Presentation on theme: "NURSING CARE Salivary Gland Disorders"— Presentation transcript:
1NURSING CARE Salivary Gland Disorders ByNi Ketut Alit AFaculty Of Nursing Airlangga University
2REFERENCESBlack, J.M. & Matassarin E, (1997). Medical Surgical Nursing: Clinical Management for continuity of care. J.B. Lippincott.co.Barbara C.L & Wilma J.P. (2006). Essentials of Medical Surgical Nursing. Philadelphia: Lippincott Williams & Wilkins.Smeltzer, S.C., & Bare, B. (2003). Brunner and Suddarth's Textbook of Medical-Surgical Nursing (10th ed.). Philadelphia: Lippincott Williams & Wilkins.Ignativicius & Bayne. (2001). Medical and Surgical Nursing. Philadelphia: W.B. Saunders Company.Luckman & Sorensen. (2000). Medical Surgical Nursing. Philadelphia: W.B. Saunders Company.Journals and article related to..
3OVERVIEW Salivary glands are exocrine glands (have duct system to flow their secretions)The saliva that is produced by these glands is brought to the oral cavity.
4Types of salivary glands The Major Salivary GlandsParotid glands.Submandibular glands.Sublingual glands.The Minor Salivary Glandsnumerous in the oral cavity and are named according to their locationsLabial & buccal glands.Glossopalatine glands.Palatine glands.Lingual glands.
5Parotid gland The largest salivary glands. Located inferior and anterior to the ears, between the skin and the masseter muscle.The parotid duct (stanson’s duct ) emerges from the anterior border of the gland and passes forward over the lateral surface of the masseter, enters the vestibule of the mouth upon a small papilla opposite the upper second molar tooth.It’s a pure serous gland, composed mostly of serous acini.Structures passing through parotid gland:Facial nerve.Retromandibular vein.External carotid artery.
6Submandibular glandFound in the floor of the mouth; it is medial and partly inferior to the body of the mandible.It is divided into superficial and deep parts by the mylohyhoid muscle.The submandibular duct ( wharton’s duct ) emerges form the anterior end of the deep part of the gland and runs forward beneath the mucous membrane of the mouth, It opens at the lingual frenulum on the floor of the mouth.It has a mixed secretion both serous and mucous, consists of a mixture of serous and mucous acini.
7Sublingual glandLocated beneath the tongue and superior to the submandibular gland.It’s ducts open into the floor of the mouth in the oral cavity.It’s a mixed gland, it has both serous and mucous acini, with the latter predominating.
8Nerve supply of major salivary glands Parotid GlandParasympthetic secretomotor supply arises from the glossopharyngeal nerve.The nerves reach the gland via the tympanic branch, the lesser petrosal nerve, the otic ganglion, and the auriculotemporal nerve.
9Nerve supply of major salivary glands Submandibular GlandParasympathetic secremotor supply is from the facial nerve.The postganglionic fibers pass directly to the gland.Sublingual GlandParasympathetic secretomotor supply is from the facial nerve.Postgaglionic fibers pass directly to the gland.
10Function of saliva Digestion : Moistens dry foods to aid swallowing. Disinfectants : Salivary lysozyme, IgA and other antibacterial substances protect against caries and oral cavity infections.Hormonal : Saliva secretes Gustin hormone which is thought to play a role in the development of taste buds.
11Non-neoplastic diseases (Infections and Inflammations ) Salivary GlandsNon-neoplastic diseases(Infections and Inflammations )
12Mumps Mumps is an acute sialadenitis which caused by an RNA virus This RNA virus is the “paramxovirus”Other virus which can cause salivary infections are:CytomegalovirusCoxsackievirusesEchovirus
13Mumps CLINICAL FEATURES Airborne droplets transmit mumps virus It mainly effects the parotid gland.Children between the ages of 5-18 years are infected the most.Once exposed the patient will develop the disease within 2-3 weeksThere is rapid swelling of the parotids bilaterallyThere is an acute pain while salivation.Symptoms: Asymptomatic Swollen, painful salivary glands on one or both sides .Pain with chewing or swallowingFeverWeakness and fatigue:ComplicationsComplications of mumps are potentially serious, but rare. These include:PancreatitisOrchitisMeningitisOrchitis= Inflammation and swelling of the testes, caused by infection
14Mumps Treatment: Mumps is a self-limited disease . Treated with bed rest .Use analgesics to relieve pain and reduce fever such as:Acetaminophen .Nonsteroidal anti-inflammatory drugs.Complications may require treatment in the hospital.Prevention:The most common preventative measure against mumps is immunization witha mumps vaccine.relieves pain by inhibiting prostaglandin synthesis in the central nervous system and reduces fever by acting on the temperature-regulating centre of the brain
15SialolithiasisSialolithiasis is the formation or presence of a calculus orcalculi in a salivary gland.It is most commonly seen in the submandibular glandand duct (about 80% of cases), then the parotid glandand duct .Sialolithiasis is rare in the sublingual gland.Most stones are solitary, but multiple stones may be present.The reason why a stone forms is unknown
16Sialolithiasis Symptoms: May be asymptomatic Dull pain from time to time over the affected gland Swollen .Pain with chewing or swallowing:ComplicationsOral infectionInvestigations:CT scan, ultrasound scan or MRI scan.Sialography (silogram).Sialendoscopy.
17Sialolithiasis Treatment: Gentle probing into the duct from inside the mouth with a thin blunt instrument can sometimes free a stone which then falls into the mouth. This is done by a doctor.Therapeutic sialendoscopy It uses a very thin endoscope (tube) with a camera and light at the tip. The tube is pushed into the duct. If a stone is seen, then a tiny pair of 'grabbers' that are attached to the tube is used to grab the stone and pull it out.A small operation. It can be usedif therapeutic sialendoscopyis not an availableShock wave treatment usesultrasound waves to breakstones. The broken fragmentsthen pass out along the duct.
18SialadenitisThe salivary glands contain a network of ducts. Saliva flows through them into the mouth. If the flow is reduced or stopped for some reason, infection can grow.This infection called sialadenitis .The most common infection is bacterial.Sialadenitis is most common in the parotid gland and the submandibular gland.
19Sialadenitis Symptoms: Tender, painful in cheek or under chin. Pus may drain through the gland into the mouth.If the infection spreads, fever, chills and malaise may occur.:ComplicationsOral infection.Upper respiratory tract infection.Upper GIT infection.Investigations:Physical examinations.CT scan, ultrasound scan or MRI scan.Culture for identify the organism.
20Sialadenitis Treatment: The first step is to make sure about fluid balance.Patient needs to receive fluids intravenouslyAntibiotics to destroy the bacteria.Sugarless sour candies or gum is recommend ,they can stimulate the glands to produce more saliva.If the infection is not improving, surgery may be needed to open and drain the gland.Prevention:Always drink plenty of fluids. This is especially important after surgery, during illness or in elderly people
21ASSESSMENT History : pain, swelling, edema Change Of appetite Diet Physical examinationThe nurse assesses for client anxiety and fear.