Salivary gland

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Salivary gland
Blausen 0780 SalivaryGlands.png
Human salivary glands.
Details
Latin Glandulae salivariae
Identifiers
Dorlands
/Elsevier
g_06/12391916
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Anatomical terminology
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The salivary glands in mammals are exocrine glands, glands with ducts, that produce saliva. They also secrete amylase, an enzyme that breaks down starch into maltose.

Structure

Salivary glands: #1 is Parotid gland, #2 is Submandibular gland, #3 is Sublingual gland.

The salivary glands are detailed below:

Parotid glands

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The two parotid glands are major salivary glands wrapped around the mandibular ramus in humans. The largest of the salivary glands, they secrete saliva to facilitate mastication and swallowing and to begin the digestion of starches. It is the serous type of gland which secretes the ptyalin. It enters the oral cavity via the parotid duct or Stensen duct. The glands are located posterior to the mandibular ramus and anterior to the mastoid process of temporal bone. They are clinically relevant in dissections of facial nerve branches while exposing the different lobes of it since any iatrogenic lesion will result in either loss of action or strength of muscles involved in facial expression. They produce 20% of the total salivary content in the oral cavity.

Submandibular glands

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The submandibular glands are a pair of major salivary glands located beneath the lower jaws, superior to the digastric muscles. The secretion produced is a mixture of both serous fluid and mucus, and enters the oral cavity via the submandibular duct or Wharton duct. Approximately 65-70% of saliva in the oral cavity is produced by the submandibular glands, even though they are much smaller than the parotid glands.You can usually feel this gland, as it is in the superficial cervical region and feels like a rounded ball. It is located about two fingers above the Adam's apple (laryngeal prominence) and about two inches apart under the chin.

Sublingual glands

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The sublingual glands are a pair of major salivary glands located inferior to the tongue, anterior to the submandibular glands. The secretion produced is mainly mucous in nature, however it is categorized as a mixed gland. Unlike the other two major glands, the ductal system of the sublingual glands do not have intercalated ducts and usually do not have striated ducts either so they exit directly from 8-20 excretory ducts. Approximately 5% of saliva entering the oral cavity come from these glands.

Minor salivary glands

There are 800-1000 minor salivary glands located throughout the oral cavity within the submucosa[1] of the oral mucosa in the tissue of the buccal, labial, and lingual mucosa, the soft palate, the lateral parts of the hard palate, and the floor of the mouth or between muscle fibers of the tongue.[2] They are 1-2mm in diameter and unlike the major glands, they are not encapsulated by connective tissue, only surrounded by it. The gland has usually a number of acini connected in a tiny lobule. A minor salivary gland may have a common excretory duct with another gland, or may have its own excretory duct. Their secretion is mainly mucous in nature (except for Von Ebner glands- see next section) and have many functions such as coating the oral cavity with saliva. Problems with dentures are sometimes associated with minor salivary glands if there is dry mouth present (see further discussion).[1] The minor salivary glands are innervated by the seventh cranial or facial nerve.[2]

Von Ebner glands

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Von Ebner glands are glands found in a trough circling the circumvallate papillae on the dorsal surface of the tongue near the sulcus terminalis. They secrete a purely serous fluid that begins lipid hydrolysis. They also facilitate the perception of taste through secretion of digestive enzymes and proteins.[1] The arrangement of these glands around the circumvallate papillae provides a continuous flow of fluid over great number of taste bud present along the sides of the papillae. It is important for dissolving the food particles to be tested.

Innervation

Salivary glands are innervated, either directly or indirectly, by the parasympathetic and sympathetic arms of the autonomic nervous system. Both result in increased amylase output and volume flow.

  • Parasympathetic innervation to the salivary glands is carried via cranial nerves. The parotid gland receives its parasympathetic input from the glossopharyngeal nerve (CN IX) via the otic ganglion, while the submandibular and sublingual glands receive their parasympathetic input from the facial nerve (CN VII) via the submandibular ganglion. These nerves release acetylcholine and substance P, which activate the IP3 and DAG pathways respectively.
  • Direct sympathetic innervation of the salivary glands takes place via preganglionic nerves in the thoracic segments T1-T3 which synapse in the superior cervical ganglion with postganglionic neurons that release norepinephrine, which is then received by β-adrenergic receptors on the acinar and ductal cells of the salivary glands, leading to an increase in cyclic adenosine monophosphate (cAMP) levels and the corresponding increase of saliva secretion. Note that in this regard both parasympathetic and sympathetic stimuli result in an increase in salivary gland secretions.[3] The sympathetic nervous system also affects salivary gland secretions indirectly by innervating the blood vessels that supply the glands.

Histology

The gland is internally divided into lobules. Blood vessels and nerves enter the glands at the hilum and gradually branch out into the lobules.

Acini

Secretory cells are found in a group, or acinus (plural, acini). Each acinus is located at the terminal part of the gland connected to the ductal system, with many acini within each lobule of the gland. Each acinus consists of a single layer of cuboidal epithelial cells surrounding a lumen, a central opening where the saliva is deposited after being produced by the secretory cells. The three forms of acini are classified in terms of the type of epithelial cell present and the secretory product being produced: serous, mucoserous and mucous.[4]

Ducts

In the duct system, the lumina are formed by intercalated ducts, which in turn join to form striated ducts. These drain into ducts situated between the lobes of the gland (called interlobar ducts or secretory ducts). These are found on most major and minor glands (exception may be the sublingual gland).[4]

All of the human salivary glands terminate in the mouth, where the saliva proceeds to aid in digestion. The saliva that salivary glands release is quickly inactivated in the stomach by the acid that is present there but the saliva also contains enzymes that are actually activated by the acid.

Clinical significance

Micrograph of chronic inflammation of the salivary gland sialadenitis).

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A sialogram is a radiocontrast study of a salivary duct that may be used to investigate its function.

Salivary duct calculus may cause blockage of the ducts, causing pain and swelling of the gland because of cysts.

Saliva production may be pharmacologically stimulated by sialagogues (e.g., pilocarpin, cevimeline). It can also be suppressed by so-called antisialagogues (e.g., tricyclic antidepressants, SSRI, antihypertensives, polypharmacy).[5] Many anti-cancer treatments may impair salivary flow such as chemotherapy and radiation therapy. Radiation therapy may cause permanent hyposalivation due to injury to the oral mucosa containing the salivary glands, resulting in dry mouth or xerostomia, whereas chemotherapy may cause only temporary salivary impairment.

Graft versus host disease after allogeneic bone marrow transplantation may manifest as dry mouth and many small mucoceles.

Tumours of the salivary glands may occur.

Other species

The salivary glands of some species however, are modified to produce enzymes; salivary amylase is found in many, but by no means all, bird and mammal species (including humans, as noted above). Furthermore, the venom glands of poisonous snakes, Gila monsters, and some shrews, are modified salivary glands.[5] In other organisms such as insects, salivary glands are often used to produce biologically important proteins like silk or glues, and fly salivary glands contain polytene chromosomes that have been useful in genetic research.

See also

References

  1. 1.0 1.1 1.2 Ten Cate's Oral Histology, Nanci, Elsevier, 2013, page 275-276
  2. 2.0 2.1 Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, p. 157
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  4. 4.0 4.1 Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011, page 132
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External links