SSalivary alivary gland gland

diseasesdiseases

Dr .Khurram ZafarDr .Khurram Zafar

SSalivary glandsalivary glands

““An introduction to An introduction to there anatomy and there anatomy and

physiology”physiology”

IIntroductionntroduction

• Salivary glands are exocrine gland ( they Salivary glands are exocrine gland ( they have duct system to flow there secretions)have duct system to flow there secretions)

• The saliva that is produced by these The saliva that is produced by these glands is brought to the oral cavity.glands is brought to the oral cavity.

• The main function of the saliva is the The main function of the saliva is the lubrication of the food that is being lubrication of the food that is being chewed and assisting in deglutition chewed and assisting in deglutition

• Saliva also performs digestion of the Saliva also performs digestion of the carbohydrates by the enzyme it hascarbohydrates by the enzyme it has

• Major salivary glandMajor salivary gland parotid glandsparotid glands submandibular glandssubmandibular glands sublingual glandssublingual glands

• Minor salivary glandsMinor salivary glands Labial & buccal glandsLabial & buccal glands Glossopalatine glandsGlossopalatine glands Palatine glandsPalatine glands Lingual glandsLingual glands

MMajor salivary glandsajor salivary glands

MMajor salivary glandsajor salivary glands

PParotid glandarotid gland

• It is enclosed in a well defined connective It is enclosed in a well defined connective tissue capsule with its superficial part lying tissue capsule with its superficial part lying in front of the ear and the deeper part in front of the ear and the deeper part lying in the retromandibular fossa.lying in the retromandibular fossa.

• Its secretory duct is the stanson’s duct Its secretory duct is the stanson’s duct which opens in the buccal mucosa oppsite which opens in the buccal mucosa oppsite to the 2to the 2ndnd maxillary molar maxillary molar

• It’s a pure serous glandIt’s a pure serous gland• All the five terminal branches of the facial All the five terminal branches of the facial

nerve pass through the parotid gland .nerve pass through the parotid gland .

PParotid glandarotid gland

PParotid glandarotid gland

SSubmandibular glandubmandibular gland• This gland is also enveloped by a well This gland is also enveloped by a well

developed capsule.developed capsule.• It is located in the submandibular triangle It is located in the submandibular triangle

behind and below the free border of the behind and below the free border of the mylohyoid muscle with its small mylohyoid muscle with its small extension lying above the mylohyoid.extension lying above the mylohyoid.

• Its has a wharton’s duct, which opens at Its has a wharton’s duct, which opens at the lingual freenum on the floor of the the lingual freenum on the floor of the mouth.mouth.

• It has a mixed secretion both serous and It has a mixed secretion both serous and mucous mucous

SSubmandibular glandubmandibular gland

SSublingual glandublingual gland

• It lies in between the floor of the It lies in between the floor of the mouth and the mylohyoid muscle,it is mouth and the mylohyoid muscle,it is composed of large main part and composed of large main part and small numerous glands.small numerous glands.

• Its duct is the Bartholin’s duct which Its duct is the Bartholin’s duct which opens with in or adjacent to the opens with in or adjacent to the wharton’s duct.wharton’s duct.

• Iis a mixed gland too.Iis a mixed gland too.

MMinor salivary glandsinor salivary glands

LABIAL & BUCCAL GLANDS:LABIAL & BUCCAL GLANDS:

These are present on the lips and the These are present on the lips and the cheeks and are of the mixed type.cheeks and are of the mixed type.

GLOSSOPALATINE GLANDS:GLOSSOPALATINE GLANDS:

They are pure mucous glands, there They are pure mucous glands, there location is the isthmus of the location is the isthmus of the glossopalatine foldglossopalatine fold

MMinor salivary glandsinor salivary glands

PALATINE GLANDS:PALATINE GLANDS:

they are also pure mucous in they are also pure mucous in variety,they consist of hundreds of variety,they consist of hundreds of glandular aggregations in the lamina glandular aggregations in the lamina propria of the postro-lateral region of propria of the postro-lateral region of the hard palate and in the the hard palate and in the submucosa of the soft palate and the submucosa of the soft palate and the uvula. uvula.

MMinor salivary glandsinor salivary glands

LINGUAL GLANDSLINGUAL GLANDS They can be divided into several groups.They can be divided into several groups. the anterior group is near the apex of the anterior group is near the apex of

the tongue and are of the mucous the tongue and are of the mucous character.character.

and the posterior group is of the mixed and the posterior group is of the mixed type. type.

There ducts open on the ventral surface There ducts open on the ventral surface of the tongue near the lingual frenum.of the tongue near the lingual frenum.

PPhysiology of salivary hysiology of salivary glandsglandsSalivary glands produce serous sections and Salivary glands produce serous sections and mucous secretions or mixed secretions.mucous secretions or mixed secretions.

SEROUS SERETIONS:SEROUS SERETIONS:• There are serous cells which specialized for There are serous cells which specialized for

the synthesis, storage and secretions of the the synthesis, storage and secretions of the proteins.proteins.

• The typical serous cell is pyramidical in shape The typical serous cell is pyramidical in shape with its broad base resting on the basal with its broad base resting on the basal lamina and its narrow apex broadening on the lamina and its narrow apex broadening on the lumen.lumen.

• The prominent feature of the serous cells ia The prominent feature of the serous cells ia the accumlation of the secretery granules in the accumlation of the secretery granules in the apical cytoplasm.the apical cytoplasm.

MMucous cellsucous cells

• These cells are also specialized for the These cells are also specialized for the synthesis, storage and secretion of synthesis, storage and secretion of secretory product.secretory product.

• The apex of these cells appear empty The apex of these cells appear empty except for some thin strands of except for some thin strands of cytoplasmcytoplasm

forming trabacular network.forming trabacular network.• The nucleus and some cytoplasm is The nucleus and some cytoplasm is

pushed towards the base of the cell.pushed towards the base of the cell.

MMucous cellsucous cells

• The secretory product of the mucous cells The secretory product of the mucous cells differ from the serous cells in two important differ from the serous cells in two important respect.respect.

1. they have little or no enzymatic 1. they have little or no enzymatic

activity and only serve the purpose of activity and only serve the purpose of

lubrication.lubrication.

2. the ratio of carbohydrate is greater to 2. the ratio of carbohydrate is greater to

that of the protein with large amount of that of the protein with large amount of

sialac acid.sialac acid.

MMyoepithelial cellsyoepithelial cells

• These cells are closely related to the These cells are closely related to the secretory and the intercalated duct system.secretory and the intercalated duct system.

• The body of the cell is small filled with a The body of the cell is small filled with a flattened nucleus and numerous branching flattened nucleus and numerous branching cytoplasmic processes.cytoplasmic processes.

• These cells are considered to have a These cells are considered to have a contractile function helping to expel contractile function helping to expel secretions from the lumina of the secretory secretions from the lumina of the secretory units and the ducts.units and the ducts.

CClassificationlassification

Of salivary glandsOf salivary glands

Reactive lesionsReactive lesions• MucoceleMucocele

• Mucus retention cystsMucus retention cysts

• SialolitiasisSialolitiasis

• Chronic sclerosing sialadenitisChronic sclerosing sialadenitis

• Necrotizing sialometaplasiaNecrotizing sialometaplasia

Salivary infectionsSalivary infections• Acute parotitis Acute parotitis

• Viral endemic parotitis(Mumps)Viral endemic parotitis(Mumps)

• Bacterial sialadenitisBacterial sialadenitis

Immune related Immune related diseasesdiseases

• Lymphoepithelial sialadenitisLymphoepithelial sialadenitis

• Sjogren Syndrome.Sjogren Syndrome.

Salivary gland Salivary gland tumorstumorsBENIGNBENIGN• Pleomorphic adenomaPleomorphic adenoma

• Monomorphic adenomaMonomorphic adenoma

• Papillary cystadenomaPapillary cystadenoma

• OncocytomaOncocytoma

• Other adenomasOther adenomas

Salivary gland Salivary gland tumorstumorsMALIGNANTMALIGNANT• Mucoepidermoid carcinoma.Mucoepidermoid carcinoma.

• Adenoid cystic carcinomaAdenoid cystic carcinoma

• Acinic cell carcinomaAcinic cell carcinoma

• Polymorphous low grade Polymorphous low grade adenocarcinomaadenocarcinoma

• Other adenocarcinomasOther adenocarcinomas