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Oral Med > Salivary Glands > Flashcards

Salivary Glands Flashcards

1
Q

E/O checks for salivation issues

A

Palpate parotid and submandibular

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2
Q

I/O checks for salivation issues (4)

A

Duct orifices
Minor salivary glands
Fluid expression
Quality of saliva

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3
Q

Functions of saliva (4)

A

Acid buffering (neutralises)

Lubrication for speech + swallowing

Taste

Antibacterial

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4
Q

List some causes of a dry mouth (5)

A

Medications - Ca channel blockers, antihypertensives

Dehydration

Salivary gland disease

Somatisation disorders + anxiety

Radiotherapy/chemotherapy

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5
Q

List medical conditions that induce saliva reduction indirectly (5)

A

Diabetes

Stroke

Addisons disease

VBD

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6
Q

List medical conditions that induce saliva reduction directly (problems with gland itself) (5)

A

Aplasia - ectodermal dysplasia

Sarcoidosis

HIV

Gland infiltration - amyloidosis

CF

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7
Q

What part of body affected by ectodermal dysplasia? (5)

A

Hair
Nails
Teeth
Sweat glands
Salivary glands
Hearing + vision

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8
Q

Name a scale used to measure mucosal dryness

A

Challacombe scale of mucosal dryness

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9
Q

Investigations for Salivary disease (5)

A
  • Blood tests
    FBCS
    U+Es
    LFT
    C reactive protein
    Glucose
    Anti-Ro antibody
    Anti-la antibody
  • Functional assays - salivary flow
  • Tissue assays - labial gland biopsy
  • Imaging
  • Plain radiographs
  • Sialography
  • Ultrasound
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10
Q

Function of sialography

A

Contrast to show ducts

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11
Q

Disadvantage of sialography

A

Ionising radiation

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12
Q

Risk of labial gland biopsy

A

Lip numbness

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13
Q

How does anxiety reduce saliva flow?

A

Inhibits salivary production by brain

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14
Q

What is a somatoform disease?

A

Mental health condition
Cause physical body symptoms in response to psychological stress

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15
Q

Examples of somatoform disease

A

IBS
TMD
Oral dysaesthesia

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16
Q

Unstimulated saliva flow

A

<1.5ml in 15 mins = hypo salivation

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17
Q

Untx causes of dry mouth

A
  • Sjogrens
  • From cancer tx
  • From salivary gland disease
18
Q

Dry eye test for dry mouth

A

Schirmer test tear flow <5mm in 15mins

19
Q

Examples of salivary substitutes

A

Sprays
Glandosane (acidic)
Orthana (encouraged)

Stimulants
Pilocarpine (sweating/taccychardia)

20
Q

Medical condition causes of hyper-salivation

A

Dementia
Stroke
Anxiety
Cerebral palsy

21
Q

Medications that can cause hyper-salivation (3)

A

Clozapine
Ketamine
Bromides

22
Q

Treating hyper salivation

A

Botox
Anxiety - tx
Antimuscarinic agents

23
Q

List some reasons for changes in gland size

A

Viral infection - herpes/mumps
Secretion retention - mucoceles/obstruction
Gland hyperplasia
Salivary neoplasms
Sialadenitis - infection

24
Q

Symptoms of mumps (6)

A
  • High temp
  • Nausea
  • Loss of appetite
  • Abdominal pain
  • Headache
  • Joint pain
25
Q

Common feature of duct obstruction

A

Swelling increases with meals
Usually submandibular as ductal pathway longer

26
Q

Investigations for duct obstruction

A

Low dose plain radiograph
Lower true occlusal - submandibular
Ultrasound

27
Q

Cause of duct obstruction

A

Sialolith
Mucous plugging
Duct stricture - due to infection/damaged duct

28
Q

Histopathology of non specific sialadentitis

A

Fibrous scar tissue

29
Q

Management of subacute obstruction

A

Surgical sialolith removal
Sialography for no stone cases - dye to wash mucous plug away

30
Q

Define sialolis

A

Chronic painless swelling of major salivary gland - usually parotid

31
Q

Define Sjogrens Syndrome

A

Autoimmune disease that causes loss of salivary/lacrimal tissue through T lymphocytic inflammatory destruction

32
Q

Classifications of Sjogrens

A

Partial
- Sicca syndrome
- Dry eyes or mouth

Primary
- No connective tissue disease

Secondary
- Connective tissue disease

33
Q

Systemic diseases Sjogrens is linked to

A

RA
Lupus
Scleroderma

34
Q

Consequences of Sjogrens

A
  • 5% malignancy risk of lymphoma
  • Inc caries/oral infection/functional issues - speech+ swallow
  • Enlargement of salivary glands
35
Q

Immunopathology findings of Sjogrens

A

Lymphocytic focci within salivary tissue from labial gland biopsy

36
Q

Sialography findings of Sjogrens

A

Snow storm
Leopard spots

37
Q

What is used to help confirm diagnosis of Sjogrens?

38
Q

Oral symptoms of sjogrens

A

Dry mouth >3mths
Swelling of salivary glands

39
Q

Ocular symptoms of sjogrens

A

Dry eyes >3mths
Sand/gravel in eyes
Eye drops >3x a day

40
Q

Criteria of AECG required

A
  1. Dry eyes/mouth
  2. Histopathology - focci present
  3. AntiRo/La
  4. Ultrasound
41
Q

Management of Sjogrens

A

OHI
Spray/stimulant

If present early lease with rheumatologist and consider immune modulating drug Hydroxychloroquine

Oral Med (19 decks)

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