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Salivary glands

Parotid gland

  • The parotid gland is found overlying the ramus of the mandible
  • Anterior and inferior to the external ear
  • The gland occupies the parotid fascial space
  • The gland extends from the zygomatic arch to the angle of the mandible.
  • The facial nerve and its branches pass through the parotid gland
  • The external carotid artery also passes through the gland
  • It gives off its two terminal branches, the maxillary artery and the superficial temporal artery within the gland.
  • Posteriorly, it is related to the posterior belly of the digastric, the stylohyoid, and the sternocleidomastoid.
  • The gland has four surfaces superior, superficial, anteromedial and posteromedial
  • The surfaces are separated by three borders, anterior, posterior and medial
  • The parotid duct (Stenson's duct) empties into the buccal cavity opposite the upper second molar
  • The parotid papilla mark's the opening of the duct

Innervation

  • Although the facial nerve runs through this gland, it does not supply its parasympathetic innervation
  • Secretion of saliva by the parotid gland is controlled by postsynaptic parasympathetic fibres originating in the inferior salivatory nucleus
  • These leave the brain via the tympanic nerve branch of glossopharyngeal nerve, travel through the tympanic plexus (located in the middle ear), and then form the lesser petrosal nerve until reaching the otic ganglion
  • After synapsing in the Otic ganglion, the postganglionic fibres travel as part of the auriculotemporal nerve  to reach the parotid gland
  • Sympathetic nerves originating from superior cervical ganglion and giving rise to the external carotid nerve plexus reach the gland by travelling along the external carotid arterial branches
  • Parasympathetic stimulation produces a water rich, serous saliva
  • Sympathetic stimulation leads to the production of a low volume, enzyme-rich saliva
  • There is no inhibitory nerve supply to the gland

Submandibular gland

  • Lies superior to the digastric muscles
  • Each submandibular gland is divided into superficial and deep lobes
  • Separated by the mylohyoid muscle
  • The superficial portion is larger and the mylohyoid muscle runs below it
  • The deep portion is smaller
  • Secretions are delivered into Wharton's ducts on the superficial portion
  • It hooks around the posterior edge of the mylohyoid muscle
  • The ducts are then crossed by the lingual nerve drain into the sublingual caruncles on either side of the lingual frenulum
  • This occurs along with the major sublingual duct

Innervation

  • Parasympathetic innervation to the submandibular glands is provided by the superior salivatory nucleus via the chorda tympani, a branch of the facial nerve that synapses in the submandibular ganglion
  • After this it follows the lingual nerve leaving this nerve as it approaches the gland
  • Increased parasympathetic activity promotes the secretion of saliva
  • The sympathetic nervous system regulates submandibular secretions through vasoconstriction of the arteries that supply it.
  • Increased sympathetic activity reduces glandular blood flow and decreases salivary secretions, producing an enzyme rich serous saliva.

 

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