Week 1

Question 1

If someone has a hx of chewing tobacco…what are some things you might be concerned about?

Answer 1

Mouth, tongue, cheek, gum, & throat cancer
Stomach & esophagus cancer
Usual effects of nicotine
higher chance of squamous cell carcinomas.

Question 2

T/F Head & Neck tumors & thyroid cancers are usu familial.

Answer 2

False. Thyroid cancer is. Head & Neck tumors are not.

Question 3

If somebody has a lump near his jaw & is really stressed…what might you put on your differential?

Answer 3

maybe this person is grinding their teeth
maybe they have TMJ or something.
This is usu associated with pain, however, which our pt doesn’t have.

Question 4

What’s the first part of the PE?

Answer 4

general appearance

Question 5

If the man’s lump were red & tender…what might that indicate?

Answer 5

most likely an inflammatory process

but it could be non-inflammation based…& just rapidly growing.

Question 6

Measurements should be done in which units?

Answer 6

SI units

Question 7

What does it mean when a mass is well-circumscribed?

Answer 7

you can feel the edges

Question 8

So…we think that our pt has a parotid gland issue b/c the mass is so large. If it were a lymph node problem what would we find?

Answer 8

the mass would be smaller, more tender & well-circumscribed

Question 9

What are the major salivary glands?

Answer 9

parotid gland
submandibular glands
sublingual glands

Question 10

Describe the secretions of the parotid gland.

Answer 10

makes up 30% of the saliva

primarily serous secretion

Question 11

Describe the secretions of the submandibular gland.

Answer 11

makes up 60% of the saliva

primarily mixed seromucous secretions

Question 12

Describe the secretions of the sublingual gland.

Answer 12

makes up 10% of the saliva.

primarily mucous secretions

Question 13

What is the primary fcn of saliva?

Answer 13

moistening & lubrication of food
initial digestion of carbs & lipids
speech & enunciation

Question 14

What are some additional fcns of salivary glands?

Answer 14

immunological fcn-secrete IgA & lysozymes

*prevent overgrowth of flora & tooth decay

Question 15

What is the problem with dehydration?

Answer 15

it can lead to salivary gland disease.

Question 16

What is Sialolithiasis?

Answer 16

a disease process involving the formation of calculi in the ducts of salivary glands, which prevents drainage of the gland
**sialoliths are stones that block the flow of saliva

Question 17

Which glands usu get sialoliths?

Answer 17

usu the submandibular gland

sometimes the parotid gland

Question 18

Why do sialoliths form?

Answer 18

the pH or viscosity of saliva and the anatomy of the duct

• *submandibular gland has an alkaline secretion
• *happens with decreased saliva (from meds or conditions or reduced food intake)

Question 19

Where does the submandibular gland drain?

Answer 19

drains into Wharton’s duct

Question 20

What are the possible treatments for sialolithiasis?

Answer 20

increasing saliva
sialolithotripsy
surgically or endoscopically removing the entire gland.

Question 21

The facial nerve (cranial nerve VII) exits the skull via the ________ , and runs just anterior to the ______. The first extracranial branch is the __________, which gives some motor innervation to the outer ear, and other motor branches go off to the posterior belly of the diagastric muscle and the stylohyoid muscle. The motor root of the facial nerve then crosses through the parotid gland, where it gives off 5 terminal branches that innervate the facial expression muscles:

Answer 21

stylomastoid foramen
outer ear
posterior auricular nerve

Question 22

What are the 5 terminal branches for facial expression? What do they innervate?

Answer 22

• Temporal branch: innervates the frontalis, orbicularis oculi and corrugator supercilii
• Zygomatic branch: innervates the orbicularis oculi
• Buccal branch: innervates the orbicularis oris, buccinator and zygomaticus muscles
• Mandibular branch: innervates the mentalis muscle
• Cervical branch: innervates the platysma

Question 23

What causes incomplete eye closure in our patient?

Answer 23

caused by decreased innervation to Orbicularis oculi by the zygomatic branch of facial nerve.

Question 24

What might our pt’s lip movement be messed up?

Answer 24

both the buccal branch and mandibular branch of facial nerve

Question 25

What might our pt’s forehead muscles be messed up?

Answer 25

controlled by the temporal branch of facial nerve which innervates the frontalis muscle.

Question 26

Why might there be reduced left mid face & jaw line sensory innervation?

Answer 26

V2 Maxillary nerve and V3 Mandibular nerve. Their final branches are the intraorbital branch, which exits the infraorbital foramen while the mental branch exits the mental foramen

Question 27

Why might the pt have difficulty chewing?

Answer 27

V3 is involved in innervating the muscles of mastication