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OBIOL 305 > Salivary Glands > Flashcards

Salivary Glands Flashcards

1
Q

When should you suspect a salivary gland disorder?

A
  • when there is localization of swelling, ulceration, pain or sensitivity to a salivary gland bearing region
  • disruption of salivary gland function
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2
Q

What are the two major types of glands?

A

Exocrine and endocrine

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3
Q

Describe the types of exocrine glands.

A

Holocrine - whole gland breaks down to create secretion (ex. ear wax)

Apocrine - bits of cell shed off

Merocrine - cells excreted by exocytosis from secretory cells into ducts

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4
Q

What are the characteristics of salivary glands?

A
  • merocrine
  • tubuloalveolar shaped secretion unit
  • compound branching system
  • cell types include: mucous, serous, myoepithelium
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5
Q

Name the three major salivary glands and the ducts they drain through.

A
  • Parotid gland: Stensen’s duct
  • Sublingual gland: Bartholin’s duct
  • submandibular gland: Wharton’s duct
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6
Q

Name some minor salivary glands and their locations.

A
  • Mucous and serous glands of lateral ventral tongue
  • Von Ebner’s glands - glands around circumvallate papillae
  • mucous and mucoserous glands of cheek and lip
  • mucous and mucoserous glands of posterior lateral hard palate, soft palate and uvula
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7
Q

Where will you not find glands?

A
  • Tongue dorsum
  • Anterior hard palate
  • Gingiva
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8
Q

What is sialadenitis?

A
  • inflammation of a salivary gland, may be chronic or acute
  • may be caused by microbial factors, obstructions, decreased secretion, change in salivary composition, radiation, idiopathic
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9
Q

What is a sialolith?

A

Salivary gland stone

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10
Q

What is sialadenosis?

A
  • Non-inflammatory, non-neoplastic englargement of the salivary glands
  • usually bilateral, with parotid involvement
  • asymptomatic
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11
Q

What is a common cause of sialdenosis?

A
  • caused by hypertrophy of acinic cells or infiltrate of fat cells into gland
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12
Q

What is sialdenosis usually associated with?

A

a systemic disorder:

  • alcoholism, malnutrition
  • bulimia, anorexia nervosa
  • hormonal disorders (esp. diabetes)
  • drug reactions
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13
Q

What is a benign lymphoepithelial lesion?

A
  • a swelling caused by an autoimmune process in which the acini are replaced with lymphocytic infiltrate
  • usually there are persisting epithelial island
  • presents as diffuse or discrete, bilateral or unilateral
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14
Q

Benign lymphoepithelial lesions have an association with the development of what?

A

Lymphoma or anaplastic carcinoma - in inuit

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15
Q

Differentiate between primary and secondary Sjorgen’s syndrome.

A

Primary: dry eyes and dry mouth

Secondary, Dry eyes and dry mouth assocaited with an autoimmune connective tissue disease (usually rheumatoid arthritis)

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16
Q

Is Sjorgen’s more likely to affect men or women?

A

Women (middle-aged)

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17
Q

Involvement of minor mucous glands in Sjorgen’s can lead to what?

A

Epistaxis, otitis media, bronchitis and pneumonia

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18
Q

Describe some oral complications associated with Sjorgen’s syndrome.

A
  • diffuse salivary gland enlargement (~50% of patients)
  • xerostomia
  • dental and periodontal problems
  • denture problems
  • susceptibility to infections
  • angular cheilitis
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19
Q

How does sialography work in the diagnosis of Sjorgen’s?

A
  • After injection of contrast medium into the gland, a radiograph is taken. A “cherry blossom” appearance of the medium is indicative of Sjorgen’s.
20
Q

What antibodies are characteristic of Sjorgen’s in serology testing for diagnosis?

A
  • rheumatoid factor
  • antinuclear antibodies
  • anti-SS-A (Ro antigen) and anti-SS-B (La antigen) show the strongest correlation
21
Q

A lump usually found on the posterior palate caused by excess glandular tissue which histologically appears as normal is indicative of what condition?

A

Hyperplasia of mucous salivary glands

22
Q

This condition appears as a cratered ulcer, usually presenting in the posterior palate, which usually resolves in 5-6 weeks. What is it?

A

Necrotizing sialometaplasia - often misinterpreted of squamous cell carcinom

23
Q

Describe the two types of mucoceles.

A

Mucous extravasation cyst - a submucousal swelling which is caused by disruption of the duct

Mucous retention cyst (Salivary duct cyst) - a submucousal swelling which is caused by obstruction of the duct

24
Q

What is a ranula?

A
  • a blue pigmented swelling, mucous extravasation cyst in the floor if the mouth
25
Q

Histologically, how can you differentiate between a mucous extravasation and a mucous retention cyst?

A

Mucous extravasation has chronically inflammed fibrous tissue and granulation tissue.

Mucous retention has an intact epithelial lining

26
Q

Gland destruction or aplasia following radiaiton, secondary to sugery or infections, Sjorgen’s syndrome, medications are all possible causes of what?

A

Xerostomia

27
Q

Xerstomia leads to increased incidence of what conditions?

A
  • secondary infections (Candidiasis)

- dental caries (root or cervical)

28
Q

What is sialorrhea?

A

Excessive salivar

29
Q

What causes sialorrhea?

A

Anything that enhances the activitiy of acetylcholine receptors will cause saliva production.

Possible that normal amounts of saliva are being produce, but poor control of swallowing makes it seem as though there is too much

30
Q

Name two disorders that affect swallowing and may lead to sialorrhea.

A

Cerebral palsy and Parkinson’s disease

31
Q

What examples of local irritation may cause sialorrhea?

A

Poor fitting dentures, canker sores

32
Q

Name the four common causes of sialorrhea.

A
  1. Gastroesophageal reflux disease
  2. Medications
  3. Heavy metal poisoning
  4. Idiopathic
33
Q

What percentage of head and neck tumors are salivary gland neoplasms?

A

3% - most common in parotid gland, then submandibular=minor salivary glands, follow by sublingual

34
Q

What is the most common benign salivary gland neoplasm?

A

Pleomorphic adenoma - benign mixed tumor

35
Q

Where are pleomorphic adenoma most common in the oral mucosa?

A

posterior palate and upper lip

36
Q

What cell types are pleomorphihc adenomas derived from?

A

myoepithelial cells and duct cells

37
Q

Can a pleomorphic adenoma undergo malignant transformation?

A

Yes

38
Q

What are the three most common types of salivary gland neoplasms?

A
  • Pleomorphic adenoma
  • Mucoepidermoid carcinoma
  • Adenoid cystic carcinoma
39
Q

Which salivary gland neoplasm is the most common in children?

A

mucoepidermoid carcinoma

40
Q

What are three configurations that mucoepidermoid carcinomas may assume?

A

solid, duct-like or with small cystic spaces

41
Q

What configuration has the best survival rate?

A

ones with higher proportions of cystic spaces - considered “low grade”

42
Q

How is an adenoid cystic carcinoma formed?

A

by masses of uniform cells dervied from duct epithelium

43
Q

What configurations can an adenoid cystic carcinoma take on?

A

irregular cystic and duct like

44
Q

What is a consistent feature of adenoid cystic carcinomas?

A

perineural invasion - main reason this tumor is very persistent

45
Q

What site makes the prognosis of an adenoid cystic carcinoma worse?

A
  • if the origin is in a minor salivary gland site

OBIOL 305 (9 decks)

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