Salivary Glands & Associated Pathology

Question 1

Saliva is involved to some degree in all of the

following functions: (5)

Answer 1

  Speech 
  Mastication 
  Taste  
  Swallowing 
  Digestion

Question 2

Taste

 Gustin:

Answer 2

protein thought to be necessary for growth and

maturation of taste buds.

Question 3

Digestion

Answer 3

 Salivary amylase degrades starch

Question 4

Saliva is involved to some degree in all of the

following functions: (5)

Answer 4

Protection 
Buffering 
Antimicrobial action 
Maintenance of tooth integrity 
Soft Tissue Repair

Question 5

Protection (3)

Answer 5

 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

Question 6

Buffering (2)

Answer 6

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

Question 7

Sialin:

Answer 7

a protein that raises pH of dental plaque after exposure

to fermentable carbohydrates

Question 8

Antimicrobial action (3)

Answer 8

 Lysozyme: hydrolyzes bacterial cell walls
 Lactoferrin: binds free iron and thereby deprives bacteria
of an essential nutrient
 Salivary IgA: causes bacterial clumping (agglutination)

Question 9

Maintenance of tooth integrity (1)

Answer 9

 Calcium and phosphate ions facilitate mineralization of

tooth surface

Question 10

Soft Tissue Repair (2)

Answer 10

 Epithelial growth factor

 Clotting factor

Question 11

Ectomesenchymal cells dictate differentiation of oral
epithelium which, in turn, proliferates and grows into
the underlying mesenchyme. The epithelial buds
undergo histodifferentiation and morphodifferentiation
to form assemblies of: (2)

Answer 11

 Alveoli that develop into acinar cells

 Epithelial cords that develop into ducts

Question 12

Stages of salivary gland development: (6)

Answer 12

 Induction of oral epithelium by underlying ectomesenchyme
 Growth of the epithelial cord
 Initiation of epithelial cord branching
 Repetitive branching and lobule formation
 Canalization of the presumptive ducts
 Cytodifferentiation to become acinar cells, myoepithelial cells,
and ductal cells

Question 13

Cytodifferentiation to become acinar cells, myoepithelial cells,
and ductal cells
Growth Factors (2)

Answer 13

• FGF (fibroblast growth factor)

* EGF (epidermal growth factor)

Question 14

GF + EGF + Terminal Bulb Cells = (3)

Answer 14

acinar cells
myoepithelial cells
duct cells

Question 15

The parotid and submandibular glands begin to form during the
— week of embryonic development with the sublingual gland
initiating development during the — week.

Answer 15

6th

8th

Question 16

The minor salivary glands begin to form by the — week of

embryonic development.

Answer 16

10th

Question 17

Hierarchy of ducts starting at the level of

the secreting unit (acinus): (5)

Answer 17

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

Question 18

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

Answer 18

Associated

with terminal end pieces (acini) and intercalated ducts.

Question 19

what do each of these develop into?
Parotid Gland –
Submandibular Gland –
Sublingual Gland –

Answer 19

Stenson’s Duct
Wharton’s Duct
Bartholin’s Duct

Question 20

Salivary Glands (Parotid Gland) (3)

Answer 20

 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.

Question 21

Mixed seromucous gland (i.e., predominately serous

with mucous contributions) (2)

Answer 21

 Responsible for 60% of unstimulated salivary flow.

 Serous demilunes

Question 22

Mixed mucoserous gland (i.e., predominately mucous secreting) (2)

Answer 22

 Responsible for 10% of unstimulated salivary flow

 Serous demilunes

Question 23

Minor salivary glands account for –% of unstimulated

salivary flow

Answer 23

10

Question 24

Most minor salivary glands are — secreting

Answer 24

mucous

Question 25

Named minor salivary glands are: (4)

Answer 25

* von Ebner’s * Blandin-Nuhn * Weber’s * Carmalt’s

Question 26

• von Ebner’s

Answer 26

Pure serous glands associated with circumvallate papillae

Question 27

• Blandin-Nuhn

Answer 27

Mucoserous glands located on ventral surface at tip of tongue

Question 28

• Weber’s

Answer 28

Mucous glands associated with the pharyngeal tonsils

Question 29

• Carmalt’s

Answer 29

Mucous glands found in the mandibular retromolar area

Question 30

Endocrine –

Answer 30

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

Question 31

Exocrine –

Answer 31

secrete product onto a surface; usually has a duct

Question 32

Merocrine –

Answer 32

little/no damage to secreting cells (salivary glands)

Question 33

Apocrine –

Answer 33

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

Question 34

Holocrine –

Answer 34

total destruction of secreting cells (sebaceous | glands)

Question 35

Fordyce’s Granules | a.k.a. Fordyce Spots) (2

Answer 35

• Not a pathologic lesion • Represent ectopic sebaceous glands

Question 36

Salivary Gland Mucocele (3)  The result of  Most common site of occurrence  Characterized by

Answer 36

 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

Question 37

Ranula

Answer 37

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

Question 38

Sjögren’s Syndrome (4)

Answer 38

 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

Question 39

Salivary Glands Mixed Tumor, a.k.a. Pleomorphic Adenoma

Answer 39

 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

Question 40

Mixed Tumor, a.k.a. Pleomorphic Adenoma | Histology (3)

Answer 40

• Well circumscribed and encapsulated • Tissue derived from mixture of ductal and myoepithelial cells • Keratinizing squamous cells and mucous producing cells are also present

Question 41

One of the most common salivary gland | malignancies

Answer 41

Mucoepidermoid Carcinoma

Question 42

Mucoepidermoid Carcinoma | Most commonly involves the

Answer 42

parotid gland | consequently, pain or facial nerve palsy may develop

Question 43

Mucoepidermoid Carcinoma | Histology (2)

Answer 43

• 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