular glands 2 lobes

A

Larger superficial lobe
Smaller deep lobe in floor of mouth

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27
Q

What separates the 2 lobes of the submandibular glands

A

Mylohyoid muscle

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28
Q

Submandibular duct

A

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

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29
Q

Serous demilunes

A

Some serous acini arranged as a crescent-shaped groups glandular cells at the bases of mucous acini in submandibular glands

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30
Q

Location of sublingual glands

A

Between mylohyoid muscle and oral mucosa of the floor of the mouth

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31
Q

Sublingual duct

A

No large duct- drains into submandibular duct and/or small ducts that pierce oral mucosa on floor of the mouth

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32
Q

Where are minor salivary glands located

A

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)

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33
Q

Weber’s glands

A

Superior pole of tonsils

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34
Q

Von Ebner’s glands

A

Base of the tongue

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35
Q

Structure of minor salivary glands

A

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

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36
Q

Parasympathetic stimulation of salivary glands

A

Causes production of copious flow of saliva

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37
Q

Parasympathetic stimulation of parotid gland

A

Glossopharyngeal nerve

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38
Q

Parasympathetic stimulation of submandibular and sublingual glands

A

Lingual nerve

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39
Q

Sympathetic stimulation of salivary glands

A

Causes secretion of protein and glycoprotein

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40
Q

Functions of saliva

A

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
Q

Oral pH

A

7.2 [6.2-7.4]

42
Q

How is oral pH maintained

A

Bicarbonate/carbonate buffer system for rapid neutralisation of acids

43
Q

Aqueous solvent of saliva

A

Necessary for taste

44
Q

Flow rate of saliva

A

0.3 - 7 ml per mintue

45
Q

Daily secretion of saliva

A

800 - 1500 ml in adults from major and minor glands

46
Q

Dysfunction of saliva is associated with

A

Oral pain
Infections
Increased risk of dental caries

47
Q

Factors affecting composition and amount of saliva produced

A

Flow rate
Circadian rhythm
Type and size of gland
Duration and type of stimulus
Diet
Drugs
Age
Gender

48
Q

Major contributor to oral health: lubrication

A

Mucous coat

49
Q

Major contributor to oral health: mechanical cleaning

A

Flow

50
Q

Major contributor to oral health: buffering salts

A

Neutralise acid

51
Q

Major contributor to oral health: remineralisation

A

Ca2+ and (PO4)3-

52
Q

Major contributor to oral health: defensive and digestive functions

A

Proteins

53
Q

Saliva

A

Secretion of proteins and glycoproteins in a buffered electrolyte solution

54
Q

Proteins in saliva

A

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
Q

What inhibits demineralisation

A

Mucin

56
Q

What has a function of taste in saliva

A

Zinc

57
Q

Oral Defence provided by

A

Mucosa
Palatine tonsils
Salivary glands

58
Q

Defence of mucosa

A

Physical barrier

59
Q

Oral defence of palatine tonsils

A

Lymphocyte subsets and dendritic cells- immune surveillance and resistance to infection

60
Q

Oral defence of salivary glands

A

Saliva washes away food particles bacteria or viruses might use for metabolic support

61
Q

Immunity- salivary glands

A

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
Q

Which glands are continuously active

A

Submandibular, sublingual and minor glands

63
Q

Stimulation of parotid glands

A

No measureable unstimulated secretion but becomes main source of saliva when stimulated

64
Q

Main source of saliva when stimulated

A

Parotid gland

65
Q

Unstimulated saliva

A

Dominate by SMG components

66
Q

Whole saliva

A

Salivary gland secretions, blood, oral tissues, microorganisms and food remnants

67
Q

Clinical Uses of saliva

A

Diagnostic/ prognostic tool
Eg for cystic fibrosis , tuberculosis

68
Q

Salivary gland disease and dysfunction

A

Obstructive
Inflammatory
Degenerative
Drug side effects
Cancer

69
Q

Xerostomia

A

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
Q

Obstruction of salivary glands

A

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
Q

Where are salivary calculi stones most often found

A

Submandibular gland (80%)

72
Q

What forms salivary calculi (stones)

A

Calcium and phosphate ions

73
Q

Inflammatory disease of salivary glands

A

Infection secondary to blockage
Mumps (viral infection)
-Fever, malaise
-Swelling of glands
-Pain especially over parotid because capsule does not allow much enlargement

74
Q

Mumps

A

Fever, malaise
Swelling of glands
Pain especially over parotid because capsule
does not allow much enlargement

75
Q

Degenerative salivary gland disease

A

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
Q

Sjögren’s syndrome

A

Mainly post-menopausal females
Also affects lacrimal glands
Rheumatoid arthritis may also be present

77
Q

Drug side-effects on salivary glands

A

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
Q

Sympatheticomimetic effect

A

Act on NA receptors or
inhibit parasympathetic action at ACh receptors

79
Q

Effects of salivary gland dysfunction

A

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
Q

Low lubrication

A

Oral function difficult

81
Q

Low natural oral hygiene

A

Poor pH control
Accumulation of plaque
Opportunistic infections

82
Q

What classifies xerostomia (dry mouth)

A

Salivary output falls to <50% of normal flow

83
Q

Salivary gland cancers

A

Rare (only about 720 cases per year)

84
Q

Sublingual tumours

A

Almost always malignant

85
Q

Adenoid Cystic Carcinoma (ACC)

A

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
Q

MYB oncogene

A

= 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
Q

Serous secretion

A

Alpha amylase for starch

88
Q

Mucous secretions

A

Mucin for lubrication of mucosal surface

89
Q

Why is final saliva hypotonic

A

Epithelium of duct doesn’t allow any water movement

90
Q

What activates parotid gland

A

Thought or smell

91
Q

Sympathetic sensory innervation of the parotid gland

A

Auriculo-temporal nerve (CN V3, mandibular branch)

92
Q

Sympathetic innervation of sublingual gland

A

Lingual nerve (branch of the facial nerve)

93
Q

Parasympathetic innervation of sublingual and submandibular glands

A

Chorda tympani branch of facial nerve

94
Q

2 lobes of submandibular glands

A

Larger superficial lobe and smaller deep lobe in floor of the mouth

95
Q

What separates 2 lobes of submandibular gland

A

Mylohyoid muscle

96
Q

Exosomes

A

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
Q

What effect does a higher salivary flow rate have on the ionic composition of saliva

A

Less acidic as less time for HCO3- to be reabsorbed

98
Q

Which immunoglobulins are found in mucus secretions?

A

IgA

GI (12 decks)

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