salivary glands Flashcards

1
Q

what is seen in patients with sever hyposalivation

A

increased incidence of caries

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2
Q

hyposalivation

A

reduced salivary flow (2/3 typical)

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3
Q

symptoms of decreased salivary loss

A
Xerostomia
Mucosal changes
Enamel erosion
Increased caries
Difficulty swallowing
changes in tatse
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4
Q

subjective feeling of dry mouth

A

Xerostomia

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5
Q

Genic cause of dry mouth

A

Rare

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6
Q

systemic disease for dry mouth

A

Mups
Sjogren’s
Diabetes mellitus
HIV

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7
Q

Medication causing dry mouth

A

Anti-cholinergic, diuretics, antidepressants, antihistamines, antihypertensives

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8
Q

what is largelt responsible for prevalence of dry mouth in elderly patients

A

age kinda, but mostly medication

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9
Q

mdical treatment that cuases dry mouth

A

Head and neck radiotherapy

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10
Q

efects of head and neck radiotherapy on salivation

A

rapid(days) and long lasting

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11
Q

initial effect of radiotherapy on salivation

A

reduced gland function

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12
Q

later effects of head and neck radiotherapy

A

cell death, primarily acinar cells

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13
Q

how do we try and spare salivary function from radiotherapy

A

newer radiation therapies for specific target tumor site

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14
Q

therapies to aid in saliva production

A

genetic modification of remaining salivary tissue

Stem cell

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15
Q

stem cel use for salivary flow

A

clauster of saliva secreting cells (Acinus-like) grown invitro from stem cells in the parotid gland

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16
Q

mangement of hyposalivation

A

frequent dental evaluation and prophylaxis due to prevalence of complication
artifical saliva
salivary stimulants

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17
Q

what must be checked for hyposalivation patients

A

caries
oral lesions
oral candidias

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18
Q

what are some artificial salivas

A
mucopolysaccharide (MouthKote)
Glycerate polymer (Oral balance
Hydroxyethylcellose( salivart, oralube, xerolube)
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19
Q

salivary stimulants

A

sugarless candies, chewing gum

secretatgogus (agonist for cholinergic muscarinic receptors)

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20
Q

Major functions of saliva

A
Protection
Buffering
Tooth integrity
antimicrobial
tissue repair
Digestion
taste
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21
Q

how does the saliva protect

A

Lubrication and protective barrier (mucins)

clearance of bacteria and sugar

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22
Q

how does the saliva buffer

A

Neutralization of acids and pH maintenanec (bicarbonate)

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23
Q

how does the saliva aid in tooth integrity

A

Enamel maturation via calcium binding proteins (proline rich proteins and statherin)

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24
Q

what does the saliva has as an antimicrobia

A

Lysozyme, peroxidase, defensins, histatins

Iga (agglutination of microorganisms, anti-viral)

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25
Q

what does the saliva do for tissue repair

A

growth factors

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26
Q

what does the saliva do for digestion

A

lubrication, swallowing: mucins

Enzyme digestions: amylase, lipase

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27
Q

what does the saliva do for taste

A

Dissolves stimuli for transport to taste recetpors: water

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28
Q

what kind of gland is the salivary gland

A

Exocrine glands

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29
Q

unstimulated saliva rate

A

.2-.4 per min

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30
Q

how much saliva is in the mouth

A

1ml as a thin film that coats everything

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31
Q

stimulated saliva rate

A

2-5 per min

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32
Q

saliva flow during sleep

A

decreases during sleep

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33
Q

what are the major saliva glands

A

Parotid gland
submandibular
sublingual

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34
Q

what are the minal saliva glands

A

Von ebners gland

Labial, palatal, buccal, lingual

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35
Q

what innervates the parotid

A

IX

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36
Q

what inneravtes the submandibular

A

VII

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37
Q

what innervates the sublingual

A

VII

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38
Q

what innerates von ebner glands

A

IX

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39
Q

what does the parotid gland make

A

serous (watery), amylase

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40
Q

what does the submandibular make

A

mixed, mostly serous

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41
Q

what does the sublingual make

A

Mixed, mostly serous

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42
Q

what does von ebner gland make

A

Lingual lipase

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43
Q

what does labial, palatal, buccal, lingual

A

Mucins

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44
Q

saliva flow percentatge from the major glands

A

60: parotid
25: submandibular
7-8: sublingual

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45
Q

what does the parotid have to have saliva leave

A

stensons duct

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46
Q

largest salivary gland

A

Paroid

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47
Q

GR for parotid

A

14-28

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48
Q

GR for submandibular

A

10-15 GR

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49
Q

what does the submandibular have to have saliva leave

A

Wharton’s duct

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50
Q

GR for sublinual

A

2 GR

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51
Q

ducts of sublingual

A

Rivinius and Bartholin’s duct

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52
Q

the functional component of the salivary gland

A

Parenchyma

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53
Q

the supporting components of the salivary gland

A

Stroma (Connective tissue

54
Q

ducts going to the eventual outside of gland

A

Intercalated
Striated
Collection

55
Q

curoudns the salivary gland

A

Capsule

56
Q

infoldings of the salivary gland

A

Septa

57
Q

what does the septa do

A

Divides gland into lobes (major larger divisions) and lobules (minor smaller divisions)

58
Q

what does the stroma contain

A
Fibroblasts (produce collagen)
Blood vessels (supply parenchyma)
Nerve fibers (supply parenchuma)
Plasma cells (Secrete antibodies)change in the stroma over age
fat cells
59
Q

how do fat cells change with age

A

increases

60
Q

what makes up the parenchyma

A

Acini (secretory endpieces) and ducts

61
Q

where are serous acini found

A

PArotid gland

62
Q

where are mucous acini found

A

minor glands

63
Q

where are mixed acini found

A

submandibular and sublingual

64
Q

when is the parotid initiated

A

4-6 week IU

65
Q

where does the submandibular initiate

A

week 6 IU (end)

66
Q

when does the sublingual and minor glands initiate

A

week 8-12

67
Q

when does acinar cell mature

A

during last 2 months of gestation

68
Q

how long does salivary gland growth continue

A

2 years postnatal(especillay acinar cells)

69
Q

parenchuma orgin of salivary glands

A

parotid: ecotderm
submandibular: ectoderm
minor: endoderm

70
Q

strom origin of salivary glands

A

Neural crest

71
Q

stesp ofsalivary gland development

A

Protrusion of epithelial cells in mesenchyme
BUd formation
branching Morphogenesis
branching morphogenesis continues, cavitation (forming ducts)
terminal differntaitionL maturation of ducts then acinar (secretory) cells

72
Q

what type of interaction is important for salivary gland development

A

heterotypic tissue interactions

73
Q

examples of heterotypic tissue interactions for salivary glands

A

Epithelial-mesenchymal signalling

Neural-epithelial signaling

74
Q

do salivary gland development pathways repleaste

A

yes, and similar as those used in tooth development

75
Q

what part of acini are H2O permiable

A

acinar cells are H2O permiable and Duct cells are not H2O permiable

76
Q

roll of Acinar cells

A

Primary secretsion

77
Q

rollof duct cells

A

Secondary secretion

78
Q

what do the Acini cells secrete

A

water, ions, (Na+ and Cl-) proteins

79
Q

tonicity of acinar cells

A

Isotonic

80
Q

action of duct cells

A

resob NA and Cl
secrete bicarbonate
secrete proteins

81
Q

tonicity of duct cells

A

Hypotonic

82
Q

How does the sympa system reach the salivary gends

A

starts in teh intermediolateral nuclasus
sympa trunk
superior cervical ganglion
all glands

83
Q

parasympa for salivary glands

A

Salivary nucleus
VII: palate and nsoe galnds, sublingusal, submandibular
IX: parotid, von ebner

84
Q

sympathetic control of salivary secetion

A

NE binds to beta-adrenergic receptor (GPCD)
adentlate cycalse, cAMP, pka
PKA phosphorylates secretory granules
Granules released

85
Q

saliva secreted due to sympathetic

A

Protein-rich
viscous
scant

86
Q

saliva secereted from parasympathetic

A

watery

copious secretion

87
Q

how does Parasympa control saliva

A

Ach binds to muscarinic receptors (GPCR)
PLC, IP3, Ca++
Ca++ opens Cl- channels
Cl- flows to lumen to created osmotic/electric gradient
Na+ and water follow by paracellular and transcellular

88
Q

how is Cl- kept in the salivary galnd cells

A

maintained at a high intracellular concentration using an energy-requiring pump

89
Q

what mkes up the major part of generalized acini

A

Cluster of Acinar cells surrounding a central lumen

90
Q

spaces between acinar cells in generalzied acini

A

Intercellular spaces

91
Q

junctions between acinar cells in generalized acini

A

Tight
desmosomes
gap

92
Q

othercells of generalized acini

A

Myopeithelial cells

93
Q

what surrounds generalized acini

A

Basal lamina

94
Q

morphology of serous acinar cell

A

Pyramidal shape resting on basal lamina with short irregular microvilla

95
Q

what does Serous acinar cell look like

A

like apolarized protein secreting cells

96
Q

what does a serous acinar cell secrete

A

enzymes and glycoproteins - packaged in secretory granules

97
Q

protein machinery of serous cells

A

well defined
Rer
Golgi apparatus
Secretory Granules

98
Q

Morphology of mucous cells

A

Cuboidal to columnar

Oval nuclei pressed toward the base

99
Q

how are mucous cells arranged around the lumen

A

arranged in tubules around a larger central lumen

100
Q

what do mucous cells secrete

A

mucins (high molecular wt, heavily glycosylated glycoprotein, for lubrication)

101
Q

how do mucous cell stain

A

secretory granules pale staining

cytoplasm pale

102
Q

serous demilune is found where

A

present in mixed glands

103
Q

what is a serous demilune

A

mucous acinus, topped by a cluster of serous cells

104
Q

what does a serous demilune result from

A

Conventional fixation

105
Q

what happens when a serous demilune is rapidly frozen

A

serous and mucous cells side by side

mucous nuclei also not compressed

106
Q

do mucous cells always stain pale

A

no depends on the stain

107
Q

where are myoepithelial cells found

A

surrounding the acini and intercalated ducts but within the basal laimina

108
Q

features of myoeptihelial cells

A

processes that curround multiple secretory cells in an acinus and intercalcated ducts

109
Q

what cells are myoeptihelial cells similar to

A

similar to smooth muscle but derived from epithelium

110
Q

what are the processes of myoepithelial celsl filled with

A

actin and soluble myosin

111
Q

innneravtion of myoepithelial cells

A

neuraly innervated

112
Q

roll of myoeptihelial cells

A

facilitate movement of saliva into the ductal system

113
Q

what ducts do major salivary glands have

A

all 3 types

114
Q

what ducts do minor salivary glands have

A

intercalated sometimes observed
Striated absent
exretory main type

115
Q

the smallest duct

A

Intercalated duct

116
Q

how many acini drain into an intercalated duct

A

several acini drin into intercalated duct

117
Q

Morphology of intercalated duct

A

cuboidal

cental nucleus

118
Q

what does the intercalated duct secrete

A

a few proteins

119
Q

size/activity of striated duct

A

longer and more active duct

120
Q

why is stuff reabsorbed in a striated duct

A

converts isotonic (primary saliva) into hypotonic (secondary saliva)

121
Q

how does striated duct absorb

A

against concentration gradient using ATP

122
Q

what is secreted in the straited duct

A

proteins

bicarbonatetd

123
Q

Morphology of the striated duct cell

A
Columnar
polarized
short microvilli
numerous infolding of basolateral membrane (striations)
prominent mitochondria
124
Q

purpose of excretory duct

A

Plumbing

125
Q

what makes up the excretory duct

A

series of connecting ducts becoming progressivel wider

126
Q

epithelium of excretory duct

A

changes from single epithelial layer to pseudostratified epithelium
eventually keratinized

127
Q

where is the excretory duct found

A

located in connective tissue

128
Q

lumen shape of the excretory duct

A

irregularly shaped

129
Q

morphology of excreoty duct cells

A

irrgularly positioned nuclei

pseudostratied

130
Q

where are exretory ducts found

A

in the septa

131
Q

what surrounds the excretory duct

A

fibroblasts

132
Q

what else might be found in the excretory duct

A

goblet cells(screting mucous)