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21 terms

Salivary glands

STUDY
PLAY
Parotid Innervation
salivary nucleus -> CN 9 AND Jacobsen's nerve-> otic ganglion -> auriculotemporal nerve -> parotid
Submand/lingual innervations
salivary nucleus -> CN 7 AND chorda tympani -> petrotympanic fissure w/ lingual nerve -> SM ganglion -> SM and SL glands
SG Histopathology
originate as ectodermal oral epith....acini units...serous/mucous.....intercalated-striated-extretory ducts.......Parotid-serous(stimulated flow)...SM- Serous mucus(main flow)......SL- Mucus.....PS system controls
Hemangioma & Arteriovenus malformation
H- overlying skin color change...........AVM- "thrill" changes w/ valsalva and posture. .......Tx: Conservative (mostly spont. Resolution) Refractory (steroids) Last resort (surgery)
Infections
Sialoadenitis/Parotitis...elderly, diabetics, staph.......Mumps, HIV.......TB, Cat-scratch, NonTB myobacterial disease
Mumps
myxovirus...2-3wk incuation.......PRODROME (FMH), parotid swelling, possible SNHL, encephalitis, orchitis, oophoritis, pancreatitis...pain increases w/ sour liquids.......
Tx: supportive/sxmatic
...
Sialothiliasis
salivary stone-> ductal damage & gland infection
Mucocele
*Most common Trauma effect. Trauma to excretory -> mucus into surrounding connective tissue.......Painess, smooth, blue lesions.... Lower lip > cheek > ventral tongue > FOM.......Tx observation and surgery
Ranula
"frog like"....blocked SL gland ducts, mucus extravasation, unilateral, bluish ... Plunging herniates mylohyoid muscle, appears in neck....
Sjogren's
most common autoimmune. "dry disease" ... xerophthalmia (eyes), xerosomia (mouth) ... *4/6 critera...at least 2 objective........ R/O lymphoma, Hep C, AIDS, Sarc, GVHD, XRT>3mos....lip biopsy, no salv flow, Abnl sialography/scintigraphy...anti-SSA or Anti SSB autoantibodies.........secondary to RA and SLE
Sarcoidosis
parotid most common site ***elevated ACE. Autoimmune.
Kimura's disease
autoimmune. Gland enlargement +/- lymphadenopathy....angiolymphoid hyperplasia **eosinophilia
Metabolic
DM & HLD....fatty infiltration, decreased salivary flow.......Pellagra (niacin), Kwashiorkor (protein), Beriberi (thiamine), Alcoholism (protein), Vitamin A def.
Idiopathic Xerostomia
RT, HTN meds, Anti-histamine, Anti-depressants, Muscle relaxants
Pleomorphic Adenoma
Most common benign tumor. Along w/ warthins and benign cyst.
Mucoepidermoid
Most common malignant. Along w/ adenoid cystic and adenocarcinoma.
Frey's syndrome
Aberrant neural pattern—sweat glands innervated by parotid PS fibers. Sweating on cheek area—gustatory sweating. Stop w/ botox, deodorant...
First Bite Syndrome
Cramping pain w/ 1st bite of food...cause: sympathectomy.... Seen w / Horner's.... Treat w/ botox, gabapentin
Branchial Cleft Cyst
residual embryonic pouch of endoderm, lined w/ digestive tract epithelium, swells with infection,infancy or late adulthood, complete surgical excision
Chronic Sialorrhea
increase in salivary flow...spills over lower lip...due to swallowing probs, poor lip closure synchronization....therapy, botox of salivary glands, duct ligation, gland excision, duct re-routing