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SALIVARY gland.pptx
- 1. Anatomy of salivary glands Karthika lekshmi.j.s Final year MBBS
- 2. Areas of focus Anatomy of the salivary gland Benign diseases Malignant diseases Management Presentation title 2
- 3. Salivary glands are compound, tubuloacinar exocrine glands whose ducts open into the oral cavity. They secrete saliva, a fluid that lubricates food to assist deglutition, moistens the buccal mucosa, which is important for speech, and provides an aqueous solvent necessary for taste and a fluid seal for sucking and suckling. Salivary glands also secrete digestive enzymes, e.g. salivary amylase, and antimicrobial agents, e.g. immunoglobulin A (IgA), lysozyme and lactoferrin, into saliva Presentation title 3
- 4. 20XX presentation title 4 SALIVARY GLANDS MAJOR PAROTID GLAND SUBMANDIBULAR SUBLINGUAL MINOR BUCCAL PALATOGLOSSAL PALATAL LABIAL LINGUAL
- 5. Development Parotid gland – ectoderm of the vestibule of the mouth Submandibular gland develops as a single large bud from the endodermal lining of the floor of the mouth. The sublingual gland, series of small buds develops from the endodermal lining of the Presentation title 5
- 6. Parotid Gland • It is a lobulated, yellowish brown gland, weighing about 25g. • Location – Retromandibular fossa – posterior to the ramus of the mandible • Secretions – Serous • Extent • Above – External Auditory meatus, zygomatic arch • Below – Upper part of the carotid triangle • Medial – Styloid process, then wraps around the neck of the mandible • Posterior – Overlaps the sternocleidomastoid • Anterior – Extends over the masseter Presentation title 6
- 8. Parotid sheath The parotid gland is enclosed in a fibrous capsule called parotid capsule It is formed by the tough investing layer of deep cervical fascia. This fascia splits in the region between the angle of the mandible and mastoid process to enclose the gland. Presentation title 8
- 9. Parotid duct • Also called Stenson’s duct • 5cm long • Emerges from the anterior border of the gland • Opens into the vestibule of the mouth, opposite to the crown of the upper 2nd molar tooth.
- 10. GOES FORWARD OVER THE MASSETER, BETWEEN UPPER AND LOWER BUCCAL BRANCHES OF FACIAL NERVE EMERGES FROM THE ANTERIOR BORDER OF THE GLAND AT THE ANTERIOR BORDER OF THE MASSETER, IT ABRUPTLY TURNS INWARD ALMOST AT A 90 DEGREE, PIERCING THE BUCCAL PAD OF FAT, BUCCOPHARYNGEAL FASCIA AND BUCCINATOR MUSCLE (1ST BEND) TURNS MEDIALLY AND OPENS OPP TO THE CROWN OF SECOND MOLAR (3RD BEND) RUNS FORWARD FOR ~1CM BETWEEN BUCCINATOR AND BUCCAL MUCOSA (2ND BEND) Parotid Duct - Course
- 12. STRUCTURES PRESENT WITHIN THE PAROTID GLAND FACIAL NERVE most superficial. It enters through the upper part of the posteromedial surface and divides into its terminal branches which run horizontally and leave the gland through its anteromedial surface. The five terminal branches of the facial nerve radiate like a goose- foot & is termed pes anserinus. RETROMANDIBULAR VEIN The retromandibular vein occupies the intermediate zone of the gland and is formed by the union of the superficial temporal and maxillary veins. It ends below by dividing into anterior and posterior divisions. The anterior division joins the facial vein to form the common facial vein Posterior division joins the posterior auricular vein to form the external jugular vein EXTERNAL C. A The external carotid artery pierces the lower part of the posteromedial surface to enter the gland where it occupies the deep zone of the gland. Within the gland it divides into superficial temporal and maxillary arteries. The transverse facial artery, branch of superficial temporal artery emerges through the anterior border of the gland.
- 14. Patey’s Faciovenous Plane The parotid gland is divided into large superficial and small deep parts or lobes. These lobes are connected by the isthmus of the glandular tissue, so that the gland appears H-shaped (shaped like a collar stud) in coronal section. The branches of facial nerve passes forward through the isthmus. The plane between the superficial and deep lobes in which nerves and veins lie has been designated by Patey as faciovenous plane. This plane helps the surgeons to remove the parotid tumor without damaging the nerve.
- 16. BLOOD SUPPLY o Arterial • External Carotid artery • Superficial Temporal artery o Venous • Retromandibular vein • External Jugular vein LYMPHATIC DRAINAGE o Superficial & deep parotid lymph nodes, drains into o Deep cervical lymph nodes NERVE SUPPLY o Parasympathetic (Secretomotor) • Auriculotemporal nerve o Sympathetic • Superior cervical sympathetic ganglion o Sensory • Auriculotemporal nerve • Great Auricular Nerve
- 18. Submandibular glands • LOCATION- partly below and partly deep to the posterior half of the mandible • SIZE-half the size of the parotid gland and weighs about 10- 20 g • Mixed gland but its predominantly serous • PARTS – wrt the mylohyoid muscle superficial part deep part
- 19. Superficial part Location – anterior part of the digastric triangle TWO ENDS – anterior and posterior THREE SURFACES – medial , lateral and inferior pic
- 20. Relations of superficial part SUPERFICIAL(inferior) • Skin • Superficial fascia containing platysma • Deep fascia • Facial vein • Submandibular lymph nodes LATERAL SURFACE • Submandibular fossa • Medial pterygoid muscle • Facial artery MEDIAL SURFACE • ANTERIOR PART • mylohyoid muscle • submental branch of facial artery • mylohyoid nerve • INTERMEDIATE PART • hyoglossus • styloglossus muscle • lingual and hypoglossal nerves • submandibular ganglion • POSTERIOR PART • styloglossus muscle • stylohyoid ligament
- 22. Deep part Relations – 1. Medial – hyoglossus 2. Lateral – mylohyoid 3. Superior – lingual nerve and submandibular ganglion 4. Inferior – hypoglossal nerve
- 23. SUBMANDIBULAR DUCT -WHARTON’S DUCT • 5 cm long • Emerges from the anterior end of the deep part • Runs forwards on the hyoglossus btw the lingual and hypoglossal nerve • Opens into the oral cavity – summit of sublingual papilla at the side of the frenulum of the tongue Presentation title 23
- 24. BLOOD SUPPLY • ARTERIAL SUPPLY • - sublingual • -submental • VENOUS DRAINAGE • -facial vein • -lingual vein • LYMPHATIC DRAINAGE • The lymphatics first drain into the submandibular lympnodes and then into jugulodigastric lymphnodes • NERVE SUPPLY • SENSORY – lingual nerve • PARASYMPATHETIC- submandibular ganglion • SYMPATHETIC – superior cervical ganglion.
- 25. Bimanual examination • The swellings of the submandibular gland can be palpated bimanually by putting an index finger in the mouth and thumb below the angle of the jaw in relation to the position of gland Presentation title 25
- 26. Presentation title 26 SURGICAL PLANES OF THE SUBMANDIBULAR REGION First plane Digastric muscle superficial part of submandibular gland Second plane Mylohyoid muscle Mylohyoid nerves and vessels Third plane Lingual nerve Hypoglossal nerve Deep part of SM gland Submandibular ganglion styloglossus Fourth plane Genioglossus Middle constrictor Lingual artery
- 28. SUBLINGUAL GLAND
- 29. • Location- floor of the mouth btw the mucus membrane and the mylohyoid muscle Size – 3-4 gms almond shaped Secretions are mucus Ducts – 20 in number which open into the sublingual fold(ducts of rivinus) ..while few from the anterior part unite to form the sublingual duct(duct of Bartholin)into the submandibular gland Presentation title 29 BLOOD SUPPLY-sublingual & submental arteries LYMPHATIC DRAINAGE- submental & submandibular nodes
- 30. MINOR SALIVARY GLANDS LABIAL Both mucus and serous elements BUCCAL Both mucus and serous elements PALATAL Mucus glands in both soft and hard palate PALATOGLOSSA L Mucus glands around the pharyngeal isthmus LINGUAL ANTERIOR- in the ventral surface of tongue opens by 4-5 ducts 20XX presentation title 30 POSTERIOR-root of the tongue –Serous glands of VON EBNER
- 31. Labial gland Palatal gland Lingual glands Palatoglossal gland
- 32. THANK YOU “And just when the caterpillar thought her life was over , she began to fly” Thought of the day