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GastroIntestinal > Salivary Glands > Flashcards

Salivary Glands Flashcards

1
Q

What are functions of saliva?

A

Lubricant for mastication, swallowing and speech

Oral hygiene
- Wash
- Immunity Antibacterial/antiviral/antifungal
- Buffer

Digestive enzyme
- Aqueous solvent necessary for taste

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2
Q

What pH does Oral pH need to be maintained at?

A

About pH 7.2
- Bicarbonate/carbonate buffer system for rapid neutralisation of acids

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3
Q

What is dysfunction of the saliva associated with?

A

Associated with oral pain, infections and increased risk of dental caries

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4
Q

What is the flow rate of saliva?

A

Flow rate from 0.3 to 7ml per minute

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5
Q

How much saliva is secreted daily?

A

Daily secretion of 800 – 1500ml in adults from major and minor glands

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6
Q

What is the pH range of saliva?

A

pH ranges from 6.2 to 7.4

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7
Q

What are the two types of oral secretion?

A

Serous secretion – α amylase – starch digestion
Mucus secretion – mucins for lubrication of mucosal surfaces

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8
Q

What type of secretion does the parotid gland secrete?

A

Serous

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9
Q

What type of secretion does the submandibular secrete?

A

Mucous and Serous

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10
Q

What type of secretion does the sublingual gland secrete?

A

Mucous and Serous

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11
Q

What type of secretion does the minor gland secrete?

A

Mainly mucous

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12
Q

What factors affect the composition and amount of saliva produced?

A

Flow rate
Circadian rhythm
Type and size of gland
Duration and type of stimulus
Diet
Drugs
Age
Gender

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13
Q

What is saliva?

A

Secretion of proteins and glycoproteins in a buffered electrolyte solution

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14
Q

How does saliva play its role as a major contributor to oral health?

A

Lubrication – mucous coat
Mechanical cleaning – flow
Buffering salts – neutralise acid
Remineralisation – Ca 2+ and PO43-
Defensive and digestive function - proteins

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15
Q

What proteins are found in saliva?

A

Proteomics and peptidomics of whole saliva

3652 proteins and 12,562 peptides detected to date
51% of proteins and 79% of peptides also contained in plasma

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16
Q

How does mucosa act as a defence?

A

Physical barrier

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17
Q

How do the palatine tonsils act as a defence?

A

Lymphocyte subsets + dendritic cells
– Immune surveillance and resistance to infection

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18
Q

How do the salivary glands act as a defence?

A

Saliva washes away food particles bacteria or viruses might use for metabolic support

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19
Q

How is immunity highlighted in the salivary glands?

A

Salivary glands are surrounded by lymphatic system
– linked to thoracic duct and blood

Broad range of functional immune cells

Oral mucosa and glands have high blood flow rate

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20
Q

What gland becomes the main source of saliva when its stimulated?

A

Parotid gland

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21
Q

Describe the structure of salivary glands

A

Composed of two morphologically and
distinct epithelial tissue
– acinar cells around
– ducts - collect to form large
duct entering the mouth

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22
Q

What are salivary glands equipped with?

A

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

i.e. just like any other secretory or
reabsorbing epithelia

23
Q

What are two types of acini?

A

Serous
Mucous

24
Q

What is serous acinus?

A

Dark staining
Nucleus in basal third
Small central duct
Secrete water + α amylase

25
Q

What is mucous acinus?

A

Pale staining - ‘foamy’
Nucleus at base
Large central duct
Secrete mucous (water + glycoproteins)

26
Q

What are intralobular ducts divided into?

A

Intercalated
Striated

27
Q

What are intercalated ducts?

A

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

28
Q

What are striated ducts?

A

Striated like a thick lawn.
Major site for reabsorption of NaCl

Appear striated at basal end
Basal membrane highly folded into microvilli for active transport of HCO3 against concentration gradient
Microvilli filled with mitochondria for energy to facilitate active transport

29
Q

What is primary saliva?

A

NaCl rich isotonic plasma-like fluid secreted by acini

30
Q

What is a function of the epithelium of the duct?

A

Doesn’t allow any water movement so final saliva becomes hypotonic

31
Q

What do the ducts secrete?

A

Ducts secrete K+ and HCO3-
and reabsorb Na+ and Cl-

32
Q

What are advantages of salivary glands?

A

Well-encapsulated, limiting undesirable spread of vector.

Luminal membranes of virtually every epithelial cell in SGs are easy to access in a relatively non-invasive manner

Ductal access of SGs uses a limited fluid volume that is not diluted or disseminated following delivery, enabling use of low vector doses.

Salivary epithelial cells are well differentiated and very slowly dividing, providing a relatively stable cell population for non-integrating vectors.

SGs normally make large amounts of protein for export, both exocrine and endocrine

A single SG is not crucial for life and can be removed in event of unexpected adverse effect with relatively little morbidity, cf liver or lung!!!

33
Q

What are the 2 general pathways for protein secretion?

A

Predominant
Constitutive

34
Q

What is the predominant pathway for protein secretion?

A

Leading to saliva (mucosal; across apical membrane)

35
Q

What is the constitutive pathway for protein secretion?

A

Leading mainly towards interstitium and bloodstream
(serosal; across basolateral membrane).

36
Q

What percentage of salivary flow comes from the major and minor salivary glands?

A

Major: 80%
Minor: 20%

37
Q

What are the minor salivary glands?

A

Submucosa of oral mucosa – lips, cheeks, hard and soft palate, tongue

38
Q

What are the major salivary glands?

A

Parotid
Submandibular
Sublingual

39
Q

What type of acini is found in the parotid gland?

A

Serous acini

40
Q

What type of acini is found in the submandibular gland?

A

Mixed and referred to as seromucous

41
Q

What type of acini is found in the sublingual gland?

A

Mixed but more mucous acini

42
Q

What is the parotid gland?

A

Superficial triangular outline between zygomatic arch sternocleidomastoid ramus of mandible + masseter and med pterygoid

Parotid duct: Stenson’s duct -crosses masseter, pierces buccinator and enters oral cavity at 7/7

Palpate a finger’s breadth below zygomatic arch

43
Q

What is the submandibular gland?

A

Two lobes separated by mylohyoid muscle

Larger superficial lobe

Smaller deep lobe in floor of mouth

Submandibular duct (Wharton’s duct) begins in superficial lobe, wraps round free posterior border of mylohyoid, runs along floor of mouth and empties into oral cavity at sublingual papillae.

44
Q

What is the sublingual gland?

A

Between mylohyoid muscle and oral mucosa of the floor of the mouth

No large duct – drains into submandibular (Wharton’s) duct and/or small ducts that pierce oral mucosa on the floor of the mouth

45
Q

Are minor salivary glands mucous or serous?

A

All minor salivary glands are mucous except serous glands of von Ebner

46
Q

What does the stimulation of parasympathetic nerves of salivary glands cause?

A

Production of a copious flow of saliva

47
Q

What does the stimulation of sympathetic nerves of salivary glands cause?

A

Causes secretion of protein and glycoprotein

48
Q

What is xerostomia?

A

Dry mouth

May be a consequence of cystic fibrosis or Sjogrens syndrome

Most common causes – medication and irradiation for head and neck cancers

High prevalence of caries and Candida infections

49
Q

What is salivary obstruction?

A

Saliva contains calcium and phosphate ions that can form salivary calculi (stones)

Most often in submandibular gland (c 80%)

Block duct at bend round mylohyoid [X] or at exit at sublingual papillae [X]

50
Q

What is inflammatory of salivary glands?

A

Infection secondary to blockage

Mumps (viral infection)
Fever, malaise
Swelling of glands
Pain especially over parotid because capsule
does not allow much enlargement

51
Q

What is degenerative of salivary glands?

A

Complication of radiotherapy to head and neck for cancer treatment

Sjogren’s syndrome
Mainly post-menopausal females
Also affects lacrimal glands
Rheumatoid arthritis may also be present

52
Q

What is the side effect of drugs on the salivary glands?

A

The most common dysfunction you will encounter

About 500 prescription drugs have a sympatheticomimetic effect

Act on NA receptors or inhibit parasympathetic action at ACh receptors

53
Q

What are the effects of salivary gland dysfunction?

A

If salivary output falls to < 50% of normal flow patient experiences xerostomia (dry mouth)

Low lubrication – oral function difficult

Low (natural) oral hygiene – poor pH control
Accumulation of plaque =>Rampant dental caries, gingivitis and periodontal disease
Opportunistic infections esp. fungal infections (candida = thrush)

GastroIntestinal (19 decks)

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