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Salivary Gland Flashcards

1
Q

How many salivary glands does the dog have

A

4
1) Parotid
2) Mandibular
3) Sublingual (Monostomatic and Polystomatic)
4) Zygomatic

*Cats have a 5th set - Molar

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2
Q

where is the parotid duct

A

labial mucosa at level of upper carnassial tooth

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3
Q

where is the mandibular duct

A

papilla lateral to the rostral border of frenulum

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4
Q

opens with mandibular duct near the lingual frenulum

A

sublingual duct

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5
Q

located later to the last upper molar

A

zygomatic gland

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6
Q

ptyalism

A

hypersialosis / hypersalivation

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7
Q

decreased salivation

A

xerostomia

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8
Q

What do you think of when an animal has ptyalism

A

toxins, cat w portosystemuc shunt, bloodhounds, salivary gland problems

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9
Q

What are issues that can occur with salivary glands

A

1) Ptyalism
2) Xerostomia
3) Intraoral swelling
4) Submandibular or intermandibular swelling / mass

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10
Q

What are differentials for submandibular swelling

A

1) Tumor, abscess, granuloma, cyst
2) Salivary Mucocele
3) Inflammation - sialadenitis
4) Lymphadenopathy
5) Seroma (after surgery)
6) Branchial cyst
7) Thyroglossal cyst

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11
Q

accumulation of saliva in tissue next to salivary gland or duct

A

sialocele
(salivary mucocele)

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12
Q

What is the most common mucocele

A

cervical mucocele

-Sublingial or mandibular glands

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13
Q

why is a sialocele not a cyst

A

it is lined with inflammatory tissuem not epithelium

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14
Q

What is a ranula

A

a sublingual mucocele associated with the sublingual gland

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15
Q

What is another word for a sublingual mucocele

A

Ranula

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16
Q

What might you see with a parotid sialocele

A

lateral face swelling
-associated with parotid gland

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17
Q

a pharyngeal mucocele is associated with what glands

A

1) Sublingual
OR
2) Mandibular

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18
Q

A ranula is associated with what gland

A

Sublingual gland

(under the tongue)

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19
Q

A cerival mucocele is the most common mucocele, it is associated with what gland(s)

A

Sublingual or Mandibular

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20
Q

What are the clinical signs of Salivary mucocele

A

LARGE
Nonpainful
Fluctuant swelling
soft, may change in size

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21
Q

where do cervical salivary mucoceles occur

A

in the intermandibular space or just caudal to it

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22
Q

where do ranulas occur

A

sublingual tissue, lateral to the tongue

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23
Q

where do pharnygeal mucoceles occur

A

oropharnyx

1) upper airway obstruction
2) inspiratory and expiratory stridor
3) respiratory distress

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24
Q

What are the consequences of pharyngeal mucoceles

A

1) upper airway obstruction
2) inspiratory and expiratory stridor
3) respiratory distress

25
Where do zygomatic mucoceles occur
ventral to the globe (very rare) -Need to rule out tooth root abscess of carnassial tooth and tumor
26
What does zygomatic mucoceles look like
-Need to rule out tooth root abscess of carnassial tooth and tumor all can cause issues ventral to the globe
27
What might cause salivary mucocele
1) Trauma - bite wounds, iatrogenic 2) Sialoliths that block duct 3) Foreign materials 4) Dirofilaria immitis aberrant migration 5) Breed over representation *often no explanation
28
How do you diagnose salivary mucoceles
history PE Fine needle aspiration and cytology Radiographs Ultrasound Sialography Advanced imaging
29
What are the characteristics of fine needle aspirate on a salivary mucocele
-Clear, golden or blood tinged -Stringy, viscous -Low cell count, typically -Periodic acid-Schiff (PAS) stain can get infected if aspirated multiple times
30
What do salivary mucoceles look like on ultrasound
depends on chronicity anechoic to hyperechoic
31
a method where contrast in injected into the salivary duct
sialography
32
Should you do mucocele drainage?
ehhh it will likely keep filling and get infected
33
What is the reason on why you might give a dog with a cervical mucocele doxycycline
Tetracyclines have a side effect that decreased salivary secretion
34
What is the treatment of choice for cervical mucoceles
Surgical management -Salivary tissue resection
35
Can you do nothing for cervical mucoceles
yes if the owner would like to only for the cervical ones, dont affect respiration or prehension if managed
36
Should you treat cervical mucoceles with radiation therapy and N-acetylcysteine?
NO
37
How do you surgically treat cervical mucoceles
remove affected salivary tissue mucocele drainage remove both the sublingual and mandibular glands make sure you know with side (history, dorsal recumbency (swelling shift), mass palpaation, look for ranula, contrast study, advanced imaging)
38
for cervical mucoceles, what glands do you remove surgically
BOTh the sublingual and mandular glands
39
What are the surgical goals for treating cervical mucoceles
1) Remove both the sublingual and mandibular glands 2) Drain accumulated fluid 3) Do no harm 3) Submit for histpathology 4) Culture and sensitivity (if concerns for infection)
40
How do you tell which side a cervical mucocele is when treating surgically
1) history 2) dorsal recumbency (swelling shift) 3) mass palpation 4) look for ranula 5) contrast study 6) advanced imaging
41
How do you find the mandibular gland prior to surgery
hold of the jugular and look for its branches of the linguofacial (ventral) and maxillary vein (dorsal) the mandibular gland is right between them
42
what are surgical tips for treating cervical mucocele
-rolled padding underneath head -hold off jugular vein for landmarks -Gelpis -gentle caudal traction and work rostral during dissection -multiple layer closure
43
Differences of passive drain vs active drain for cervical mucocele surgery
Passive Drain: most dependent postion, exit site separate from primary incision, drain not directly under incision, keep exit site covered, remove in 3-5 days Active Drain Placement: drain not gravity-dependent, closed system, allows fluid quantitation and analysis, decreased risk of ascending infection both minimize risk for seroma
44
What are the two surgical approaches to surgically treating cervical mucoceles
Lateral and Ventral
45
For cervical mucoceles, the lateral approach has lower risk of ___________ while the ventral has lower risk of ________ *
Lateral: lower risk of incisional complications Ventral: lower risk of recurrence (gets entire duct)
46
How do you treat ranula
1) Marsupialization - creates hole for drainage 2) En bloc exision 3) Sublingual and mandibular gland removal
47
What is marsupialization
creation of a pouch; applied especially to surgical exteriorization of a cyst by resection of the wall and suture of the cut edges of the remaining cyst to the adjacent edges of the skin, thereby establishing a pouch of what was formerly an enclosed cyst
48
how do you treat pharyngeal mucocele
1) Marsupialization - creates hole for drainage 2) En bloc exision 3) Sublingual and mandibular gland removal
49
what are the complications of mucocele treatment
1) lymph node removal 2) recurrence 3) remove wrong side 4) incomplete removal 5) incisional seroma (common), do headwrap and warm compresses 6) xerostomia (uncommon)
50
You can remove up to _____ % of salivary tissue
50%
51
What is the prognosis of mucoceles
excellent prognosis
52
How do feline sialoceles typically present
Dysphagia; ptyalism unknown cause in most Mandibular-sublingual glands
53
Mucoceles are most commonly associated with which salivary gland
Sublingual - but it cant come out without the mandibular both glands are removed due to their close association with each other
54
cerivcla mucoceles require _____ for curative treatment
salivary gland excision for curative treatment
55
Intraoral mucoceles may resolve with
excision or marsupialization
56
there are multiple differentials for head and neck masses so you should
do a thorough examination and workup (hx, phys exam, aspirate, etc)
57
sialolithiasis
rare condition parotid gland skull radiography and sialography for dx calcium containing remove the stone +/- the gland
58
sialadenitis
rare as a primary problem inflammatory condition mandibular gland trauma systemic viral disease autoimmune can progress to necrosis

GI MED & SX (5 decks)

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