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ANATOMY SALIVARY GLANDS

Parotid gland

Largest salivary gland

Composed mostly of serous acini

Entirely outside the boundaries of the oral cavity in a shallow triangular -shaped trench formed by: o Sternocleidomastoid muscle behind o Ramus of mandible in the front o Superiorly the base of the trench formed by the external acoustic meatus and the posterior aspect of the

zygomatic arch

Gland normally extends anteriorly over the masseter muscle and inferiorly over the posterior belly of the digastric muscle.

Facial nerve divides the gland into superficial and deep lobes.

The parotid duct (Stensen’s duct) emerges from the anterior border of the gland and passes anteriorly across the external

surface of the masseter muscle and then turns medially to penetrate the buccinator muscle of the cheek and open into the oral cavity adjacent to the crown of the second upper molar tooth.

The parotid gland encloses the external carotid artery, the retromandibular vein, and the origin of the extracranial part of the facial nerve [VII].

Nerve supply Parasympathetic 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. Submandibular gland

The elongate submandibular glands are smaller than the parotid glands, but larger than the sublingual glands. Each is hook-shaped:

o The larger arm of the hook is directed forward in the horizontal plane below the mylohyoid muscle and is therefore outside the boundaries of the oral cavity – this larger superficial part of the gland is directly against a shallow

impression on the medial side of the mandible (submandibular fossa) inferior to the mylohyoid line. o Smaller arm of the hook (or deep part) of the gland loops around the posterior margin of the mylohyoid muscle to

enter and lie within the floor of the oral cavity where it is lateral to the root of the tongue on the lateral surface of

the hyoglossus muscle.

Consists of a mixture of serous and mucous acini.

Lies beneath the lower border of the body of the mandible.

Divided into superficial and deep parts by the mylohyoid muscle.

The deep part of the gland lies beneath the mucous membrane of the mouth on the side of the tongue.

The submandibular duct (Wharton’s duct) emerges from the medial side of the deep part of the gland in the oral cavity and passes forward to open on the summit of a small sublingual caruncle (papilla) beside the base of frenulum of the tongue

The lingual nerve loops under the submandibular duct, crossing first the lateral side and then the medial side of the duct, as the nerve descends Anteromedially through the floor of the oral cavity and then ascends into the tongue.

Nerve supply Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani, and the submandibular ganglion. The

postganglionic fibers pass directly to the gland Sublingual gland

Smallest of the three major paired salivary glands.

Each is almond shaped and immediately lateral to the submandibular duct and associated lingual nerve in the floor of the oral cavity.

Lies beneath the mucous membrane (sublingual fold) of the floor of the mouth, close to the frenulum of the tongue. Lies directly against the medial surface of the mandible where it forms a shallow groove (sublingual fossa) superior to the

anterior one-third of the mylohyoid line.

It has both serous and mucous acini, with the latter predominating.

The sublingual ducts (8 to 20 in number) open into the mouth on the summit of the sublingual fold.

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Nerve supply Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani, and the submandibular ganglion.

Postganglionic fibers pass directly to the gland Vessels

Vessels that supply the parotid gland originate from the external carotid artery and from its branches that are adjacent to

the gland.

The submandibular and sublingual glands are supplied by branches of the facial and lingual arteries.

Veins from the parotid gland drain into the external jugular vein

Veins from the submandibular and sublingual glands drain into lingual and facial veins.

Lymphatic vessels from the parotid gland drain into nodes that are on or in the gland. These parotid nodes then drain into the superficial and deep cervical nodes.

Lymphatics from the submandibular and sublingual glands drain mainly into submandibular nodes and into deep cervical nodes, particularly the jugulo-omohyoid node.

Functions of saliva

Moistens oral mucosa

Moistens and cools food

Medium for dissolved food

Buffer (HCO3)

Digestion (amylase and lipase)

Antibacterial (lysozyme, IgA, peroxidase, FLOW)

Mineralization

Protective pellicle Salivary glands (Lecture notes)

Major salivary glands o Parotid o Submandibular o Sublingual

Minor salivary glands Parotid region Part of the face in front of ear, below zygomatic arch is the parotid region

Major and minor groups of salivary glands Major groups of salivary glands which consist of three major glands

1. The parotid 2. Submandibular 3. Sublingual

The parotid and submandibular glands each drain into the mouth in a single long duct Sublingual → many small ducts opening below the tongue

Minor groups Found in lips, cheeks, tongue, floor of mouth, palate, larynx, trachea, tonsils and lacrimal gland. Liable to undergo some pathological change as the major groups.

Deficiency Deficiency of saliva causes dry mouth (xerostomia)

E.g. dehydration, Sjögren’s syndrome, atropine blocks, action of parasympathetic nerves on the glands. Surface anatomy Has a triangular profile when viewed externally and in cross section

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Below ear interval between mandible and anterior border of sternocleidomastoid muscle.

Largest of salivary glands

Broad superficial and small deep lobe

Facial nerve between the two lobes

Mainly a serous gland (thin watery secretions)

Stensen’s duct (main duct) empties into oral cavity opposite the crown of second maxillary molar.

Relations of the parotid gland

Lateral / superficial surface

Skin and superficial fascia

Great auricular nerve

Anteromedial surface

Posterior border of mandibular ramus

Masseter and medial pterygoid muscle

Temporomandibular joint

Branches of facial nerve Posteromedial relations

Mastoid process with sternocleidomastoid and posterior belly of digastric muscle

Styloid process and its attached muscles (stylohyoid, styloglossus)

Carotid sheath and its contents o Internal carotid artery o Internal jugular vein

o Vagus nerve o Glossopharyngeal nerve o Accessory nerve o Hypoglossal nerve

Structures passing through parotid gland

Facial nerve

Retromandibular nerve

External carotid artery

Auriculotemporal nerve (form V3) Blood supply

External carotid artery o Superficial temporal o Maxillary arteries

Vein drains into the retromandibular vein Submandibular gland

May be divided into superficial and deep parts

o Superficial part lies beneath the lower margin of the body of the mandible o Deep part of submandibular gland, the submandibular duct and sublingual gland may be palpated through the

mucous membrane covering the floor of the mouth in the interval b/w the tongue and lower jaw

Its duct opens beside the frenulum of the tongue