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Oral Diseases > theme 10 > Flashcards

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
Q

antibodies present in primary SS

A

anti-Ro + La

26
Q

ways to manage dry mouth

A

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
Q

roles of saliva

A 
mechanical washing
anti-microbial activities
remineralised of dental tissues
buffer
lubrication - mucin
limited digestion - amylase
28
Q

dry mouth problems

A 
discomfort
ulceration
gum disase
infections - fungal, ascending salivary gland infections
poor denture retention
alternated taste sensation
speech + swallowing difficulties
29
Q

most common salivary gland to suffer from malignancy

A

parotid

30
Q

most common benign salivary gland tumour

A

pleomorphic adenoma

31
Q

4 malignant epithelial salivary gland tumours

A

mucoepidermoid carcinoma
adenoid cystic carcinoma - bad prognosis
acidic cell carcinoma
adenocarcinoma

32
Q

where does warthin tumour present

A

parotid only

33
Q

type of epithelial cells on salivary glands

A

myoepithelial

34
Q

2 layers of ductal system

A

luminal + alumna (basal cells)

35
Q

features of pleomorphic adenoma

A

slow growing, mobile, smooth, painless swelling

36
Q

treatment for pleomorphic adenoma

A

superficial parotidectomy, extracapsular dissection

37
Q

risk with treating parotid gland tumours

A

risk to facial nerve

38
Q

histopathological features of pleomorphic adenoma

A

pleomorphic + ep + myoep, ep + mesenchyme = chondromyxoid matrix
well demarcated, bosselated, variably encapsulated

39
Q

risk of pleomorphic ademona

A

malignancy potential ~10-15yrs

carcinoma ex pleomorphic adenoma
tend to be very high grade, fast growing

40
Q

risk factor for warthins tumour

A

smoking

41
Q

features of warthins tumour

A

slow growing, mobile, smooth, painless

42
Q

histopathological features of warthins tumour

A

encapsulated, papillary structure form cystic spaces, gelatinous contents, lined by oncocytic ep

43
Q

features of basal cell adenoma

A

made of back to back ducts - no chondromyxoid matrix

44
Q

features of canalicular adenoma

A

canal like systems of ep cells

decompressed bag of jelly when excised

45
Q

clinical presentation of malignancy salivary gland neoplasms

A 
firm fixed lump
poorly demarcated
rapid growth
painless first, pain at later stage 
skin/mucosal ulceration
face palsy if affecting nerve
bone invasion
46
Q

reasons for recurrent salivary gland swellings

A

salivary calculi/sialolithiasis
papillary obstruction
duct stricture
punctuate sialectasis

47
Q

causes of persistent diffuse enlargement of salivary glands

A

sjogrens
sialosis
sarcoidosis

48
Q

causes of nodular enlargement

A

neoplasm
lymph node
cyst

49
Q

order for investigating salivary glands

A
  1. clinical examination/palpation
  2. plain radiography - FOM occlusal
  3. ultrasound
  4. sialography
  5. CT/MRI
50
Q

8 types of salivary gland surgery

A
  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
Q

3 nerves that may be damaged in submandibular surgery

A
  1. facial nerval cervical branch
  2. lingual nerve
  3. hypoglossal nerve
52
Q

complications of parotidetomy

A

pain/swelling
facial nerve weakness
sialocele
Freys syndrome

53
Q

what is Freys syndrome

A

postganglionic parasympathetic fibres connect to sympathetic instead - causes person to sweat when eating instead

54
Q

general rule for lip swellings

A 
upper = malignant
lower = mucocele

Oral Diseases (14 decks)

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