Salivary Glands and TMJ

Question 1

\_\_\_\_\_ is involved to some degree in all of the
following functions:
 Speech
 Mastication
 Taste
 Swallowing
 Digestion
Protection
Buffering
Antimicrobial action
Maintenance of tooth integrity
Soft tissue repair

Answer 1

Saliva

Question 2

_____: protein thought to be necessary for growth and

maturation of taste buds.

Answer 2

 Gustin:

Question 3

____ degrades starch

Answer 3

Salivary amylase

Question 4

_____: a protein that raises pH of dental plaque after exposure
to fermentable carbohydrates

Answer 4

Sialin:

Question 5

Function of saliva:
 Lubrication protects lining mucosa from noxious stimuli,
bacterial toxins, and minor trauma
 Washing action to rid mouth of non-adherent bacteria
 Clearance of sugars from mouth

Answer 5

Protection

Question 6

Function of saliva:
 Prevents potential pathogenic bacteria from colonizing the
mouth (most require an acidic pH)
 Buffering of microbial acids (bicarbonate & phosphate ions)

Answer 6

Buffering

Question 7

______ hydrolyzes bacterial cell walls

Answer 7

Lysozyme:

Question 8

______ binds free iron and thereby deprives bacteria

of an essential nutrient

Answer 8

Lactoferrin:

Question 9

______ causes bacterial clumping (agglutination)

Answer 9

Salivary IgA:

Question 10

Function of saliva:
 Calcium and phosphate ions facilitate mineralization of
tooth surface

Answer 10

Maintenance of tooth integrity

Question 11

Function of saliva:
 Epithelial growth factor
 Clotting factor

Answer 11

Soft Tissue Repair

Question 12

_____ cells dictate differentiation of oral
epithelium which, in turn, proliferates and grows into
the underlying mesenchyme

Answer 12

Ectomesenchymal

Question 13

Alveoli develop into _____

Answer 13

acinar cells

Question 14

Epithelial cords develop into ____

Answer 14

ducts

Question 15

FGF + EGF + Terminal Bulb Cells give rise to what 3 types of cells?

Answer 15

Acinar cells, myoepithelial cells, and duct cells

Question 16

The parotid and submandibular glands begin to form during the ____ week of embryonic development

Answer 16

6th

Question 17

The sublingual gland

initiating development during the _____ week of embryonic development

Answer 17

8th

Question 18

The minor salivary glands begin to form by the ___ week of embryonic development.

Answer 18

10th

Question 19

What is the Hierarchy of ducts starting at the level of

the secreting unit (acinus)?

Answer 19

 Intercellular canaliculus
 Intercalated duct
 Striated duct
 Excretory duct
 (a.k.a. collecting duct)
 Terminal excretory duct

Question 20

Crypts between cells that contain villi

Answer 20

Intercellular Canaliculus

Question 21

____ are lined with cuboidal cells that could be stem cells

Answer 21

Intercalated Duct

Question 22

Associated with terminal end pieces (acini) and intercalated ducts.

Answer 22

Myoepithelial Cells (a.k.a. Basket Cells):

Question 23

____ contain microvilli involved in electrolyte resorption; Na and Cl are absorbed and K and HCO3 are secreted

Answer 23

Striated Duct

Question 24

_____ is a smooth duct with no villi; no secretion or absorption here

Answer 24

Excretory (collecting) duct

Question 25

What is the name of the duct for the parotid gland

Answer 25

Stetson's duct

Question 26

What is the name of the duct for the submandibular gland

Answer 26

Wharton's duct

Question 27

What is the name of the duct for the sublingual gland

Answer 27

Bartholin's duct

Question 28

``` ____ gland: Pure serous secreting gland  Responsible for 20% of unstimulated salivary flow  Salivary gland enlargement occurs in parotitis (mumps), Sjögrens syndrome, bulimia nervosa, anorexia nervosa, benign and malignant neoplasia. ```

Answer 28

Parotid gland

Question 29

____ gland:  Mixed seromucous gland (i.e., predominately serous with mucous contributions)  Responsible for 60% of unstimulated salivary flow.  Serous demilunes

Answer 29

Submandibular gland

Question 30

_____ gland: Mixed mucoserous gland (i.e., predominately mucous secreting)  Responsible for 10% of unstimulated salivary flow  Serous demilunes

Answer 30

Sublingual gland

Question 31

Minor salivary glands account for ___% of unstimulated | salivary flow

Answer 31

10%

Question 32

Most minor salivary glands are _____ secreting

Answer 32

mucous

Question 33

Minor salivary gland: Pure serous glands associated with circumvallate papillae

Answer 33

• von Ebner’s

Question 34

Minor salivary gland: Mucoserous glands located on ventral surface at tip of tongue

Answer 34

• Blandin-Nuhn

Question 35

Minor salivary gland: Mucous glands associated with the pharyngeal tonsils

Answer 35

• Weber’s

Question 36

Minor salivary gland: Mucous glands found in the mandibular retromolar area

Answer 36

• Carmalt’s

Question 37

– product secreted into blood and affects other cells; | no duct system

Answer 37

• Endocrine

Question 38

– secrete product onto a surface; usually has a duct

Answer 38

• Exocrine

Question 39

– little/no damage to secreting cells (salivary glands)

Answer 39

• Merocrine

Question 40

– partial injury to secreting cells (mammary/sweat | glands)

Answer 40

• Apocrine

Question 41

– total destruction of secreting cells (sebaceous | glands)

Answer 41

• Holocrine

Question 42

• Not a pathologic lesion • Represent ectopic sebaceous glands

Answer 42

Fordyce’s Granules | a.k.a. Fordyce Spots

Question 43

The result of trauma that severs the duct resulting in extravasation of mucin into the surrounding soft tissues  Most common site of occurrence are the lips, tip of the ventral surface of the tongue and soft palate  Characterized by a accumulation of mucin containing numerous foamy histiocytes surrounded by granulation tissue

Answer 43

Salivary gland mucocele

Question 44

A term used to designate a mucocele that occurs in the floor of the mouth. most often involve the sublingual salivary gland.

Answer 44

Ranula

Question 45

 Chronic, systemic autoimmune disease  80% to 90% of cases occur in middle aged females  Xerostomia, xerophthalmia or keratoconjunctivitis sicca  Parotid gland swelling due to lymphocytic & plasma cell infiltrate

Answer 45

Sjögren’s Syndrome

Question 46

Benign tumor that accounts for 53% to 77% of parotid gland tumors; 44% to 68% of subman- dibular gland tumors; and 38% to 43% of minor salivary gland tumors  Histology: • Well circumscribed and encapsulated • Tissue derived from mixture of ductal and myoepithelial cells • Keratinizing squamous cells and mucous producing cells are also present

Answer 46

Mixed Tumor aka Pleomorphic Adenoma

Question 47

 One of the most common salivary gland malignancies  Most commonly involves the parotid gland. Consequently, pain or facial nerve palsy may develop  Histology: • Composed of a mixture of mucous producing cells and squamous epidermoid cells. • Abundant cellular pleomorphism and a tendency to form cystic areas within the tumor cell mass

Answer 47

Mucoepidermoid Carcinoma

Question 48

___ are involved in proprioception in TMJ

Answer 48

Ruffini corpuscles

Question 49

____ are involved in dynamic mechanoreception (chewing) in TMJ

Answer 49

Pacinian corpuscles

Question 50

____ are involved in static mechanoreception in TMJ

Answer 50

Golgi tendon organs

Question 51

____ are involved in pain in TMJ

Answer 51

Free nerve endings

Question 52

The TMJ is classified as a ____ joint:

Answer 52

synovial sliding-ginglymoid | hinged

Question 53

____ joints permit movement between two bones.

Answer 53

Synovial

Question 54

Each bone of TMJ is covered by _____ cartilage.

Answer 54

hyaline

Question 55

The two bones of TMJ are united and surrounded by a ____ thereby creating a joint cavity.

Answer 55

fibrous capsule

Question 56

The joint cavity is filled with ______ (approximately 1mL) that is derived from villus cells which line the internal surface of the capsule

Answer 56

synovial fluid

Question 57

_____ separates the bones of TMJ

Answer 57

fibrous disc

Question 58

Both the condylar neck and head develop by | _____ ossification.

Answer 58

endochondral

Question 59

the cartilage cells in the condylar head and neck do or do not exhibit ordered columns?

Answer 59

do not

Question 60

_____ head of lat pterygoid attaches to the joint capsule and articular disc (a.k.a. meniscus)

Answer 60

Superior

Question 61

____ head of lat pterygoid attaches to the condylar neck in the pterygoid fovea

Answer 61

Inferior

Question 62

The articulating surfaces are covered with a layer of ___ tissue

Answer 62

fibrous tissue

Question 63

Articular surface on the posterior | slope of the articular tubercle.

Answer 63

glenoid fossa

Question 64

: Comprised of collagen and elastic fibrous connective tissue, fat cells, and is highly vascular. Elastic fibers from this bilaminar zone insert into the petrotympanic fissure.

Answer 64

Retrodiscal Connective Tissue (a.k.a. bilaminar zone)

Question 65

T/F: The disc is attached to the medial and lateral surfaces of the condyle, but not the temporal bone

Answer 65

True

Question 66

The most peripheral (external) layer of TMJ synovial membrane is the ____

Answer 66

fibrous capsule of the joint

Question 67

The most internal layer of TMJ synovial membrane is the _______

Answer 67

intimal layer

Question 68

The intermediate layer of TMJ synovial membrane is the _____

Answer 68

vascular subintima

Question 69

The intimal layer contains of what two cell types?

Answer 69

Type A and Type b Synovial Cells:

Question 70

Type ___ Synovial Cells:  Macrophage-like cells that exhibit phagocytic functions and are capable of producing inflammatory cytokines, e.g., IL-1, IL-6, IL-8, and TNF-α

Answer 70

Type A synovial Cells:

Question 71

Type ___ synovial Cells:  Fibroblast-like cells that synthesize hyaluronate which is a major component of the synovial fluid in both the superior and inferior compartments of the joint.

Answer 71

Type B synovial Cells:

Question 72

Chronic or acute joint trauma may cause the Type ____ synovial cells to undergo a syncytial (fusing) transformation into multinucleated giant cells that exhibit osteoclastic-like functions

Answer 72

Type A synovial Cells:

Question 73

______: the disc is trapped in the antero-medial position, | causing limited opening, pain, and “clicking” upon opening

Answer 73

Internal Derangement:

Question 74

In ____, With these chronic inflammatory changes, osteophytes are noted on the condylar heads. Also, a decreased vascularity is found in the retrodiscal area, leading to pain on function.

Answer 74

arthritic degeneration

Question 75

Loss of articular coverings and synovial membranes, leading to direct bone-to-bone fusion

Answer 75

Ankylosis