Salivary Glands Flashcards
Salivary duct anatomy
acinus (surrounded by myoepithelial cells)
⇒ intercalated duct
⇒ striated duct
⇒ excretory duct
Saliva electrolytes
High K
Low Na
Parotid saliva
Watery (high serous cells)
High enzymes
Low mucin
SMG / SLG saliva
SMG - mixed serous and mucin
SLG - mostly mucin
Antibacterial activity of saliva
IgA
lysozymes
leukotaxins
opsonins
Granulomatous (infectious) sialadenitis causes
Frequent in HIV Actinomycosis Cat scratch Sarcoid TB Wegener's
Heerfordt’s disease
uveoparotid fever (sarcoid) =
- uveitis
- mild fever
- non-suppurative parotitis
- CN 7 paralysis
Sjögren disease Rx
Pilocarpine (Salagen)
— cholinergic agonist for post-XRT and SD
Cevimeline (Evoxac)
—cholinergic agonist for SD and second-line for post-XRT
Post-XRT Xerostomia Rx
Amifostine - chemoprotectant
Pilocarpine (Salagen)
Cevimeline (Evoxac)
Pleomorphic adenoma (benign mixed tumor) histo
epithelial
myoepithelial
stromal elements
Warthin histo
papillary cystadenoma lymphomatosum
Oncocytoma histo
sheets, nests, or cords of oncocytes (granular-appearing cells)
Mucoepidermoid ca histo
Low
- Higher ratio of mucous to epidermoid cells
- Presence of cystic spaces
High
- Higher ratio of epidermoid to mucous cells
- May resemble SCCA
MC parotid ca
Mucoep
MC SMG and minor SG ca
Adenoid cystic
Adenoid cystic histo
Types:
- Tubular (best)
- Cribriform
- Solid (worst)
Acinic cell histo
Serous acinar cells and cells with clear cytoplasm
Well circumscribed and surrounded by fibrous capsules
Calcification may be prominent
Frey syndrome pathophys
Parasympathetic salivary nerves from the auriculotemporal nerve innervate the sweat glands of the skin flap
Frey syndrome Dx
Minor’s starch-iodide test
Frey syndrome Rx
topical antiperspirant
topical glycopyrrolate
topical atropine
