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General Health and Disease (GHD) > Salivary Glands > Flashcards

Salivary Glands Flashcards

1
Q

Functions of saliva?

A 
Protection:
- lubrication, barrier and clear sugar
Buffering:
- protect demineralisation 
Pellicle:
- Ca binding
Maintenance of tooth integrity:
- Ca and Pi supersaturation
Antimicrobial:
- prots and peps with antibacterial
Tissue repair:
- GFs
Digestion:
- breakdown food with enzymew
Taste:
- bind to taste substances
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2
Q

Salivary glands - Types of saliva?

A

Serous:
- watery, from parotid and submandibular
Mucous:
- slimy, from sublingual and minor glands

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3
Q

Salivary glands - Name the major glands - cell type? Position? Duct? Innveration (para and symph)?

A

Parotid:
- pure serous, in front of the external ear, from the Stensen’s duct and innervated by IX
Submandibulae:
- mixed cell type mainly serous, posterior pairt of the floor of the mouth, from the Wharton’s duct and innervated by VII
Sublingual:
- mixed but mainly mucous, anterior part of the floor of the mouth, from the Ducts of Rivinus, innervated by VII
Symph: all via the superior cervical ganglion

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4
Q

Salivary glands - minor salivary glands - #? Secretion type? Location? Names?

A 
#:
- 600-1000
Secretion type:
- mucous
Location:
- virtually everywhere except gingival and alveolar mucosae 
Names:
- labial, buccal, palatal and lingual
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5
Q

Salivary glands - general structure - fruit comparisons and what it relates too?

A

Similar to a bunch of grapes

  • grapes; secretary end pieces (acini)
  • stems; ducts
  • air; CT
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6
Q

Salivary glands - type of ducts - names? CT location?

A

Intercalated duct
Striated duct
Secretary duct
CT is located surround the ducts

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7
Q

Salivary glands - structural units of a salivary gland - epith? (Main part? Ducts? Special cells?) And CT? (Main part? Speta role? Location? Carries?)

A 
Epith:
- secretary end-pieces 
- ducts (intercalated, striated and secretory)
- myoepith; on acini and ducts
CT:
- capsule
- speta; divide gland into lobes and lobules 
- surrounded all epith units 
- carries; blood and nerve supply
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8
Q

Salivary glands - lobes and lobules- created by? Differences?

A

Lobes:
- largest unit and separated by thick speta
Lobules:
- smaller
- separated by thin speta
- contains intercalated and striated ducts (intralobular ducts)

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9
Q

Salivary glands - functional arrangement of a salivary gland - anatomy? Intra to interlobular

A

Intralobular:
- serous acinus, mucous acinus (myoepith cell) and serous demilune, intercalated duct leading to the striated duct
Interlobular:
- collecting duct

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10
Q

Salivary glands - development of salivary glands - starts? Gland derivatives? CT derivatives?

A 
Starts during the 6th week (parotid)
Parotid and most minor gland:
- from the ectoderm
Submandibular: ectoderm
Sublingual: endoderm
All lingual minor glands: endoderm
CT:
- probably ectomesenchyme
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11
Q

Salivary glands - development of salivary glands - 8 weeks - Initiation? Activates? Formation? Final stage? Cellular differentiation depends on? Age changes?

A

Initiation:
- start via epith-mesenchymal interactions
Activation:
- this allows epith prolif, until forms a lobule shape
Formation:
- lobule formation
Final stage:
- epith canalisation (form the ducts via epith) and cellular differentiation
Continous process until 2 years old
Cellular diff:
- epith-mesenchymal inter
- nerves: symph and para (influence overall growth of gland)
- form secretory cells (epith cells) and myoepith
Age changes:
- increased fat cells

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12
Q

Salivary gland - resting secretion - when it occurs? Role?

A

It occurs:
- throughout day and night
Role: mouth and oro-pharynx
- most, lubricated and protected

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13
Q

Salivary gland - volume of saliva? Flow rate equation? Rate (unstim vs stim)?

A 
Volume:
- 500-750 ml/day
(90% major)
Great variability between individual
Flow rate:
- volume (ml) ÷ time (mins) 
Unstim: 0.3ml/min (mainly submandibular)
Stim: 1.75ml/ml (mainly parotid and submand)
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14
Q

Salivary gland - anatomy?

A

Anatomy:

- acinus, capsule, septum, lobe, secretory units, and ducts (intercalalted, striated and collecting)

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15
Q

Salivary gland - acinar cells - what are they? Role? Specialised shape? Cell types?

A 
What are they:
- cells comprising of acinus (secretory end piece)
Role:
- saliva production (serous or mucous)
Specialised shape:
- pyramidal shaped cells for function
Cell types:
- serous acinus, mucous acinus and serous demilune
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16
Q

Salivary gland - serous acinus cells - nuc location? RER? Cytoplasmic apperance? Discharge secretions where?

A 
Nuc loc:
- basal part of cell
RER:
- basophilic 
Cytoplasmic apperance:
- granular
Discharge secretion:
- into tubular lumen via intracellular canaluculi running between the cells
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17
Q

Salivary gland - mucous acinar cells - cytoplasm (stain)? Nuc? Granules?

A 
Cytoplasm:
- pale, mucin lost or not easily stained, cytoplasm can appear empty in a H&E stain
Nuc:
- flattened nuc
Granules:
- large mucin granules
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18
Q

Salivary gland - serous demilunes - what is it? Location? Discharge?

A 
What is it:
- crescent of serous cells 
Location:
- mucous acinus capped by serous cells
Discharge:
- via the intercellular canaliculi between the mucous cells
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19
Q

Salivary gland - myoepithelial cells - located? Shape? Grouping? Process #? Function?

A 
Located:
- on acini and intercalated ducts
Shape:
- star shaped 
Grouping:
- 1,2 or 3 cells in each salivary body 
Process #:
- 4-8 processes
Function:
- contractile elements 
- squeeze acinus (aid secretion)
- regulate duct lumen size
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20
Q

Salivary gland - intercalated ducts - type of cell? Nuc?

A

Type of cell:
- low cuboidal cells
Nuc:
- large central nuc

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21
Q

Salivary gland - striated ducts - not present? Cell shape? Mod? Folding?

A 
Not present:
- sublingual glands
Cell shape:
- columnar shaped cells
Modificiation:
- of primary saliva 
Folding:
- massive basal membrane folding
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22
Q

Salivary gland - collecting ducts - lumen? Cell type? Merges?

A 
Lumen:
- large lumen
Cell type:
- pseudostratified columnar epith
Merges:
- stratified near termination merges with stratified squamous oral epith
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23
Q

Salivary gland - histology - parotid composition? Submandibular composition? Sublingual composition?

A

Parotid composition:
- composed of serous acinu
- large number of ducts
- adipocytes and plasma cells
Submandibular gland:
- mixed but more serous cells, also myoepith and demilunes
- intercalated and striated ducts are less than in parotid
Sublingual:
- mixed, but mostly mucous cells
- intercalated ducts are short and difficult to recognize
- intralobular ducts fewer on # than parotid and submand

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24
Q

Summary of major salivary glands - names? Sizes? Location? Excretory ducts? Striated ducts? Intercalated ducts? Acini? Fluid characterisitics? Innervation?

A

Parotid:

  • largest, encapsulated
  • behind the mandibular ramus, ant and inferior to ear
  • Stenson’s duct: open opposite max second molar on buccal mucosa
  • short straited ducts
  • long intercalated ducts
  • serous acibu
  • secreting watery, but amylase-rich
  • innveration XI

Submandibular

  • intermediate, encapsulated
  • beneath the mandible
  • Wharton’s open near lingual frenum on the floor of the mouth
  • striated duct long
  • intercalated short
  • mainly serous
  • vicous, mucin rich
  • VII

Sublingual

  • smallest, no capsule
  • floor of mouth
  • Bartholin’s: opens at same area as the submand, with additional ducts (Rivinus) at submand folds
  • straited and intercalated absent
  • mucous
  • vicious and mucin rich
  • VII
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25
Q

Summary of minor salivary gland - names? ducts? Acini? Fluid? Innveration?

A 
All
- rare striated and intercalated ducts
Palatinal
- mucous
- mucin rich
- VII 
Buccal
- mucous
- mucin rich
- VII
Labial
- mucous
- mucin rich
- VII
Von Ebners (lingual)
- serous
- watery and lipid rich
- IX
Retromolar
- mucous
- mucin rich
- VII/IX
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26
Q

General structure of salivary glands?

A

Like a bunch if grapes:

  • grapes are the acini
  • stems are the ducts
  • air is the CT
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27
Q

Functional arrangement of salivary glands - chronology?

A

Inner to outer:

  • secretary duct
  • striated duct
  • interclalated duct
  • acinus
28
Q

Salivary glands - serous acinar cells - organelles?

A

Organelles:

  • Nuc at basal cell
  • basophillic RER
  • granular apperance
  • cells discharge their secretions into the tubular lumen via intracellular canaliculi running between cells
29
Q

Salivary glands - mucous acinar cells - organelles?

A

Organelles:

  • plate cytoplasm- mucin lost ir not easily stained, so cytoplasm can appear medium in H&E Staines secretion
  • flattened basal nuc
  • large mucin granules
30
Q

Salivary glands - saliva - characterisitics? Resting state and stimulated state? Flow rate?

A

Compostion:

  • hypotonic fluid (99% water and 1% dry matter)
  • .5 -1.5 litres daily
  • resting state 2/3 volume prod by submand
  • stimated state 60% by parotid
31
Q

Salivary glands - saliva - composition? Variations?

A

Varies:
- from gland to gland, rats of secretion and between species
Compostion:
- 99% water
- electrolytes and inorganic constituents
- formed elements and organic constituents

32
Q

Salivary glands - saliva - electrolytes?

A

Cations:
- Na, K, Ca and Mg
Anions:
- Cl, HCO3, Pi, thiocynate, SO4, F, I, and OH

33
Q

Salivary glands - salivary secretion - stage I and stage II?

A

Stage I:
- electrolyte transport bu acinar cell go produce isotonic saliva
Stage II:
- ductal modification of electrolyte composition of primary saliva to produce hypotonic saliva ⁰

34
Q

Salivary glands - salivary gland secretion - Stage I?

A

Step I:
- ACh bind muscarinic receptor on acinar cell
- increased Ca influx
- from increased Ca its caused Ca gated channels to remove K and take in Cl and HCO3
Step 2:
- Na in via paracellular to balance charge
- H20 follows Na (paracell or transcell)
- aquaporins allow h20
- high perm to h20
- causes cell shrinkage
Step 3:
- act of Na/K/Cl cotransporter to take in Na
- Na/H exchange to take in Na
- Na/K pump to take in K and remove Na (with ATP)
Step 4:
- stimulus removed; the free intracellular Ca, cell volume, cytoplasmic pH and transport return back to normal

35
Q

Salivary glands - salivary secretion - stage II

A 
From striated ducts
Step 1:
- Na/K pump removes Na into plasma 
Step 2:
- reansorption of Na and Cl via Na and Cl channels, Na/H exchanger and Cl/HCO3 transporter

All duct is impermeable so water and stays in lumen

Result in saliva with increased HCO3, reduced Cl and Na

36
Q

Salivary glands - inorganic saliva composition and flow rate relation?

A

Compostion:

  • salivary secretion as a function of salivary flow rate compared with concentrated ions in plasma
  • saliva is hypotonic to plasma at all flow rates
  • salivary conc of HCO3, Cl and and Na increases with increasing flow rate
  • salivary conc of K decreases with increases flow rate
37
Q

Salivary glands - formation of organic constituents of saliva? Secretory pathways? Prot conc dependent on?

A

Mostly by acinar cells (but can be ductal too)
- proteins are the major organic component
component:
- prot conc depend in duration of stim and flow rate
(Long stim and high flow rate results in high saliva total prot conc)
Secretory pathways:
- constitutive exocytosis (continous) minor
- regulated exocytosis (major)

38
Q

What is exocytosis?

A
  • A process which a cell transports secretory products through the cytoplasm to the plasma membrane
  • Secreotry products are packed into teanposrt vesicles
39
Q

What is constitute exocytosis? Prot conc? Flow?

A
  • prots not concentrated into secretory vesicles awaiting stimulus
  • continous flow of protein in small vesicles to plasma mem
  • responsible for a continous secretion if several proteins without stim
40
Q

What is regulated exocytosis? Controlled by? Storage? Secretion?

A
  • acceleration of constitutive
  • controlled by symph innveration
  • after synthesis proteins stored in granules
  • stim, granules empty content into lumen
41
Q

Salivary gland - buffering action of saliva - defintion? Key components? Other buffers?

A

Buffering capacity: ability of the saliva to maintain the pH when exposed to acids
HCO3:
- from major glands
- conc increases with flow rate
- miminises drop in pH around teeth after consumption of sugar (min demineral)
Buffers:
- phosphate and protein

42
Q

Salivary gland - What is a Stephan curve? Fluor vs hydroxy?

A

The change in plaque pH influencing demineralisation and remineralisation

Fluroapatite - 4.5 demin
Hydroxyapatite- 5.5 demin

43
Q

Saliva - remineralisation of teeth - composition?

A

Composition:

  • supersaturaed with Ca and PO4
  • high flow rate associated with Caz PO4, OH and pH (reduced demin, increases remin and calculus form)
  • helped by presence of flouride in saliva
44
Q

Saliva - organic component - constituents?

A

Constituents:
- prots, carbs, lipids and small organic molecules
Proteins:
- amylase, lipase, mucin, statherin, IgA,

45
Q

Saliva - organic components - amylase (secreted by? Role? Function? Inactivated? Plaque?)

A 
Secreted by:
- parotid glands
Role:
- carbohydrate digestion
Function:
- breakdown starch and maltose
Inactivated:
- low pH
Plaque:
- breakdown of plaque
46
Q

Saliva - organic components - lipase? (Secreted by? Role?)

A 
Secreted by:
- lingual minor glands (Von Ebner)
Role:
- fat digestion 
- active at gastric pH
- digestion of milk fat for newborns
47
Q

Saliva - organic components - mucin? (Molecule type? Formation of mucus? Role? Location? Function? Important role? Immune?

A

Molecule type:
- complex molecule (peptide core and oligosaccardie chains)
Mucus:
- mucin + water
Role to lubricate
Location:
- on all oral soft tissues (prevents drying and provide barrier)
- hydrophilic and likes water and so stops dehydration
Important for pellicle
Aggregate bacteria

48
Q

Saliva - organic components - statherin (prevent? Pellicle?)

A

Prevent:
- precipitation of Ca and PO4 (supersaturated), good for mineral
- but can inhibit remineral, but cant permeate early carious lesions (not a major problem)
Prevent calculus
Present in enamel

49
Q

Saliva - organic components - antimicrobial components of H20, amylase, lysozyme, peroxidase, lactoferrin, histatins and cystatins?

A

Water - cleansing
Amylase - bacterial adhesion
Lysozyme - leaves polysacc wall
Peroxidase - same as above
Lactoferrin - bind Fe inhibit bacteria growth and adherence
Histatins- inhibit growth Candida
Cystatins - inhibit tissue damaging bacterial enzymes

50
Q

Saliva - organic components - IgA (secretion? Synth? Specificity?

A 
Secreted by 
- minor glands
Synth:
- plasma cells in CT
Specific:
- stim by bacteria against specific antigens provides local immunity
51
Q

Salivary glands - saliva secretion - neural control (parasympth and sympth)

A

Parasymth:

  • from brainstem and salivary nuclei (sup pons and inf brainstem nuc)
  • VII nerve to the sub glands
  • XI nerve to the parotid via otic ganglion
  • to the submandibular ganglion
  • ACh release to muscarinic receptors in the salivary glands

Sympth:

  • thoracic spinal cord (T1-4)
  • to the superior cervical ganglion
  • via the sympth nerve
  • to the salivary gland releasing NA act b-adr
52
Q

Salivary glands - saliva secretion - neural control - reflex defintion? Stimuli? Reaction?

A

Reflex:
- innate, automatic, predicate, repsonse involving the CNS, to a known stimulus
Stimuli:
- associated with feeding
Reaction:
- complex secretomotor and vasometer innveration
Lack uniformity of response between gland and species
Secretion dependant in reflex activity

53
Q

Salivary glands - saliva reflex - gustatory (reflex type? Stimuli? Flow? Innervation?

A 
Reflex type:
- unconditioned 
Stimuli:
- via taste buds 
- basic tastes cause secretion Sour > Salt > Bitter > Sweet
Flow:
- max flow achieved using 5% citric acid (7ml per min)
Innervation:
- VII, IX and C nerves
54
Q

Salivary glands - saliva secretion - neural control - flow chart?

A 
Sensory info from mechanoreceptors and chemo receptors 
Cerebral cortex 
Salivary centre in medulla
Autonomic
Salivary glands
Secretion
55
Q

Salivary glands - masticatory salivary reflex (stimulus from? Innervation? Reflex pathway?)

A

Stimulus from:
- mechanorecprtors afferent neurons affecting periodontal ligament, oral mucosa, TMJ and muscles
Imnervation:
- V
Reflex pathway:
- unilateral
- stim of one side of the mouth induces ipsilateral salivation

56
Q

What is Lashley cup?

A

A measure of flow rate
To be placed near the duct opening to collect saliva
Outer chamber for suction to buccal mucosa

57
Q

Salivary glands - olfactory salivary reflex (type of repsonse? Gland?)

A

A unilateral response of the parotid gland

No repsonse of the parotid to the odour of lemon
But taste has a reaction

But with the submand gland, the odour of beef increases flow rate of saliva

Olfactory parotid reflex doesn’t exist
Olfactory submand reflex does exist

58
Q

Salivary glands - saliva secretion - neural control (sympth nerves? Parotid gland - innervation and synapse? Submand and subling - innveration and synapse?)

A

Sympth nerves:
- from the synoatheric trunk follow blood vessels
Parotid gland:
- receives parasynth signals from IX synoases in otic ganglion
Submand and sublingual:
- parasympth signals form facial nerve synapses in the mand ganglion

59
Q

Unconditioned salivary reflex?

A

Gustatory and masticatory and olfactory

Higher centres: - facilitate, also inhibit (dry mouth with anxiety) but can enhance response

60
Q

Condition salivary reflexes?

A

Pavlov’s dogs
Not easily demonstrated in man
Assocaitaion of sound with food without food stimulus

61
Q

Salivary glands - saliva secretion - neural control - psychic stimuli hypothesis?

A

Mouthwatering occurs on anticipation if sight of food when hungry, but it is more of a sudden awareness of saliva in mouth rather than more

62
Q

Salivary glands - saliva secretion - neural control (signal factord)

A

Sensory recpeotes for a salivary reflex or a condition reflex

But cant enhance

63
Q

Factors affecting salivary flow rate?

A 
Increased presence of food in mouth 
- chemical and mechanical 
Increased of smell of food
Time of day
- increased in afternoon and reduced in night 
Season 
- lowest in winter and highest in summer
Light:
- bright increased and dark decreased 
Hydration:
- reduced dehydrated 
Body positon:
- increased standing and reduced sitting
Drugs:
- on glands and nerves
Reduces with age
64
Q

Xerostomia - defintion? Causes?

A

Defintion:
- unstimulated flow less than 50% of normal
Causes:
- disease such as systemic, intrinsic or extrinsic
- medication such as analgesics antidepressants and anti-histamines
- dehydration, nerve damage tobacco and alcohol and stress and anxiety

65
Q

Xerostomia affect on QoL?

A 
Eating:
- taste alteration
- dysphagia
- mastication problems
- avoid foods
Social
- speech difficulties
- bad breath
- sip water 
QoL:
- embarrassment and self conscious
- irrtibale
- discomfort with dentures
66
Q

Physical impact of Xerostomia - oral cavity? Mucosa? Tongue teeth? Lips? Saliva?

A

Oral cavity:
- food debris, poorly fitting denture and bad breath
Mucosa:
- burn sense, dry and sticky mucosa, dental mirror sticks
- mucositis, ginguvigs, mouth lesions and infection
- infection, ulcers and fissures, and erythematosus
Tongue:
- erythrma, atrophy of filiform, dry and fissured
Teeth:
- dental caries (cervical and root caries) and demin
Lips:
- cracked lips, peeling and fissuring and angular cheiltis
Saliva:
- reduced pooling, stringy and frothy saliva

67
Q

Sjögrens’s syndrome - what is it? Prevalence? Ages? Symptoms? Causes? Diganoses? Treatment?

A

Long term autoimmune disease affecting body moisture producing glands (mouth and dry eyes)
Prevalence:
- 1/100
Lab test and imaging
Between 35-50
More common in females
Family history
Symptoms:
- dry eyes and dry mouth
- dry throat, dry nose, cracked tongue dry skin, persistent dry cough and prolonged fatigue
Causes:
- unknown but combination of genetics hormonal and environmental
Diagnoses:
- blood test via antibodies and rheumatoid factor
Salivary flow test
Eye test - function of lacrimal glands
Lip/salivary gland biopsy - reveal lympho closed around salivary due to gland inflammation
No known treatment

General Health and Disease (GHD) (31 decks)

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