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theme 10 Flashcards

1
Q

developmental abnormalities of salivary glands

A

aplasia/hypoplasia
ductal atresia
accessory salivary gland/ectopic salivary gland

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2
Q

what is a sialography

A

involves injection of radio-opaque dye into duct

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3
Q

2 type of salivary gland infections

A

bacterial sialadenitis

viral sialadenitis - mumps

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4
Q

predisposing factors to bacterial sialadenitis

A

reduced salivary flow - medications, dehydration, radiotherapy, sjogrens, poor OH
sialolithiasis

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5
Q

how are submandibular gland stones easily identified compared to parotid

A

heavily calcified compared to parotid

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6
Q

2 types of bacterial sialadenitis

A

acute - suppurative, acute, redness, pain, swelling, lymphadenopathy

chronic - progressive destruction + fibrosis to protect gland

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7
Q

2 examples of chronic sialadentitis

A

post radiotherapy + sjogrens

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8
Q

virus causing mumps

A

paramyxovirus

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9
Q

features of mumps

A

unilateral parotid swelling

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10
Q

features of HIV-associated salivary gland disease

A

lymphoepithelial lesions within parotid, lymphocytes associated with cystic change - cysts within parotid

uncommon due to triple therapy

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11
Q

what are mucoceles

A

mucous cyst - fluid filled swelling occurs on lower lip or FOM

temporary, painless

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12
Q

2 types of mucoceles

A

extravasation - broken salivary gland duct = leakage into ST around gland

retention - blockage of salivary gland = build up of mucous

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13
Q

causes of dry mouth

A 
medication - antidepressants most common
dehydration
diabetes 
renal failure
radiotherapy
sjogrens
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14
Q

how does pilocarpine work

A

stimulates residual secretory capacity

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15
Q

characteristics of sjogrens

A

dry eyes, dry mouth, muscle + joint pain, fatigue

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16
Q

causes of sjogrens

A

cause unknown - involves immune system mediated inflammatory mechanisms

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17
Q

2 categories of sjogrens

A

primary + secondary

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18
Q

causes of secondary sjogrens

A

RA, lupus, scleroderma, primary biliary cirrhosis

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19
Q

who does primary SS affect most

A

women

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20
Q

examples of objective evidence of salivary gland involvement

A
  1. unstimulated whole salivary flow - <1.5ml
  2. parotid sialography showing presence of diffuse sialectasis without evidence of obstruction in major ducts
  3. salivary scintigraphy showing delayed uptake, reduced concentration and/or delayed excretion of tracer
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21
Q

what must be present on SS biopsy

A

inflammation

focus score used

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22
Q

risk of which cancer with SS

A

lymphoma - MALT associated most common

23
Q

3 components to diagnosing SS

A

symptoms, clinical signs, evidence of immune system disturbed

24
Q

what type of scan used for salivary glands

A

unltrasound

doppler detect changes in pattern of blood flow

25
antibodies present in primary SS
anti-Ro + La
26
ways to manage dry mouth
good OH stay hydrated less sugar/coffee/alcohol limit drug use replacement - oralube/xerostom/biotene/water immuno-modulatory - ciclosporins stimulant - pilocarpine or cevimeline, sugar freee gum, lozenges, mint also reinforce good OH
27
roles of saliva
``` mechanical washing anti-microbial activities remineralised of dental tissues buffer lubrication - mucin limited digestion - amylase ```
28
dry mouth problems
``` discomfort ulceration gum disase infections - fungal, ascending salivary gland infections poor denture retention alternated taste sensation speech + swallowing difficulties ```
29
most common salivary gland to suffer from malignancy
parotid
30
most common benign salivary gland tumour
pleomorphic adenoma
31
4 malignant epithelial salivary gland tumours
mucoepidermoid carcinoma adenoid cystic carcinoma - bad prognosis acidic cell carcinoma adenocarcinoma
32
where does warthin tumour present
parotid only
33
type of epithelial cells on salivary glands
myoepithelial
34
2 layers of ductal system
luminal + alumna (basal cells)
35
features of pleomorphic adenoma
slow growing, mobile, smooth, painless swelling
36
treatment for pleomorphic adenoma
superficial parotidectomy, extracapsular dissection
37
risk with treating parotid gland tumours
risk to facial nerve
38
histopathological features of pleomorphic adenoma
pleomorphic + ep + myoep, ep + mesenchyme = chondromyxoid matrix well demarcated, bosselated, variably encapsulated
39
risk of pleomorphic ademona
malignancy potential ~10-15yrs carcinoma ex pleomorphic adenoma tend to be very high grade, fast growing
40
risk factor for warthins tumour
smoking
41
features of warthins tumour
slow growing, mobile, smooth, painless
42
histopathological features of warthins tumour
encapsulated, papillary structure form cystic spaces, gelatinous contents, lined by oncocytic ep
43
features of basal cell adenoma
made of back to back ducts - no chondromyxoid matrix
44
features of canalicular adenoma
canal like systems of ep cells | decompressed bag of jelly when excised
45
clinical presentation of malignancy salivary gland neoplasms
``` firm fixed lump poorly demarcated rapid growth painless first, pain at later stage skin/mucosal ulceration face palsy if affecting nerve bone invasion ```
46
reasons for recurrent salivary gland swellings
salivary calculi/sialolithiasis papillary obstruction duct stricture punctuate sialectasis
47
causes of persistent diffuse enlargement of salivary glands
sjogrens sialosis sarcoidosis
48
causes of nodular enlargement
neoplasm lymph node cyst
49
order for investigating salivary glands
1. clinical examination/palpation 2. plain radiography - FOM occlusal 3. ultrasound 4. sialography 5. CT/MRI
50
8 types of salivary gland surgery
1. removal of caliculi 2. ductal dialtion/repositiioning 3. excision of sublingual gland 4. excision of submandibular gland 5. parotidectomy - superficial or total 6. extracapsular dissection 7. excision of minor salivary gland tumours 8. minimally invasive surgery
51
3 nerves that may be damaged in submandibular surgery
1. facial nerval cervical branch 2. lingual nerve 3. hypoglossal nerve
52
complications of parotidetomy
pain/swelling facial nerve weakness sialocele Freys syndrome
53
what is Freys syndrome
postganglionic parasympathetic fibres connect to sympathetic instead - causes person to sweat when eating instead
54
general rule for lip swellings
``` upper = malignant lower = mucocele ```

Oral Diseases (14 decks)

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