Salivary Glands/Head and Neck Malignancy

Question 1

Duct of the parotid gland

Answer 1

stenson’s duct

Question 2

Duct of the submandibular glands

Answer 2

wharton’s duct

Question 3

salivary enzymes

Answer 3

alpha-amylase

lipase

Question 4

alpha-amylase

Answer 4

carb digestion

inactivated by low pH

Question 5

lipase

Answer 5

lipid digestion

converts triglycerides to FA and monoglycerides

Question 6

mucin

Answer 6

bolus formation and swallowing food

Question 7

helps maintain neutral pH in salivary glands and mouth

Answer 7

HCO3-

Question 8

salivary fluid secretion is regulated by

Answer 8

cholinergic signaling (parasympathetic)

Question 9

salivary protein is regulated by

Answer 9

NE (sympathetic)

Question 10

acinar epithelial cells produce fluid of similar ionic composition to

Answer 10

plasma

Question 11

salivary ducts actively absorb/secrete…

Answer 11

absorb Na, Cl

secrete K+, HCO3-

Question 12

production of hypOtonic saliva is accomplished by…

Answer 12

salivary ductal cells lacking aquaporins

Question 13

What allows majority of Na secreted by acing cells to reach mouth?

Answer 13

High salivary flow

Question 14

GI hormones role in regulation of salivary secretion

Answer 14

NO ROLE

Question 15

sympathetic stimulation is a major contributor to increased fluid volume

Answer 15

FALSE

minor role

Question 16

purely serous salivary gland

Answer 16

parotid

Question 17

mixed seromucous, but predominately serous gland

Answer 17

submandibular gland

Question 18

mixed seromucous, but predominately mucous gland

Answer 18

sublingual gland

Question 19

unstimulated - most saliva via which gland?

Answer 19

submandibular

Question 20

stimulated - most saliva via which gland?

Answer 20

parotid

Question 21

sialadentis

Answer 21

inflammation of the salivary glands

via infections, virus, bacteria, stones, trauma, AI

Question 22

acute sialadenitis

Answer 22

most commonly parotid/submandibular

• viral (MUMPS - paramyxovirus, coxsackie a, ECHO, Epstein-Barr)
• bacterial (STAPH AUREUS, h. influenza, strep pyogenes)
• AI (SJOGRENS)

clinical sx: pain, fever, malaise

Question 23

Mumps

Answer 23

epidemic parotiditis
myxovirus
sx: fever, malaise, HA, painful swelling of one or both parotid glands

complications: sensorineural deafness, encephalitis, orchitis or oophoritis, pancreatitis

Question 24

chronic sialadenitis

Answer 24

usu via scarring/inflamm of duct and/or parenchyma

Question 25

chronic non-obstructive sialadenitis

Answer 25

usu via granulomatous inflammation (sarcoid, TB, actinomycosis, cat scratch disease)

Question 26

chronic obstructive sialadenitis

Answer 26

most comm secondary to stone formation

Question 27

sialolithiasis

Answer 27

submandibular glands mostly inspirated secretions, ductal debris, Ca phosphate coalesce recurrent episodes pain/swelling w/ meals middle aged males

Question 28

mucocele

Answer 28

most common lesion of salivary gland usu at lower lip, oral cavity, result of trauma 2nd-3rd decades

Question 29

Sjogren syndrome

Answer 29

immune-mediated destruction of salivary and lacrimal -isolated disorder or AI or virus) middle-aged women sx: dry mouth/eyes

Question 30

Sjogren syndrome histo

Answer 30

- periductal lymphocytic and plasma cell infiltrate - primarily CD4 T cells - lymphocytic sialadenitis in labial salivary gland biopsy - ductal epithelial hyperplasia

Question 31

benign salivary gland tumors

Answer 31

- pleomorphic adenoma | - warthin tumor

Question 32

malignant salivary gland tumor

Answer 32

-mucoepidermoid carcinoma

Question 33

pleomorphic adenoma

Answer 33

benign mixed tumor -most comm neoplasm of maj/minor salivary glands -F>M, 3rd-6th decade -most common site: tail of parotid (superficial lobe), can involve facial n. -usu painless tx: excision, may recur if inadequate

Question 34

pleomorphic adenoma histo

Answer 34

- well demarcated - admixture of epithelial, myoepithelial and stroll components within a fibrous capsule - mitosis and necrosis are UNCOMMON

Question 35

warthin tumor | papillary cyst adenoma lymphomatosum

Answer 35

``` benign second most common -white M>F, 5-6 decade -mostly parotid -cigarette smoking ```

Question 36

warthin tumor histo

Answer 36

papillary structure mature lymphocytes -oncocytic bilayered epithelium

Question 37

mucoepidermoid carcinoma

Answer 37

- most common MALIGNANT tumor of parotid gland - most common salivary tumor in child - either sex, 3-6th decade - low (slow growing, painless) or high grade (rapidly enlarging, painful)

Question 38

mucoepidermoid carcinoma histo

Answer 38

- mixture of squamous cells, mucus-secreting cells, intermediate cells - divided into low, intermediate, high grades

Question 39

>95% H/N cancers are

Answer 39

HNSCC - most in oral cavity - 50% HNSCC harbor oncogenic strains of HPV

Question 40

leukoplakia

Answer 40

precursor lesion to oral squamous cell carcinoma

Question 41

50% of HNSCC harbor oncogenic strains of

Answer 41

HPV

Question 42

HPV-positive HNSCC

Answer 42

- tonsil and base of tongue - non-keratinized - younger cohorts - 3:1 men - stage: Tx, T1-2 - risk: sexual behavior - increasing incidence - improved survival

Question 43

HPV-negative tumors

Answer 43

- located at all sites - keratinized - older cohorts - 3:1 men - variable - EtOH - dec incidence - unchanging survival