Salivary gland pathology

Question 1

Where is the nucleus for the parotid gland?

Answer 1

Inferior salivatory nucleus in medulla

Question 2

Preganglionic nerve for parotid gland

Answer 2

Preganglionic neurones of glossopharyngeal CNIX start here. Tympanic branch of CNIX forms tympanic plexus in middle ear cavity, from which arises the lesser superficial petrosal nerve, which goes to the otic ganglion.

Question 3

Postganglionic neurone of parotid gland

Answer 3

Fibres from otic ganglion rejoin the auriculotemporal nerve (CNV3)

Question 4

Where is the nucleus of the submandibular and sublingual gland?

Answer 4

Superior salivatory nucleus

Question 5

Preganglionic and postganglionic fibres of SLG and SMG

Answer 5

Preganglionic fibres join the nervus intermedius. Through the facial, fibres join the chorda tympani which join the lingual nerve. Reaches the submandibular ganglion. Postganglionic fibres go straight to SMG. Fibres go through lingual nerve to the SLG.

Question 6

how does saliva production vary during the day?

Answer 6

peak saliva production in the afternoon. minimal salivary production at night.

Question 7

what are the 2 modes of salivary production are recognised?

Answer 7

baseline/stimulated and stimulated

Question 8

what is serous saliva?

Answer 8

thin, water saliva

Question 9

what is mucous saliva?

Answer 9

thick saliva

Question 10

what saliva does the parotid gland produce?

Answer 10

serous saliva

Question 11

where are the minor salivary glands distributed?

Answer 11

lips, cheeks, palate, floor of mouth, retro-molar area, upper aerodigestive tract

Question 12

what controls the minor saliva glands?

Answer 12

under control of the ANS

Question 13

what are secretory acini composed of?

Answer 13

serous secretory cells or mucous secretory cells

Question 14

what do myoepithelial cells embrace the secretory units?

Answer 14

their contractions help to expel the secretions

Question 15

what do the units drain into?

Answer 15

terminal secretory units merge to form small intercalated ducts which are lined by secretory cells. intercalated ducts drain into large ducts called striated ducts. striated ducts drain into excretory ducts.

Question 16

what is the primary stage of saliva secretion?

Answer 16

occurs in acini. main stage of production secreted as fluid isotonic with plasma (true for serous acini)

Question 17

what is the secondary stage of saliva?

Answer 17

modification stage. occurs in striated ducts. ions are reabsorbed to produce hypotonic saliva containing less sodium and chloride, and more and carbonate than plasma.

Question 18

where does the sublingual salivary gland lie?

Answer 18

lies just deep to the floor of the mucosa of the mouth between the mandible and the genioglossus. bounded inferiorly by the mylohyoid muscle.

Question 19

what is the sublingual gland drained by?

Answer 19

it is drained by many small ducts

Question 20

how much of the secretions does the submandibular gland secretion?

Answer 20

secretes around 65% of unstimulated release
50% of stimulated secretions

Question 21

where does the submandibular gland lie?

Answer 21

submandibular triangle. gland forms the shape of a C around the anterior margin of the mylohyoid muscle

Question 22

what does the mylohyoid divide the submandibular gland into?

Answer 22

superficial lobe of submandibular
deep lobe of submandibular

Question 23

boundaries of the parotid gland?

Answer 23

superiorly - zygomatic bone
posteriorly - external auditory canal
inferiorly - styloid process, ICA, jugular veins
anterior border - anterior border of masseter muscle

Question 24

what space does the parotid gland lie?

Answer 24

80% overlies masseter and mandible
20% is the retromandibular portion - lies in the prestyloid compartment of the parapharyngeal space

Question 25

what are the 4 categories of salivary dysfunction?

Answer 25

disturbances of glandular flow
obstruction to flow of saliva
infections of tissues of the glands
neoplasms

Question 26

what is sialorrhea?

Answer 26

increase in salivary flow

Question 27

what can cause sialorrhea?

Answer 27

psychosis, mental retardation, neurological diseases, rabes, poisons

Question 28

what is xerostomia and what can cause it?

Answer 28

decrease in salivary flow
mumps, sarcoidosis, sjoegrens syndrome, lupus

Question 29

what causes sialorrhea?

Answer 29

increased secretomotor tone (increased parasympathatic tone)

Question 30

what is sjrogens syndrome?

Answer 30

causes dry eyes, dry mouth, dry joints
lymphocytic infiltration of salivary glands
autoimmune disease

Question 31

what can tumours of the parotid gland cause?

Answer 31

can lead to congestion within the parotid sheath leading to palsy of the motor branches of the facial nerve

Question 32

what is a plunging ranula?

Answer 32

an extravasation of saliva from the sublingual gland due to trauma or obstruction of the duct. fluid from the obstructed gland dissects between the fascial planes and muscle of the base of the tongue to the submandibular space

Question 33

what is sialosis?

Answer 33

sialosis refers to diffuse, non-inflammatory, non-neoplastic recurrent enlargement of a major salivary gland. it is uncommon and has a variety of systemic causes, e.g., diabetes or alcoholism

Question 34

what is sialadenosis?

Answer 34

chronic, bilateral, diffuse, non-inflammatory, non-neoplastic swelling of the major salivary glands that primary affects the parotids, occasionally involves submandibular but rarely involves the minors

Question 35

what is sialolithiasis?

Answer 35

calcium rich stones that form inside salivary glands. cause unknown.