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GI lectures > saliva + salivary glands > Flashcards

saliva + salivary glands Flashcards

1
Q

give 4 functions of saliva

A
  1. lubricant
  2. oral hygiene
  3. maintaining oral pH
  4. release digestive enzymes
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2
Q

what is saliva used as a lubricant for (3)

A

mastication - chewing
swallowing
speech

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3
Q

how is saliva used in oral hygiene

A

wash

immunity - antibacterial/antiviral/antifungal
because it contains lots of lysosomes

buffer

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4
Q

what pH should oral pH be maintained at

A

about pH 7.2 (slightly alkaline)

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5
Q

how does saliva maintain oral pH

A

by the bicarbonate/carbonate buffer system for the rapid neutralisation of
acid

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6
Q

how is saliva involved in releasing digestive enzymes

A

salivary alpha amylase is released from the parotid gland for starch digestion

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7
Q

what is dysfunction of saliva associated with

A

oral pain
infections
increased risk of dental caries

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8
Q

flow rate of saliva

A

0.3 to 0.7ml per minute

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9
Q

daily secretion of saliva

A

800 - 1500 ml in adults from major and minor glands

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10
Q

pH range of saliva

A

from 6.2 to 7.4

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11
Q

2 types of secretion

A

serous
mucous

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12
Q

what is serous secrtion

A

alpha amylase for starch
digestion

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13
Q

what is mucous secretion

A

mucins for lubrication of
mucosal surfaces

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14
Q

what secretion does parotid gland do

A

serous

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15
Q

what secretion does submandibular gland do

A

both mucous and serous

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16
Q

what secretion does sublingual gland do

A

both mucous and serous

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17
Q

what are the 3 main major salivary glands

A

parotid
submandibular
sublingual

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18
Q

what secretion do minor glands do

A

predominantly mucous but some are serous

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19
Q

what is the only serous minor gland

A

Von Ebner’s

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20
Q

factors affecting the composition & amount of saliva produced (9)

A
  • Flow rate
  • Circadian rhythm (sleep cycle)
  • Type & size of gland
  • Duration and type of stimulus that causes saliva to be produced
  • Diet
  • Drugs
  • Age
  • Gender
  • Time of day
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21
Q

what provides defences of oral cavity (3)`

A
  1. mucosa
  2. salivary glands
  3. palatine tonsils
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22
Q

how does mucosa provide defence of oral cavity

A

physical barrier

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23
Q

how do salivary glands provide defence of oral cavity

A

saliva washes away food particles which bacteria or viruses may use as metabolic support

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24
Q

how do palatine tonsils provide defence of oral cavity

A

act as the “surveillance system” for the immune system

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25
Q

how are salivary glands involved in immunity

A

salivary glands are surrounded by lymphatic system (linked to thoracic duct and blood) - which contains a broad range of functional immune cells

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26
Q

which glands are continuously active

A

Submandibular, sublingual & minor glands

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27
Q

what dominates unstimulated components of the salivary system

A

unstimulated components of the salivary system are dominated by submandibular
components

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28
Q

when is parotid gland the main source of saliva

A

parotid gland ONLY becomes main source of saliva when STIMULATED

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29
Q

what are salivary glands composed of

A

two morphologically and distinct epithelial tissues:

  1. acinar cells
  2. ducts
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30
Q

what are acinar cells

A

functional unit of a salivary gland

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31
Q

what are ducts

A

surrounded by acinar cells

they collect to form the large cut entering the mouth.

equipped with channels
and transporters in the apical and basolateral membranes enabling transport of fluid and electrolytes

the ducts are NOT just a plumbing system, they modify the electrolyte
composition of saliva

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32
Q

what are the 2 types of acini

A
  1. serous
  2. mucous
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33
Q

describe serous acini

A
  • dark staining nucleus
  • nucleus in basal third
  • small central duct
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34
Q

what does serous acini secrete

A

water and alpha amylase

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35
Q

where is serous acini found

A

mainly in the parotid gland

36
Q

describe mucous acini

A
  • pale staining - “foamy”
  • nucleus at base
  • large central duct
37
Q

what does mucous acini secrete

A

mucous (water & glycoproteins)

38
Q

where is mucous acini found

A

submandibular & sublingual glands

39
Q

what are the 3 types of ducts

A
  • intercalated
  • striated
  • interlobar ( excretory)
40
Q

what are intralobular ducts

A

they are divided into intercalated &
striated

41
Q

what are intercalated ducts

A

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

42
Q

what are striated ducts

A
  • striated like a thick lawn
  • major site for reabsorption of NaCl
  • appear striated at basal end
  • basal membrane is highly folded into microvilli (giving the duct its striated
    appearance) for active transport of HCO3 against concentration gradient
  • the microvilli are filed with mitochondria for energy to facilitate the active transport
43
Q

what do striated ducts secrete

A

HCO3- and K+ secreted

44
Q

what do striated ducts absorob

A

Na+ and Cl- absorbed

45
Q

describe concentration of final saliva

A

the epithelium of the ducts reabsorbs water so final saliva is hypotonic

(has less water in it so have a higher concentration of solutes (K+ & HCO3-)

46
Q

what are the diseases and dysfunction of the salivary gland (6)

A
  • xerostomia
  • obstruction
  • inflammation
  • degeneration
  • drug side effects
  • cancer
47
Q

what is xerostomia

A

dry mouth

48
Q

what causes xerostomia

A

may be a consequence of cystic fibrosis or Sjorgren’s syndrome (autoimmune
condition where immune cells attack glands resulting in little or no saliva produced - affects mainly women)

most common causes:
- medication and irradiation for head and neck cancers

49
Q

what causes salivary gland obstruction

A

saliva contains calcium and phosphate ions that can form salivary calculi - stones

50
Q

where is salivary gland obstruction most common

A

most common in submandibular gland (80% incidence) - they block the duct at the bend around the round mylohyoid or at exit at the sublingual papillae

51
Q

what causes salivary gland inflammation

A
  • caused by infection secondary to obstruction
  • infections caused by; mumps (viral infection) - results in fever, malaise, swelling of the glands
52
Q

what is salivary gland degeneration

A
  • complication of radiotherapy to head and neck for cancer treatment
  • Sjorgren’s syndrome - mainly in post-menopausal females, also affects lacrimal glands (tears)
53
Q

how do drugs cause salivary gland side effects

A

about 500 prescription drugs have a Sympathomimetic effect

act on NA receptors or inhibit parasympathetic action at ACh receptors

54
Q

what happens if salivary output falls to
less than 50% of normal
flow

A

xerostomia - dry mouth

55
Q

what happens if salivary glands have low lubrication

A

oral function becomes difficult

56
Q

what results in dental caries

A

low natural oral hygiene - poor pH control
= accumulation of plaque
= dental caries or increases
incidence of opportunistic
infections especially fungal
e.g candida - thrush

57
Q

how much of salivary flow do the 3 major glands contribute to

A

parotid, submandibular and sublingual contribute to 80% of salivary flow

58
Q

how much of salivary flow do the minor
glands contribute to

A

minor salivary glands contribute to 20% of salivary flow

59
Q

where are the minor salivary glands found

A

they are found in the submucosa or the oral mucosa of the lips, cheeks, hard & soft plate and the tongue

60
Q

describe parotid gland

A

superficial triangular outline
between:
- Zygomatic arch
- Sternocleidomastoid
- Ramus of mandible

61
Q

what is parotid duct also known as

A

Stenson’s duct

62
Q

where is parotid duct

A

crosses masseter muscle and pierces through the buccinator muscle where it enters the oral cavity near the second upper molar

can be palpated a fingers breadth below the zygomatic arch

63
Q

what provides sensory sympathetic innervation to parotid

A

the auriculo-temporal nerve

  • a branch of the mandibular nerve
  • (V3 -this division of the trigeminal nerve exits the skull through the foramen ovale)
64
Q

what provides parasympathetic innervation to parotid

A

supplied by glossopharyngeal nerve (IX)

65
Q

what does sensory sympathetic innervation do (parotid)

A

inhibits / minimises secretion

66
Q

what does parasympathetic innervation do (parotid)

A

stimulates secretion

67
Q

horizontal structure of parotid duct

A

horizontally it has a triangular outline with the apex on the carotid sheath

68
Q

which structures pass through the parotid

A
  • external carotid artery
  • retromandibular vein
  • facial nerve (VII - exits skull through the stylomastoid foramen) - supplies the muscles of facial expression

so the parotid capsule is very tough

69
Q

what are parotid glands made up of

A

the parotid glands are entirely made up of serous acini with ducts interspersed

70
Q

structure of submandibular gland

A

Two lobes separated by mylohyoid muscle

  1. larger superficial lobe
  2. smaller deep lobe in the floor of the mouth
71
Q

describe the course of submandibular duct

A

begins in the superficial lobe,

wraps around the free posterior border of the mylohyoid,

then runs along the floor of the mouth and empties into the oral cavity at the
sublingual papillae - located
more posteriorly than the
sublingual gland

72
Q

what is submandibular duct also known as

A

whartons duct

73
Q

histology of submandibular gland

A
  • mixed gland with serous & mucous acini
  • some serous acini are arranged in crescent-shaped groups of glandular cells at the bases of mucous acini referred to as serous demilunes
74
Q

what provides parasympathetic innervation to submandibular

A

supplied by the chorda tympani branch of the facial nerve (VII)

75
Q

what provides sympathetic innervation to submandibular

A

supplied via the lingual nerve which is derived from the facial nerve (VII)

76
Q

where are sublingual glands

A

located more anteriorly than the submandibular glands

located in the floor of the mouth between mylohyoid muscles and oral mucosa of floor of mouth

very close to the submandibular gland

77
Q

how is saliva transmitted in sublingual glands

A

saliva is transmitted via the submandibular duct as well or small ducts that pierce oral mucosa floor of mouth

78
Q

size of sublingual gland

A

much smaller than submandibular - but size is variable

79
Q

histology of sublingual gland

A

mixed gland with both serous & mucous acini - but mainly mucous

80
Q

what provides parasympathetic innervation to sublingual

A

supplied by the chorda tympani branch of the facial nerve (VII)

81
Q

what provides sympathetic innervation to sublingual

A

supplied via the lingual nerve which is derived from the facial nerve (VII)

82
Q

where are minor salivary glands concentrated in

A

in the; buccal labial, palatal & lingual regions

also found at; superior pole of tonsils (Weber’s glands), tonsillar pillars & at the base of the tongue (von Ebner’s glands - underlying circumvallate papillae)

83
Q

why does each minor salivary gland have its own simple duct

A

because they lack a branching network of draining ducts so each salivary unit has its own simple duct

84
Q

what does parasympathetic stimulation do in minor salivary glands

A

stimulates salivary secretion

85
Q

what does sympathetic stimulation do in minor salivary glands

A

inhibits salivary secretion (but some baseline secretion)

GI lectures (9 decks)

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