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salivary gland diseases Flashcards

1
Q

Parotid gland is serous/mucous acini

A

Serous

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2
Q

Location of parotid gland

A

Posterior aspect of the masseter, below the ear. Wraps around posterior border of mandible

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3
Q

What cranial nerve is related to parotid gland

A

Superficial/deep lobe divided by CN7 facial nerve

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4
Q

Describe Stenson’s duct and its opening

A

Duct for parotid gland.

6cm in length. Lies on masseter, turns medially at anterior border and pierces buccinator into oral cavity

Opening adjacent to maxillary second molar

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5
Q

Secretion of parotid gland controlled by

A

CN9

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6
Q

Sign of infection of parotid gland

A

Ear lobe raised

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7
Q

Size of submandibular gland

A

Walnut

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8
Q

Submandibular gland location

A

Partly superficial partly deep to the mylohyoid myscle

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9
Q

Relations and opening of duct for submandibular gland

A

Wharton’s duct

5cm
Opens into floor of mouth lateral to lingual frenum
Lingual nerve loops under Wharton’s duct

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10
Q

Submandibular gland is serous/mucous

A

Mixed

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11
Q

Histological appearance of submandibular gland

A

Serous demilunes

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12
Q

Size of sublingual gland

A

Almond

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13
Q

Location of sublingual gland

A

Superior surface of mylohyoid muscle

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14
Q

Sublingual gland open into

A

8-20 ducts open into floor of mouth or into submandibular duct

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15
Q

Innervation of sublingual and submandibular gland

A

CN VII through chorda tympani

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16
Q

Sublingual gland serous/mucous

A

Predominantly mucous

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17
Q

Blockage of sublingual gland ducts result in formation of

A

Ranula

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18
Q

Minor salivary glands found at

A 
Buccal mucosa
Labial mucosa
Lingual mucosa
Soft palate
Floor of mouth
Lateral portions of hard palate
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19
Q

Minor salivary gland function

A

Each cluster of minor salivary glands has an individual duct that leads to surface of mucosa, keeping mucosa moist with mucous saliva

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20
Q

Plain films of minor salivary glands can be used to show

A

Calcifications and stones

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21
Q

Sialogram: a portion of the duct does not show the dye

A

Stricture of duct, narrow and fibrosed hence not getting any dye. Clinically would get constant swelling of the gland

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22
Q

Sialogram appearance for Sjogren’s

A

T cells attack salivary gland. Acini dead, dye goes to the end of each acini. Fruit laden branchless tree appearance

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23
Q

What is sialadenitis

A

Salivary gland infection (acute/chronic)

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24
Q

Cause of sialadenitis

A

Viral or bacterial or fungal or mycobacteria; bacteria usually Staph Aureus (staph from skin/nasal cavity inoculated and transmitted to mouth lead to ascending infection)

Fluid balance changes eg dehydration

Blocked ducts; stones can cause recurrent sialadenitis

Decreased salivary flow eg dehydration, Sjogren’s, drugs

–> retrograde spread of bacteria through ductal system

25
Q

Mumps is caused by

A

Paramyxovirus (acute)

26
Q

Mumps is common in

A

children 3-8 years old

27
Q

Mumps is characterised by

A

Painful swelling of parotid/submandibular glands

Pain over affected glands
Fever, chills, headache

Begin 16-18 days after exposure, last 5-12 days

28
Q

Mumps is transmitted by

A

Urine, saliva, respiratory droplet

29
Q

Mumps patients are contagious from

A

Contagious from day 1 before clinical appearance of symptoms until 14 days after clinical resolution

30
Q

Complications of mumps

A

Meningitis, pancreatitis, nephritis, sterility

31
Q

MMR vaccine should be given at

A

infancy

32
Q

Treatment for mumps

A

Symptomatic care eg analgesics, antipyretics, hydration

33
Q

Treatment for acute bacterial sialadenitis

A

Symptomatic and supportive care – IV fluid hydration

Culture causative organism and give appropriate antibiotics

34
Q

Histologic feature of mycobacteria sialadenitis

A

Acid fast bacilli

35
Q

What is sialolithiasis and cause

A

Obstructive salivary gland disease; calcified structures develop within ductal system

Arise from deposition of calcium salts around nidus of debris

36
Q

Age range for sialolithiasis

A

Young and middle aged adults (never in children!)

37
Q

Which gland is sialolithiasis more common in and why

A

Submandibular gland because mucous and thicker

Duct has to loop over lingual nerve –> kink

38
Q

Sialolithiasis result in episodic pain in affected gland especially at

A

mealtimes

39
Q

What does sialoendoscopy do

A

Endoscopic transluminal of ductal system can remove stones up to 4mm diameter

Bigger stones have to be fragmented with Holmiun laser

40
Q

Cause of mucocele

A

Trauma –> rupture of salivary duct –> mucin spills into surrounding soft tissue

41
Q

Clinical presentation of mucocele

A

Bluish fluctuant swelling

Lower lip, ventral tongue, cheek

42
Q

Principle of excision of mucocele

A

Excision should include adjacent minor salivary glands

43
Q

Source of mucin spillage that causes ranula

A

Sublingual gland, wharton’s duct, minor salivary glands

44
Q

Ranula occurs in what demographic

A

Children and young adult

45
Q

Treatment for ranula

A

Marsupialisation

46
Q

Clinical presentation of neoplasm of salivary gland

A

Painless/dull ache

Firm to rubbery texture

47
Q

Parotid tumours are mostly benign or malignant

A

80% benign (pleomorphic adenoma)

48
Q

Large malignant tumour at parotid gland, how to excise

A

Remove whole gland with sacrifice of facial nerve

avoid enucleation and tumour spill

49
Q

Demographic of pleomorphic adenoma

A

4th-6th decade

F>M

50
Q

Behaviour of pleomorphic adenoma

A

Rarely, can get transformation to carcinoma ex pleomorphic adenoma

51
Q

Most common salivary gland neoplasm is

A

Mucoepidermoid carcinoma

52
Q

Demographic for mucoepidermoid carcinoma

A

3rd to 8th decade (peak at 5th)

F>M

53
Q

Low vs high grade mucoepidermoid carcinoma

A

Low: a lot of mucous cells, slow growing, painless

High: a lot of epithelial cells, rapidly growing, painful

54
Q

Where does adenoid cystic carcinoma mainly occur

A

Parotid gland and minor salivary glands

55
Q

Demographics for adenoid cystic carcinoma

A

5th decade

M>F

56
Q

Clinical presentation of adenoid cystic carcinoma

A 
Slow growing
Expansile
Dull pain
Paresthesia
Facial weakness (perineural invasion)
57
Q

Classic histologic appearance of adenoid cystic carcinoma

A

Cribiform swiss cheese appearance

58
Q

Treatment for adenoid cystic carcinoma

A

Complete local excision

Sacrifice of facial nerve due to tendency for perineural invasion

Oms (24 decks)

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