Salivary glands 1.pdf

anatomy,histology &
physiology of salivary glands
Biju.P.R
Introduction
 Salivary Gland is any cell or organ
discharging a secretion into the oral
cavity.
 Major and minor Salivary Glands
 Major (Paired)
 Parotid
 Submandibular
 Sublingual
 Minor
 Those in the Tongue,
Palatine Tonsil, Palate, Lips
and Cheeks
anatomy of salivary glands
Parotid Gland
 Largest
 Average Wt - 25gm
 Irregular lobulated mass lying
mainly below the external acoustic
meatus between mandible and
sternomastoid.
 On the surface of the masseter,
small detached part lies b/w
zygomatic arch and parotid duct-
accessory parotid gland or ‘socia
parotidis’
Parotid Capsule
 Derived from investing layer of deep cervical fascia.
 Superficial lamina-thick, closely adherent-sends fibrous septa
into the gland.
 Deep lamina-thin- attached to styloid process,mandible and
tympanic plate.
 Stylomandibular ligament.
External Features
 Resembles an inverted 3 sided
pyramid
 Four surfaces
 Superior(Base of the Pyramid)
 Superficial
 Anteromedial
 Posteromedial
 Separated by three borders
 Anterior
 Posterior
 Medial
Relations
 Superior Surface
 Concave
 Related to
 Cartilaginous part of ext
acoustic meatus
 Post. Aspect of
temperomandibular joint
 Auriculotemporal Nerve
 Sup. Temporal vessels
 Apex
 Overlaps posterior belly of digastric
and adjoining part of carotid triangle
 Superficial Surface
 Covered by
 Skin
 Superficial fascia containing facial branches of
great auricular N
 Superficial parotid lymph nodes and post
fibers of platysma
 Anteromedial Surface
 Grooved by posterior border of ramus of
mandible
 Related to
 Masseter
 Lateral Surface of temperomandibular joint
 Medial pterygoid muscles
 Emerging branches of Facial N
 Posteromedial Surface
 Related
 to mastoid process with
sternomastoid and posterior
belly of digastric.
 Styloid process with
structures attached to it.
 External Carotid A. which
enters the gland through
the surface
 Internal Carotid A. which
lies deep to styloid process
Borders
 Anterior border
 Separates superficial surface
from anteromedial surface.
 Structures which emerge at this
border
 Parotid Duct
 Terminal Branches of
facial nerve
 Transverse facial vessels
 Posterior Border
 Separates superficial surface
from posteromedial surface
 Overlaps sternomastoid
 Medial Border
 Separates anteromedial
surface from posteromedial
surface
 Related to lateral wall of
pharynx
Structures within
Parotid Gland
 External carotid A
 Retromandibular Vein
 Facial Nerve
Superficial temporal A
Maxillary
A
P.Auricular A
Superficial temporal V
Maxillary V
Post auricular
V
External jugular Common Facial V
Facial
Nerve
tempora
l
buccal
mandibula
r
cervical
zygomatic
Zygomaticotemporal
Cervicofacial
 Facial Nerve trunk lies approximately 1 cm
inferior and 1 cm medial to tragal cartilage pointer
of external acoustic meatus.
Parotid Duct
 ductus parotideus; Stensen’s duct
 5 cm in length
 Appears in the anterior border
of the gland
 Runs anteriorly and downwards
on the masseter b/w the upper
and lower buccal branches of
facial N.
 At the anterior border of
masseter it pierces
 Buccal pad of fat
 Buccopharyngeal fascia
 Buccinator Muscle
 It opens into the vestibule of
mouth opposite to the 2nd
upper molar
Surface anatomy of Parotid Duct
 Corresponds to middle third of a line drawn from
lower border of tragus to a point midway b/w nasal
ala and upperlabial margin
Blood supply
 Arterial
 Branches of Ext. Carotid A
 Venous
 Into Ext. Jugular Vein
Lymphatic Drainage
Upper Deep cervical nodes
via Parotid nodes
Nerve Supply
 Parasymapthetic N
 Secretomotor via
auriculotemporal N
 Symapathetic N
 Vasomotor
 Delivered from plexus
around the external
carotid artery
 Sensory N
 Reach through the
Great auricular and
auriculotemporal N
Submandibular Salivary Glands
 Irregular in shape
 Large superficial and small deeper part
continous with each other around the post.
Border of mylohyoid
 Superficial Part
 Situated in the digastric triangle
 Wedged b/w body of mandible and mylohyoid
 3 surfaces
 Inferior,Medial,Lateral
 Capsule
 Derived from deep cervical fascia
 Superficial Layer is attached to base of mandible
 Deep layer attached to mylohyoid line of mandible
 Relations
 Inferior- covered by
 Skin
 Supeficial fascia containing
platysma and cervical
branches of facial N
 Deep Fascia
 Facial Vein
 Submandibular Nodes
 Lateral surface
 Related to submandibluar
fossa on the mandible
 Madibular attachment of
Medial pterygoid
 Facial Artery
 Medial surface
 Anterior part is related to myelohyoid
muscle,nerve and vessles
 Middle part-
Hyoglossus,styloglossus,lingual nerve,
submandibular ganglion,hypoglossal
nerve and deep lingual vein.
 Posterior Part-Styloglossus,stylohyoid
ligament,9th
nerve and wall of pharynx
 Deep part
 Small in size
 Lies deep to mylohyoid
and superficial to
hyoglossus and
styloglossus
 Posteriorly continuous
with superficial part
around the posterior
border of mylohyoid
 Submandibluar duct
 Whartons duct
 5 cm long
 Emerges at the anterior end of deep
part of the gland
 Runs forwards on hyoglossus b/w
lingual and hypoglossal N
 At the ant. Border of hyoglossus it is
crossed by lingual nerve
 Opens in the floor of mouth at the side
of frenulum of tongue
Blood Supply
 Arteries
 Branches of facial and
lingual arteries
 Veins
 Drains to the
corresponding veins
 Lymphatics
 Deep Cervical Nodes via
submandibular nodes
 Nerve Supply
 Branches from
submandibular ganglion,
through which it receives
 Parasymapthetic fibers
from chorda tympani
 Sensory fibers from lingual
branch of mandibular
nerve
 Sympathetic fibers from
plexus on facial A
Sublingual Salivary Glands
 smallest of the three glands
 weighs nearly 3-4 gm
 Lies beneath the oral mucosa
in contact with the sublingual
fossa on lingual aspect of
mandible.
 Relations
 Above
 Mucosa of oral floor,
raised as sublingual fold
 Below
 Myelohyoid Infront
 Anterior end of its fellow
 Behind
 Deep part of
Submandibular gland
Lateral
 Mandible above the
anterior part of
mylohyoid line
Medial
 Genioglossus and
separated from it by
lingual nerve and
submandibular duct
 Duct
 Ducts of Rivinus
 8-20 ducts
 Most of them open directly into the
floor of mouth
 Few of them join the submandibular
duct
 Blood supply
 Arterial from sublingual and submental arteries
 Venous drainage corresponds to the arteries
 Nerve Supply
 Similar to that of submandibular glands( via lingual nerve ,
chorda tympani and sympathetic fibers)
Embryology
 Salivary glands develop as outgrowths of buccal epithelium
 Parotid – ectodermal in origin
 Submandibular &
Sublingual – endodermal in origin
 Parotid – 4th
Wk of gestation
 Submandibular – 6th
Wk of gestation
 Sublingual – 9th
Wk of gestation
histology
 Compound Tubuloalveolar glands
 Structure
 Closely packed acini or alveoli with ducts scattered in
between
 Supported by connective tissue which divides the gland into
lobules
 Cells lining the alveoli
 Serous or mucous
 Serous
 Stain darkly (zymogen granules)
 Wedge shaped with round nucleus, lying
towards the base
 Mucous
 Lightly stained
 Appears empty
 Polyhedral
 Contain mucinogen granules
 Nucleus flattened ,close to the basement
membrane
 Parotid
 Serous type
 Sublingual
 Mucous
 Submandibular
 Mixed type –some mucous
alveoli capped by serous
cresents –
’Demilunes’
Parotid
Sublingual
Submandibular
 Ducts
 Secretions pass through a system of ducts
 Smallest – intercalated ducts lined by flattened cells
 Intercalated ducts open into striated ducts lined by cuboidal cells
 Striated ducts open into excretory ducts lined by simple columnar
epithelium
 Myoepithelial cells
 Present in relation to alveoli and
intercalated ducts
 Those on the alveoli are
branched-’Basket Cells’
 Those on the ducts are fusiform
 Contractile cells helps to squeeze
out secretions from alveoli
physiology
 Main function of Salivary
Gland-secretion of saliva
 Daily secretion -800 to
1500 ml
 pH : 6-7
Saliva Compositon
Water (99.5%) Solid (0.5%)
Organic Inorganic
Ptyalin
Mucin
Lysozyme
IgA
Lactoferrin
Na+
K+
Ca+
Cl-
HCO3
Mg
 Ionic Composition
 Saliva in the acini-isotonic with plasma
 Under resting condition ionic composition of saliva reaching
the mouth
 Na+ and Cl- 15 mEq/l (1/7 to 1/10 conc of Plasma)
 K+ 30 mEq/l (7 times that of Plasma)
 HCO3- 50-70 mEq/l (2-3 times that of plasma)
 During maximal salivation
 Na+ and Cl- (1/2 to 2/3 conc of Plasma)
 K+ (4 times that of Plasma)
 HCO3- 50-70 mEq/l (2-3 times that of plasma)
Functions of Saliva
 Keep the mouth moist
 Aids in swallowing
 Aids in speech
 Keeps the mouth and teeth
clean
 Antimicrobial action
 Digestive function
 Bicarbonate acts as buffer
Salivary
Salivary
Families
Families
Anti-
Anti-
Bacterial
Bacterial
Buffering
Buffering
Digestion
Digestion
Mineral-
Mineral-
ization
ization
Lubricat-
Lubricat-
ion &Visco-
ion &Visco-
elasticity
elasticity
Tissue
Tissue
Coating
Coating
Anti-
Anti-
Fungal
Fungal
Anti-
Anti-
Viral
Viral
Carbonic anhydrases,
Carbonic anhydrases,
Histatins
Histatins
Amylases,
Amylases,
Mucins, Lipase
Mucins, Lipase
Cystatins,
Cystatins,
Histatins, Proline-
Histatins, Proline-
rich proteins,
rich proteins,
Statherins
Statherins
Mucins, Statherins
Mucins, Statherins
Amylases,
Amylases,
Cystatins, Mucins,
Cystatins, Mucins,
Proline-rich proteins, Statherins
Proline-rich proteins, Statherins
Histatins
Histatins
Cystatins,
Cystatins,
Mucins
Mucins
Amylases, Cystatins,
Amylases, Cystatins,
Histatins, Mucins,
Histatins, Mucins,
Peroxidases
Peroxidases
●
Under neural control
●
Mainly by parasympathetic signals from
Sup & Inf salivatory nuclei
Control of Salivary Secretion
Sup Salivatory Nu
Inf Salivatroy Nu
Facial N
Otic Ganglion
Chorda tympani N
Submandibular G
Parotid Gland
 Parasympathetic stimulation-
profuse secretion of watery saliva
 Sympathetic stimulation-
scanty viscid secretion
 Sympathetic supply comes from cervical
sympathetic chain along the blood vessels
 Salivatory nuclei are excited by
 Taste and tactile stimuli from tongue
and other areas of mouth and
pharynx
 Stimuli from esophagus and stomach
(due to stimulation of vagal afferent
fibers
 (unconditioned reflex)
 Stimuli arising from higher centers
of brain due to sight, smell or
thought of food
 (conditioned reflex).
Pavlov with his dog
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Salivary glands 1.pdf

  • 1. anatomy,histology & physiology of salivary glands Biju.P.R
  • 2. Introduction  Salivary Gland is any cell or organ discharging a secretion into the oral cavity.  Major and minor Salivary Glands  Major (Paired)  Parotid  Submandibular  Sublingual  Minor  Those in the Tongue, Palatine Tonsil, Palate, Lips and Cheeks
  • 4. Parotid Gland  Largest  Average Wt - 25gm  Irregular lobulated mass lying mainly below the external acoustic meatus between mandible and sternomastoid.  On the surface of the masseter, small detached part lies b/w zygomatic arch and parotid duct- accessory parotid gland or ‘socia parotidis’
  • 5. Parotid Capsule  Derived from investing layer of deep cervical fascia.  Superficial lamina-thick, closely adherent-sends fibrous septa into the gland.  Deep lamina-thin- attached to styloid process,mandible and tympanic plate.  Stylomandibular ligament.
  • 6. External Features  Resembles an inverted 3 sided pyramid  Four surfaces  Superior(Base of the Pyramid)  Superficial  Anteromedial  Posteromedial  Separated by three borders  Anterior  Posterior  Medial
  • 7. Relations  Superior Surface  Concave  Related to  Cartilaginous part of ext acoustic meatus  Post. Aspect of temperomandibular joint  Auriculotemporal Nerve  Sup. Temporal vessels  Apex  Overlaps posterior belly of digastric and adjoining part of carotid triangle
  • 8.  Superficial Surface  Covered by  Skin  Superficial fascia containing facial branches of great auricular N  Superficial parotid lymph nodes and post fibers of platysma  Anteromedial Surface  Grooved by posterior border of ramus of mandible  Related to  Masseter  Lateral Surface of temperomandibular joint  Medial pterygoid muscles  Emerging branches of Facial N
  • 9.  Posteromedial Surface  Related  to mastoid process with sternomastoid and posterior belly of digastric.  Styloid process with structures attached to it.  External Carotid A. which enters the gland through the surface  Internal Carotid A. which lies deep to styloid process
  • 10. Borders  Anterior border  Separates superficial surface from anteromedial surface.  Structures which emerge at this border  Parotid Duct  Terminal Branches of facial nerve  Transverse facial vessels
  • 11.  Posterior Border  Separates superficial surface from posteromedial surface  Overlaps sternomastoid  Medial Border  Separates anteromedial surface from posteromedial surface  Related to lateral wall of pharynx
  • 12. Structures within Parotid Gland  External carotid A  Retromandibular Vein  Facial Nerve Superficial temporal A Maxillary A P.Auricular A Superficial temporal V Maxillary V Post auricular V External jugular Common Facial V Facial Nerve tempora l buccal mandibula r cervical zygomatic Zygomaticotemporal Cervicofacial
  • 13.  Facial Nerve trunk lies approximately 1 cm inferior and 1 cm medial to tragal cartilage pointer of external acoustic meatus.
  • 14. Parotid Duct  ductus parotideus; Stensen’s duct  5 cm in length  Appears in the anterior border of the gland  Runs anteriorly and downwards on the masseter b/w the upper and lower buccal branches of facial N.
  • 15.  At the anterior border of masseter it pierces  Buccal pad of fat  Buccopharyngeal fascia  Buccinator Muscle  It opens into the vestibule of mouth opposite to the 2nd upper molar
  • 16. Surface anatomy of Parotid Duct  Corresponds to middle third of a line drawn from lower border of tragus to a point midway b/w nasal ala and upperlabial margin
  • 17. Blood supply  Arterial  Branches of Ext. Carotid A  Venous  Into Ext. Jugular Vein Lymphatic Drainage Upper Deep cervical nodes via Parotid nodes
  • 18. Nerve Supply  Parasymapthetic N  Secretomotor via auriculotemporal N  Symapathetic N  Vasomotor  Delivered from plexus around the external carotid artery  Sensory N  Reach through the Great auricular and auriculotemporal N
  • 19. Submandibular Salivary Glands  Irregular in shape  Large superficial and small deeper part continous with each other around the post. Border of mylohyoid  Superficial Part  Situated in the digastric triangle  Wedged b/w body of mandible and mylohyoid  3 surfaces  Inferior,Medial,Lateral
  • 20.  Capsule  Derived from deep cervical fascia  Superficial Layer is attached to base of mandible  Deep layer attached to mylohyoid line of mandible
  • 21.  Relations  Inferior- covered by  Skin  Supeficial fascia containing platysma and cervical branches of facial N  Deep Fascia  Facial Vein  Submandibular Nodes  Lateral surface  Related to submandibluar fossa on the mandible  Madibular attachment of Medial pterygoid  Facial Artery
  • 22.  Medial surface  Anterior part is related to myelohyoid muscle,nerve and vessles  Middle part- Hyoglossus,styloglossus,lingual nerve, submandibular ganglion,hypoglossal nerve and deep lingual vein.  Posterior Part-Styloglossus,stylohyoid ligament,9th nerve and wall of pharynx
  • 23.  Deep part  Small in size  Lies deep to mylohyoid and superficial to hyoglossus and styloglossus  Posteriorly continuous with superficial part around the posterior border of mylohyoid
  • 24.  Submandibluar duct  Whartons duct  5 cm long  Emerges at the anterior end of deep part of the gland  Runs forwards on hyoglossus b/w lingual and hypoglossal N  At the ant. Border of hyoglossus it is crossed by lingual nerve  Opens in the floor of mouth at the side of frenulum of tongue
  • 25. Blood Supply  Arteries  Branches of facial and lingual arteries  Veins  Drains to the corresponding veins  Lymphatics  Deep Cervical Nodes via submandibular nodes
  • 26.  Nerve Supply  Branches from submandibular ganglion, through which it receives  Parasymapthetic fibers from chorda tympani  Sensory fibers from lingual branch of mandibular nerve  Sympathetic fibers from plexus on facial A
  • 27. Sublingual Salivary Glands  smallest of the three glands  weighs nearly 3-4 gm  Lies beneath the oral mucosa in contact with the sublingual fossa on lingual aspect of mandible.
  • 28.  Relations  Above  Mucosa of oral floor, raised as sublingual fold  Below  Myelohyoid Infront  Anterior end of its fellow  Behind  Deep part of Submandibular gland
  • 29. Lateral  Mandible above the anterior part of mylohyoid line Medial  Genioglossus and separated from it by lingual nerve and submandibular duct
  • 30.  Duct  Ducts of Rivinus  8-20 ducts  Most of them open directly into the floor of mouth  Few of them join the submandibular duct
  • 31.  Blood supply  Arterial from sublingual and submental arteries  Venous drainage corresponds to the arteries  Nerve Supply  Similar to that of submandibular glands( via lingual nerve , chorda tympani and sympathetic fibers)
  • 32. Embryology  Salivary glands develop as outgrowths of buccal epithelium  Parotid – ectodermal in origin  Submandibular & Sublingual – endodermal in origin  Parotid – 4th Wk of gestation  Submandibular – 6th Wk of gestation  Sublingual – 9th Wk of gestation
  • 34.  Compound Tubuloalveolar glands  Structure  Closely packed acini or alveoli with ducts scattered in between  Supported by connective tissue which divides the gland into lobules
  • 35.  Cells lining the alveoli  Serous or mucous  Serous  Stain darkly (zymogen granules)  Wedge shaped with round nucleus, lying towards the base  Mucous  Lightly stained  Appears empty  Polyhedral  Contain mucinogen granules  Nucleus flattened ,close to the basement membrane
  • 36.  Parotid  Serous type  Sublingual  Mucous  Submandibular  Mixed type –some mucous alveoli capped by serous cresents – ’Demilunes’ Parotid Sublingual Submandibular
  • 37.  Ducts  Secretions pass through a system of ducts  Smallest – intercalated ducts lined by flattened cells  Intercalated ducts open into striated ducts lined by cuboidal cells  Striated ducts open into excretory ducts lined by simple columnar epithelium
  • 38.  Myoepithelial cells  Present in relation to alveoli and intercalated ducts  Those on the alveoli are branched-’Basket Cells’  Those on the ducts are fusiform  Contractile cells helps to squeeze out secretions from alveoli
  • 40.  Main function of Salivary Gland-secretion of saliva  Daily secretion -800 to 1500 ml  pH : 6-7
  • 41. Saliva Compositon Water (99.5%) Solid (0.5%) Organic Inorganic Ptyalin Mucin Lysozyme IgA Lactoferrin Na+ K+ Ca+ Cl- HCO3 Mg
  • 42.  Ionic Composition  Saliva in the acini-isotonic with plasma  Under resting condition ionic composition of saliva reaching the mouth  Na+ and Cl- 15 mEq/l (1/7 to 1/10 conc of Plasma)  K+ 30 mEq/l (7 times that of Plasma)  HCO3- 50-70 mEq/l (2-3 times that of plasma)  During maximal salivation  Na+ and Cl- (1/2 to 2/3 conc of Plasma)  K+ (4 times that of Plasma)  HCO3- 50-70 mEq/l (2-3 times that of plasma)
  • 43. Functions of Saliva  Keep the mouth moist  Aids in swallowing  Aids in speech  Keeps the mouth and teeth clean  Antimicrobial action  Digestive function  Bicarbonate acts as buffer
  • 44. Salivary Salivary Families Families Anti- Anti- Bacterial Bacterial Buffering Buffering Digestion Digestion Mineral- Mineral- ization ization Lubricat- Lubricat- ion &Visco- ion &Visco- elasticity elasticity Tissue Tissue Coating Coating Anti- Anti- Fungal Fungal Anti- Anti- Viral Viral Carbonic anhydrases, Carbonic anhydrases, Histatins Histatins Amylases, Amylases, Mucins, Lipase Mucins, Lipase Cystatins, Cystatins, Histatins, Proline- Histatins, Proline- rich proteins, rich proteins, Statherins Statherins Mucins, Statherins Mucins, Statherins Amylases, Amylases, Cystatins, Mucins, Cystatins, Mucins, Proline-rich proteins, Statherins Proline-rich proteins, Statherins Histatins Histatins Cystatins, Cystatins, Mucins Mucins Amylases, Cystatins, Amylases, Cystatins, Histatins, Mucins, Histatins, Mucins, Peroxidases Peroxidases
  • 45. ● Under neural control ● Mainly by parasympathetic signals from Sup & Inf salivatory nuclei Control of Salivary Secretion Sup Salivatory Nu Inf Salivatroy Nu Facial N Otic Ganglion Chorda tympani N Submandibular G Parotid Gland
  • 46.  Parasympathetic stimulation- profuse secretion of watery saliva  Sympathetic stimulation- scanty viscid secretion  Sympathetic supply comes from cervical sympathetic chain along the blood vessels
  • 47.  Salivatory nuclei are excited by  Taste and tactile stimuli from tongue and other areas of mouth and pharynx  Stimuli from esophagus and stomach (due to stimulation of vagal afferent fibers  (unconditioned reflex)  Stimuli arising from higher centers of brain due to sight, smell or thought of food  (conditioned reflex). Pavlov with his dog