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ORL > Salivary Gland > Flashcards

Salivary Gland Flashcards

1
Q

Daily salivary output

A

1000 -1500ml

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2
Q

pH at which Demineralization of tooth enamel is optimal

A

5 to 5.5

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3
Q

Parasympathetic supply of parotid gland

A

Inferior salivatory nucleus> Glossopharyngeal n > Jacobson n > Otic ganglion

Postganglionic: auriculotemporal br of trigeminal n

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4
Q

Parasympathetic supply of sub mandibular gland

A

Superior salivatory nucleus > nervous intermedius and chorda tympani

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5
Q

Areas with highest intraoral flow volume

A

Mandibular lingual

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6
Q

Lowest intraoral volume

A

Maxillary incisors

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7
Q

Specific gravity of saliva

A

1.002 to 1.0012

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8
Q

Principal saliva buffer

A

Bicarbonate

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9
Q

Promotes remineralization of enamel, phosphoprotein

A

Statherin

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10
Q

optimal pH for α-amylase activity

A

6-8 ; Cl as cofactors

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11
Q

the most potent stimuli to the salivary center

A

Gustatory stimuli

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12
Q

Stimuli leading to Greatest increase in salivary flow

A

Acids

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13
Q

Stimuli leading to Least increase in salivary flow

A

Sweets

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14
Q

the least potent stimuli to the salivary center

A

Olfaction

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15
Q

What salivary gland tumors can present bilaterally ?

A

Warthin Tumor

Lymphoepithelial cyst of HIV

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16
Q

is an epithelial-lined retention cyst of the sublingual gland

A

simple ranula

17
Q

simple ranula ruptures and dissects through the mylohyoid muscle into the submandibular space, it forms a mucocele

A

Plunging Randal

18
Q

Ultrasound can detect up to 90% of sialolith more than __ mm

A

2

19
Q

benign lymphoepithelial lesion is characterized by a lymphoreticular infiltrate with acinar atrophy, irregularly placed nuclei, and ductal metaplasia;

A

Mikulicz Disease

  • affects women with 50th to 60th decade of life
  • associated with Sjogren syndrome
20
Q

5o-60 Yo female presenting with firm painful sm mass, on FNAB: parenchyma atrophy &a progressive fibrosis

A

Kuttner tumor, chronic sclerosing sialadenitis

  • exclusively in SMG
  • increased risk for salivary ductal carcinoma
21
Q

For post abdominal and hip surgery patients when do we expect their risk highest for acute parotitis?

A

Within two weeks post op

Due to postop dehydration

22
Q

Risk factors for developing Neonatal suppurative parotitis?

A

Preterm
Male
Dehydration
NGT feeding

23
Q

second most common inflammatory salivary gland disease of childhood after mumps.

A

Recurrent Parotitis of Childhood (RPC)

Risk factors:
congenital abnormalities or strictures of the Stensen duct and a history of viral mumps, trauma, or foreign bodies within the duct

S.aureus , Strep viridans

24
Q

Patient presenting with acute inflammation and swelling of right parotid gland eventually involving contralateral gland, with prodrome of fever, myalgia, anorexia. Exacerbated pain when eating or chewing

A

MUMPS

acute bilateral, nonsuppurative, viral parotitis caused by the paramyxovirus

Complications:orchitis, aseptic meningitis, pancreatitis, nephritis, and sensorineural hearing loss

Vaccine: live attenuated Jerry Lyn; after 12mo age, effective for at least five years

25
Q

Patient with history of dental caries , post extraction noted to have progressive swelling of preauricular area with multiple draining sinuses. On smear, (+) gram positive filamentous rods with sulfur granules. Diagnosis & tx?

A

Actinomycosis

6 weeks IV then 6 months oral Med: penicillin
Alternative: clindamycin, doxycycline
,erythromycin

26
Q

Patient with history of cat scratch, progressive enlargement and suppurations of submandibular LAD, what is the etiologic agent?

A

Bartonella henselae > Cat scratch disease

Parinaud oculoglandular syndrome - unilateral conjunctivitis on ipsilateral side of CLAD

Self limiting disease in most cases

27
Q

What autoantibodies are present among Sjögren Syndrome patients?

A

Ro (SS-a), La (SS-b)

Xerostomia, C albicans on tongue

28
Q

What drug classes are associated with xerostomia?

A

Sedatives, antipsychotics, antidepressants, antihistamines, and diuretics

29
Q

3 presentations of Sarcoidosis

  1. Major salivary gland involvement
  2. Non caseating granuloma of minor salivary gland
  3. ?
A

Heerfordt syndrome/Uveoparotid fever
FN palsy and uveitis

Do. Biopsy of labial mucosa

30
Q

Most commonly involved location for minor salivary gland neoplasms?

A

Palate

31
Q

Explain the bicellular stem cell theory (reserve cell theory) of salivary gland tumorigenesis.

A

Excretory duct cell and intercalated duct cell can be sources of stem cell for neoplasms

32
Q

Explain multicellular theory

A

Salivary gland neoplasms can arise from various cells making up the salivary gland unit

Warthin and oncocytic tumors - Striated duct
Mixed tumors from intercalated and myoepithelial cells

33
Q

Milan Staging

A 
I. Non diagnostic 25% 
II. Non Neoplastic 10%
III. Atypia of unknown significance (AUS) 10-35%
IV. Neoplasm 
Benign <5%
Salivary gland of Unknown Malignant Potential (SUMP) 35%
V. Suspicious for malignancy 60%
VI. Malignant 90%
34
Q

On MRI, this tumor occupies post styloid compartment, displaces carotid artery anteriorly, with serpiginous flow voids. What is the entity and sign?

A

Glomus tumor ; Salt and pepper appearance

35
Q

Pleomorphic adenoma is the most common benign tumor of the lacrimal gland.

It occupies the prestyloid space vs neurogenic or glomus tumors which occupy the post styloid compartment

A

Both statements are true

36
Q

Risk of malignancy of pleomorphic adenoma?

A

1.5% within the first 5 years of diagnosis

10% if observed >15 years

37
Q

Histopathologically, Basal cell adenoma can be mistaken for what salivary gland malignancy?

A

Adenoid cystic carcinoma

38
Q

What is he microscopic characteristic of Warthin tumor?

A

Papillae of epithelium into cystic space of Lymphid matrix

Other names: papillary cystadenomalymphomatosum, adenolymphoma

ORL (7 decks)

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