saliva and salivary glands Flashcards
Name the largest salivary gland
Parotid Gland
Name the second largest salivary gland
Submandibular Gland
Name the third largest salivary glands
Sublingual
Name the duct(s) of the parotid gland and where it/they open
Stensens duct - just by 2nd upper maxillary molar
( pierces buccinator)
What type of secreation comes from the parotid duct
Serous saliva
Is the parotid duct encapsulated
Yes
Name the borders of the parotid Gland
Superiorly - zygomatic arch
Inferiorly - inferior border mandible
Anteriorly - masseter muscle
Posteriorly - sternocleidomastoid
What divides the parotid into 2 lobes
Facial nerve- a superficial and deep lobe are formed
Where is the superficial lobe of the parotid
Subcutaneous, anterior to the external ear, between skin and masseter
Where is the deep lobe of the parotid found
Inferior to the ear , posterior to mandible ramus
Name 4 structures in the parotid gland
2 nerves : Facial nerve
Auriculotemporal nerve
2 vessels : Retromandibular vein forms ( from superficial temporal Vn and maxillary vein )
External carotid artery -( gives off the maxillary artery and superficial temporal Artery here)
What nerve(s) supplies the parotid
Glossopharyngeal nerve ( Cn IX)-parasympathetic
Auriculotemporal nerve ( sensory )-branch of V3
Superficial cervical ganglion ( sympathetic )
What artery supplies the parotid gland
external carotid artery
What vein supplies the parotid gland
Retromandibular vein
What is the lymphatic drainage of the parotid gland
Deep Parotid LN
Name 2 illnesses affecting the parotid gland
Parotitis ( Mumps ) -
Sialolitiasis ( stones)
What is mumps and how does it present
70% unilateral
Painful enlarged tender parotid gland
How is mumps prevention/treatment /complications
Prevention - vaccination
Treatment - pain relief
Complications - testicle/ovary swelling ( infertility risk)
-meningitis
- deafness
How could you differentiate mumps from a stone or cancer
Mumps- fevers ,red enlarged usually unilateral 70%-
Cancer - unilateral bony hard - non painful until advanced
Sialolithiasis - may see stone in duct or on X-ray
Can you do dental treatment while a patient has mumps
No wait 5 days from symptom onset unless urgent
What percentage of saliva does the parotid gland make
25%
Where are the minor salivary glands found -
All through the mouth but not gingiva or anterior hard palate
What is the duct(s) of the submandibular gland and where do they/it open
Whartons duct - open floor mouth at sublingual caruncles
What secretion is from submandibular duct
Mixed -serous and mucus
What percentage of saliva does the submandibular gland produce
60-65%
is the submandibular gland encapsulated
Yes
Is the submandibular gland the largest major salivary gland
No - 2nd largest ( parotid largest )
What is the location of submandibular duct
In submandibular triangle in the posterior floor mouth -superiorly is the -inferior mandible border
- anteriorly - anterior belly digastric
-posterior - posterior border digastric
2 lobes
superficial -abve the mylohyoid muscle
deep -around posterior part mylohyoid muscle -
Name the 2 lobes of the submandibular gland and where found
superficial -abve the mylohyoid muscle
deep -around posterior part mylohyoid muscle -
What is the arterial supply to the submandibular gland
Facial Artery
What is the venous drainage of the submandibular gland
Facial vein
Which major salivary gland is most common to form stones
Submandibular
What nerve(s) supplies submandibular gland
Parasympathetic -chorda tympana ( branch of VII)
Sensory - Lingual nerve( branch of V3)
Sympathetic -superficial cervical ganglion
What is the lymphatic drainage of the submandibular gland
Submandibular LN
Sublingual gland - where is it
in anterior floor mouth within sublingual fossa
Between mylohyoid and oral mucosa
Is the sublingual gland the largest gland of the major salivary glands
Smallest
Is the sublingual gland encapsulated
No
What type of saliva does the sublingual gland make
Mostly mucous
What is the name of the sublingual duct(S) and where do they open
Bartholins - open in the floor of mouth in sublingual caruncles
Rivinus ducts- 8-20 small ducts in sublingual folds
What nerve supplies sublingual gland
Parasympathetic -Chordae tympani ( off VII)
Sensory- Lingual nerve (branch of V3 )
Sympathetic - superficial cervical ganglion
What is the arterial supply to the sublingual gland
Sublingual Artery
What is the venous drainage of the sublingual gland
Sublingual vein
What is the lymphatic drainage of the sublingual gland
Submandibular LN
Name 2 problems of salivary glands and how may tell difference
Sialolothiasis ( stones ) block duct so saliva flow blocked - swelling and pain in gland
Can sometimes visualises stolen or palpate it at its opening - or see on X-ray
Pain and swelling post eating - / cause ? created dehydration
Txn : heat massage sour sweets to increase flow saliva
Sjigrens disease -autoimmune - attacks salivary glands and minor salivary glands - xerostomia ( hypo saliva - leads to severe caries as diagnosed late and been no saliva to protect teeth as unable maintain a safe pH >5.5
Name a disease of the minor salivery glands
Sjögren’s syndrome. autoimmune disease in which cells of a person’s immune system attack the salivary and other moisture-producing glands, leading to dry mouth and eyes.
How can salivary lands be classified and under the 2 classifications what are the classes
By ductal system
-exocrine ( duct)
- endocrine no duct
Type of secretion
serous- watery thin
mucus - viscous slimy
Mixed -( both above )
What is the autonomic control system do to salivary glands
Parasympathetic - lots watery saliva ( low amylase levels )
Sympathetic - scant viscous secretions with high amylase levels
What is the structure system of saliva glands
Group of secretory units( ACINAR CELLS) surrounding a central lumen (= ACINUS) make saliva fluid
then drains into
interconnected ducts
then
into salivary duct
then
into oral cavity
Name 3 types of saliva and what they look like and function
Serous - watery low amylase - diluting and rinsing
Mucous - slimy lubricating saliva
Seromucous - combination both
How many minor salivary glands do we have
600-1000
How much saliva do the minor salivary glands make
10% ( even though there’s a 1000)
What type of saliva do the minor salivary glands make
Mucous mostly ( Special minor ones at base circumvilliate papilla make serous saliva)
Where are the minor salivary glands found
All through the mouth EXCEPT gingival and anterior hard palate
What is a ranula
saliva filled cyst - develops under tongue leaked out of a blocked or damaged salivary gland
Name 2 problems of saliva secretion
Hypersalivation - medications
Hyposalivation ( decreased saliva )
- lead to problems of dental /oral infections
rampant caries
difficulty swallowing \
eating as food not moistened
Name 4 causes of hypo salivation
Medications
Radiation
Autoimmune diseases eg Sjogren disease
Salivary gland problem - cystic fibrosis or diabetes (causes gland swelling so less flow )
What 2 elements involved in tooth protection
Saliva and acquired pellicle
What is the function of saliva- name 2 categories and give examples in each and the element
Protective
Maintains pH ( buffers- HCO3)
Lubricates/hydrateses ( hypotonic)
Stops demineralisation - contains salivary calcium
Defends host - antibacterial ( lactoferrin)
- anti fungal
-antiviral
Immunological - sIgA
Digestive - Bolus formation
-enzymes ( amylase and lipase )
-taste
What is secretory IgA and its function
Found in saliva - has 4 binding sites that “ grab and clump” microorganisms preventing innfection
What is lactoferrin
An iron binding protein in saliva that binds iron so the bacteria can not use it ( bacteriostatic)
What is the acquired pellicle
A thin protein layer covering all oral exposed teeth surfaces involved I protecting teeth from erosion by concentrate salivary calcium and contains carbonic anhydrase that helps neutralise pH (buffer)
What happens if we consume acidic/citric foods
pH decreasesin the mouth causing ionisation od salivary calcium causing demineralisation of hydroxyapatite and tooth erosion
Saliva tries to buffer this drop by buffers ( 90% buffering by bicarbonate ) and also carbonic anhydrase in acquired pellicle catalyses carbonic acid neutralising the pH . Pellicle also tries concentrate Calcium
What happens as consume citric juices
Ph decreases due to 1. acidity
2. citrate in the juice ( chelates the calcium ions ) so decreases calcium
Both lead to dental erosion
Saliva tries to buffer this drop by buffers ( 90% buffering by bicarbonate ) and also carbonic anhydrase in acquired pellicle catalyses carbonic acid neutralising the pH . Pellicle also tries concentrate Calcium
What happens as drink fizzy ( carbonated juices )
1.Carbohdrates ( sugars )consumed become fermented by bacteria —> decrease in pH
- Carbon dioxide reacts with water in mouth forming carbonic acid ( acidic so decreases pH)
Both cause tooth erosion
How does the saliva and acquired pellicle try to stop tooth erosion
Saliva - buffers 90% by bicarbonate
- washes out some of food /acid and dilutes
-contains salivary calcium ( concentrated in acquired pellicle
Acquired pellicle on teeth
- concentrates salivary calcium so helps hydroxyapatite remineralisation
-contains carbonic anhydrase catalyses carbonic acidd formation so increasing pH )
What pH does tooth decay start
<5.5
What happens to carbohydrate foods ingested
Fermented by bacteria lowering pH and increasing tooth decay
. autoimmune disease in which cells of a person’s immune system attack the salivary and other moisture-producing glands, leading to dry mouth and eyes.( hypo salivation). Ass diagnosed late severe dental caries as mouth been unable to maintain a pH > 5.5 as lack of saliva to help correct the pH
