Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DS4102 > W5 - Salivary Gland Disorders - Thomson > Flashcards

W5 - Salivary Gland Disorders - Thomson Flashcards

1
Q

What are the 4 salivary glands

A
  1. Parotid
  2. Submandibular
  3. Sublingual
  4. Minor salivary glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of saliva does the parotid, submandibular and sublingual glands produce, respectively?

A

Parotid - Serous

Submd - Mixed (10% mucinous)

Subling - Mixed (10% serous)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does the majority of saliva come from? (glands)

A

Submandibular (75%)

Parotid (25%)

Sublingual (5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Problems that salivary hypofunction / xerostomia cause (5)

A

Difficulty chewing and swallowing

Erythematous & atrophic oral mucosa

Lobulation & depapillation of tongue

Caries

Oral candidiasis / angular cheilitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary causes of xerostomia (salivary gland pathology) (6)

A 
Aplasia (missing gland)
Excision / irradiation
Infection / obstruction
Sjogrens
HIV
Cystic Fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary causes of xerostomia (4)

A

Anxiety
Neurological
Drug therapy
Fluid / electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type of drugs cause xerostomia? (5)

A

antihistamines

antidepressants

antipsychotics

anti-cholinergics

diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can salivary gland diseases be classified (2)

A

Neoplastic

non neoplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Reasons for non-neoplastic salivary gland disease (7)

A 
Developmental
Obstructive
Inflammation
Ischaemic
Trauma
Infection
Autoimmune
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 classifications of salivary disease clinical presentation + examples

A
  1. Acute inflammatory swellings (acute sialadenitis)
  2. Recurrent swellings (sialolith)
  3. Persistent diffuse enlargement (sjogrens)
  4. Nodular enlargement (neoplasm, cyst, lymph node)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Synonym for sialolith

A

Salivary calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

4 reasons for recurrent swelling of salivary gland

A
  1. Salivary calculi
  2. Papillary obstruction
  3. Duct Stricture
  4. Punctate sialectasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is acute sialadenitis? 3 types?

A

Infection causing acute inflammatory swelling

  1. Viral (mumps)
  2. Suppurative
  3. Granulomatous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 reasons for persistent diffuse enlargement of salivary glands

A

Sjogrens syndrome

Sialosis

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is sjogrens syndrome?

A

Chronic multisystem autoimmune exocrinopathy

  • affects middle aged / elderly females
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2 types of sjogrens syndrome

A

Primary “Sicca syndrome” - salivary and lacrimal glands affected

Secondary - salivary/lacrimal glands, + connective tissue/autoimmune disease
- Rheumatoid arthritis, Systemic lupus erythematous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of sjogrens syndrome (4)

A

Persistent xerostomia - dry mouth, caries, depapillated tongue, etc.

Persistent xeropthalmia - dry eyes

Salivary and lacrimal gland enlargement

Parotitis - swollen parotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Investigations / tests for sjogrens (5)

A

Unstimulated SFR - <1.5mL in 15 min

Sialography imaging

Labial gland biopsy

Schirmer test - tear production <5 mm / 5 min

Blood test - Rheumatoid factor, Anti-Ro, Anti-La antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is this

A

Sialography test for investigating sjogrens syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What dangerous thing can histopathology show about sjogren syndrome?

A

Lymphocyte infiltration within intra-glanular septa, acinar atrophy and destruction -> risk of LYMPHOMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of sjogrens syndrome

A

Keep in mind that salivary gland damage is irreversible -> focus on symptomatic relief

Biotene

Caries control

Management of infection and candidiasis

Regular parotid gland examination

Visits with opthamology and rheumatology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Benign vs malignant salivary gland tumour symptoms

A

Benign: slowly enlarging, symptomless lump

Malignant: 
Rapid enlargement
Pain
Ulceration
Bone destruction
Trismus
Facial paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pt says this has been growing slowly. Feels no pain

A

Benign salivary gland tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pt says this has grown quickly, is painful, difficulty opening mouth

A

Malignant submandibular salivary gland tumour

25
Q

3 types of benign salivary gland tumour

A

Pleomorphic salivary adenoma

Adenoma

Adenolymphoma aka Warthin’s tumour

26
Q

5 examples of malignant salivary gland tumours

A 
Mucoepidermoid carcinoma
Acinic cell carinoma
Adenoid cystic carcinoma
Adenocarcinoma
Carcinoma
27
Q

What is the most common salivary gland tumour

A

75% Parotid (80% of these are benign)

15% Submandibular (60% benign)

10% Minor salivary glands (40% benign)

28
Q

Features of pleomorphic salivary adenoma

A

“Mixed tumour” that makes up the majority of salivary gland tumours

  • Arising from duct epithelium or myoepithelial cells
  • Incomplete capsule with ductal, fibrous, elastic and cartilage tissue
  • Rubbery, lobulated swellings that slowly grow
  • Squamous metaplasia and keratin foci
  • Occasionally turns malignant
29
Q
A

Pleomorphic salivary adenoma (PSA)

30
Q

Features of adenoid cystic carcinoma (4)

A
  • Slow growing malignant tumour
  • Late metastases
  • Bony invasion and infiltration along nerve sheaths
  • Cribiform “swiss cheese” histological appearance
31
Q
A

Adenoid cystic carcinoma
- bony invasion and infiltration along nerve sheaths

“Swisscheese” cribiform histological appearance

32
Q

How to investigate sus salivary glands (8)

A
  1. Clinical exam / palpation
  2. Salivary flow rate
  3. Radiography
  4. Ultrasound
  5. Sialography
  6. CT / MR scan
  7. Scintiscanning
  8. Sialadenoscopy
33
Q
A

salivary gland pathology

- stone, tumour

34
Q
A

salivary gland pathology

35
Q

6 types of salivary gland surgery

A
  1. Removal of calculi
  2. Ductal repositioning
  3. Excision of sublingual gland
  4. Excision of submandibular gland
  5. Parotidectomy (superficial, total)
  6. Excision of minor salivary gland lesions / tumours
36
Q

What important structures run through the parotid (5)

A
  1. Facial nerve
  2. Auriculotemporal nerve
  3. External carotid
  4. Retromandiular vein
  5. Stylomandibular ligament
37
Q
A

“Snowstorm appearance”
- Sjorgrens syndrome

S & S

38
Q
A

Sialography

Interruptions / holes in line (radiopaque dye) indicate presence of calculi

39
Q

What are MR scans useful for?

A

Soft tissue evaluation

- not as good for bone

40
Q

How does salivary gland scintiscanning work?

A

Demonstrates uptake and distribution of isotope

  • Assess salivary gland function
  • Demonstrates tumour formation
41
Q

What is likely the cause of recurrent swelling during meal times

A

Sialolith

42
Q

What sizes of sialolith can be removed by sialendoscopy? (3)

A

3-4mm - endoscopy

5-7mm - laser / lithotripsy

> 8mm - combined technique

43
Q
A

Ranula

- fluid collection / cyst under the tongue

44
Q

What is the problem with sublingual gland cyst surgery / ranula removal

A

Will also need to remove sublingual gland in addition to ranula
- If you just remove the cyst, will likely return

45
Q

What nerves can be affected by submandibular gland pathology

A

Hypoglossal nerve - motor supply to muscles of tongue

Lingual nerve

46
Q
A

Submandibular gland swelling

47
Q
A

Sebaceous cyst / epidermoid cyst
- Connected to skin

  • NOT in submandibular gland triangle thus cannot be submandibular swelling/pathology
48
Q

Why do we cut here? (dotted line)

A

Avoids the marginal mandibular branch of the facial nerve

49
Q

What is this and what went wrong

A

Mandibular branch of facial weakness

  • Surgeon did not cut two finger widths below md, knicked the nerve

Should have cut like this pic

50
Q

What does the auriculotemporal nerve innervate

A

TMJ and skin of ear lobe

- runs through parotid

51
Q
A

Facial nerve palsy

52
Q

What is freys syndrome

A

When auriculotemporal nerve is injured due to trauma from surgery near parotid

Every time the patient salivates, sweat is also produced on the surface

53
Q

Lump in the upper lip vs lower lip consideration

A

Be very wary - could be malignant tumour if in upper lip
38 min

Lower lip lump more likely to be benign tumour

54
Q
A

Mucocele or benign minor salivary gland tumour

55
Q
A

Palatal swelling showing signs of potentially malignant tumour

56
Q
A

Adenoid cystic carcinoma

“swiss cheese histologic appearance”

  • malignant

in this picture, dentist had extracted tooth bc they thought swelling was abscess. after the tooth healed the palatal swelling became ulcerated

57
Q
A

“swiss cheese appearance” of adenoid cystic carcinoma

- malignant

57
Q
A

“swiss cheese appearance” of adenoid cystic carcinoma

- malignant

DS4102 (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions