Objectives

2947 Describe the distribution of taste buds in the tongue.

• circumvalate
• folate
• fungiform
• filiform

2948 Recognize the features suggestive of a benign or malignant neoplasm of the salivary glands.

• benign
  • painless mass
  • slow growing
• malignant
  • painful mass
  • can also be slow growing
  • facial nerve palsy
  • lympadenopathy
  • skin involvement

2949 Describe the nerve supply to the tongue including motor, sensory and special sensory components.

• motor
  • XII (hypoglossal nerve)
• sensory
  • solitary nucleus (receives all peripheral taste nerves)
  • cranial nerves
    • anterior 2/3 of tongue: facial nerve (VII)/ chorda tympani
    • posterior 2/3: glossopharyngeal nerve (IX)
    • small area on epiglottis: vagus nerve (X)
  • peripheral nerves
    • anterior 2/3: lingual nerve (V3) to trigeminal nucleus
    • posterior 2/3: pharyngeal brancges of glossopharyngeal nerve

2950 Describe the location of the major and minor salivary glands and indicate the nerve supply to the major salivary glands.

• major salivary glands
  • parotid
    • stenson’s duct at 2nd molar
    • parasympathetic innervation: glossopharyngeal nerve, auriculotemporal nerve, parotid gland
  • submandibular
    • wharton’s duct under tongue
    • superior salivatory nucleus, facial nerve, submandibular ganglion
  • sublingual
    • duct of rivinus
    • superior salivatory nucleus, facial nerve, submandibular ganglion
• minor salivary glands
  • 600-1000

2952 List the functions of saliva and list 3 causes of xerostomia.

• functions of saliva
  • lubricate
  • helps mastication and swallowing
  • helps articulate
  • taste
  • oral hygiene
  • protective role (IgA)
• xerostomia causes
  1. medications
  2. head and neck cancer
  3. Sjogren’s syndrome

2955 Define sialadenitis and sialolithiasis and know the presenting features of each.

• sialadenitis
  • infection of salivary gland (most common parotid)
  • presentation:
    • sudden onset of gland enlargement
    • induration
    • tenderness
    • +/- purulent saliva at duct opening
• sialolithiasis
  • stones in salivary gland/duct
  • presentation:
    • painful swelling with eating, resolves
    • can be infected