salivary glands

Question 1

where are minor salivary glands present and what is the most common pathology present?

Answer 1

mostly mucous glands: 500-1000 glands all over mouth except gingivae and anterior hard palate

Commonest pathology is a mucus extravasation cyst due to trauma
treatment= excision with overlying mucosa + underlying glandular tissue

next most common pathology is: benign/malignant tumours
treatment = excision with a margin of normal tissue

Question 2

what are the major salivary glands and what is their purpose?

Answer 2

Parotid glands
Submandibular glands
. you can palpate these extra orally

Sublingual glands: only palpable intra orally

These glands only produce saliva at the thought of food or presence of it therefore when fasting there is increased likelihood of infection, minor salivary glands always produce saliva in the mouth

Question 3

describe the submandibular gland

Answer 3

1-the second largest gland
paired glands located in the submandibular triangles

2-encapsulated and covered by cervical fascia and stylohyoid ligament

3- drains via Wharton’s duct in the floor of mouth
4- mixed seromucous gland
5- the gland has a deep lobe that can be palpated intraorally.

Question 3

describe the parotid gland

Answer 3

1- the largest paired gland enclosed by fascia located in front of the ear beneath the ramus of the mandible

2-Stenson’s duct opens opposite the second maxillary molar tooth
3- mixed seromucous gland but predominantly serous: watery saliva
4- it is devided into two sections the superficial parotid gland 4/5 above the facial nerve and the deep parotid gland which has the facial nerve and makes up 1/5 of the gland the ala that sits behind the ramus of the mandible

5- it has important structures such as the facial nerve the maxillary artery the terminal branch of the external carotid artery and the superficial extension of the temporal artery and the the nerve is the orricular nerve

Question 4

What borders the submandibular gland?

Answer 4

Superiorly : the facial artery and vein, marginal branch of the inferior alveolar nerve
Anteriorly : head of the digastric muscles
Posteriorly: the stylohyoid ligament and muscle

Question 5

Describe the sublingual gland

Answer 5

smallest paired gland , lies in floor of mouth covered only by oral mucosa

drains via tiny ducts (Rivinis’s ducts) on the plica sublingularis or
a common duct which joins the submandibular duct (Bartholin’s duct)
mucous gland

Question 6

What is the commonest pathology to occur in the salivary glands?

Answer 6

1- Inflammatory disorders: such as viral (mumps, coxsackie,CMV, HIV), more commonly bacterial,
or uncommon :TB, sarcoid
2-radiation induced: xerostomia
3-obstruction/ trauma: commonly of the ducts
4-neoplasms
5- autoimmune/degenerative
Sjorgens Syndrome

Question 7

what is Sialadenitis?

Answer 7

Viral form of inflammation from the mumps virus (paramyxovirus)
Effects children most commonly bilaterally in the parotid and submandibular glands, self limiting

C.M.V - Most primary infections are asymptomatic, but severe disseminated disease may be seen in babies and immunocompromised eg transplant and HIV+ve patients.

H.I.V.

Question 8

what is the difference between a bacterial infection from a odontogenetic source or from a salivary gland source in terms of Tx?

Answer 8

if it is an odontogenic source you would excise and drain and then treat the tooth but if it from a salivary gland source you cannot as they are enclosed and the only way to drain is from the ducts therefore the tx in this case if it is from a bacterial source would be antibiotics