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MD4001 Week 4 > 7. Parotid, submandibular and sublingual glands > Flashcards

7. Parotid, submandibular and sublingual glands Flashcards

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1
Q

Name the 3 major paired salivary glands?

A

Parotid
Submandibular
Sublingual

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2
Q

Functions of salivary glands, secrete saliva for which functions?

A 
• Begin digestion of starches
• Keep mouth moist
• Lubricate food
• (Help) prevent tooth decay
• Control bacterial flora of oral
cavity
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3
Q

Name the 3 types of salivary secretory units?

A
  • Serous (amylase, lysozyme) i.e. protein secreting
  • Mucous (sialomucins) i.e. mucin secreting
  • Mixed (containing serous secretion and sialomucins)
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4
Q

Largest of the salivary glands, almost entirely serous secretions, no mucus, which one?

A

Parotid

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5
Q

Anatomical relations of the parotid gland?

A

Enclosed in parotid sheath (capsule) that is part of the deep investing cervical fascia
Fatty tissue between lobes of gland allow flexibility around mandible; subcutaneous lateral surface almost flat
Parotid duct (Stensen’s duct) passes anteriorly & horizontally before piercing buccinator to enter the oral cavity near the upper 2nd molar tooth

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6
Q

Name the structures/vessels embedded in the parotid gland?

A
  1. Retromandibular vein (from superficial temporal & maxillary)
  2. External carotid artery (posterior auricular, maxillary & superficial temporal)
  3. CN VII – but does not innervate the parotid gland!!!
  4. Parotid lymph nodes
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7
Q

CN VII enters the _______ _______ meatus & exits through the ________ foramen

A

CN VII enters the internal acoustic meatus & exits through the stylomastoid foramen

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8
Q

After exiting the stylomastoid foramen, what 2 nerve branches are given off the CN VII before entering the parotid gland?

A

Posterior auricular

Digastric

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9
Q

What is the PS/secretomotor supply to parotid?

A 
Parasympathetic innervation (secretomotor innervation to produce saliva):
• Preganglionic fibres from CN IX travel to the otic ganglion in the tympanic nerve & lesser petrosal nerve
• Postganglionic fibres from the otic ganglion pass to the auriculotemporal nerve (CN V3) that sends branches to the parotid gland
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10
Q

What is the sympathetic supply to the parotid gland?

Result?

A

Sympathetic innervation is derived from the superior cervical ganglion & the nerve plexus on the external carotid artery
This results mainly in vasoconstriction & some reduction in the volume of saliva that leads to dry mouth

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11
Q

Anatomical position and location of the submandibular gland?

Secretions?

A

Found along mandible, partly superficial (below) & partly deep (above) to the mylohyoid (free posterior border of muscle)
The gland wraps around the mylohyoid
Deep part lies in the floor of the oral cavity, lateral to the root of the tongue

Submandibular ducts) begin in gland between mylohyoid & hyoglossus

Lingual nerve (CN V3) loops under the duct before it opens into the oral cavity

Mixed serous & mucus secretions

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12
Q

Capsule around the submandibular?

A

Has a fascial capsule covering the gland that is continuous with the deep investing cervical fascia

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13
Q

Submandibular:
Ducts opening into oral cavity?
Blood supply?
Venous drainage?

A

Submandibular ducts open into 3 orifices in the oral cavity besides the base of the frenulum (small sublingual papilla/caruncles)
Openings are visible & saliva can be seen coming from them or spraying from them while yawning

Blood supply is via submental arteries (branch of facial artery)

Venous drainage is via submental veins (to lingual & facial veins)

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14
Q

Sublingual gland:
Secretions?
shape?
Location/relations?

A

Mostly mucous secretions & some serous

Almond-shaped, lies in the floor of the mouth between the mandible & hyoglossus, lateral to the submandibular duct & lingual nerve (CN V3)

Sits in sublingual fossa of mandible, superior to anterior part of the mylohyoid line

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15
Q

Where do sublingual glands insert into the mouth?

A

Sublingual folds inside the mouth overlay the sublingual glands, these extend to the frenulum of the tongue
Sublingual ducts are numerous & drain into the oral cavity via openings into crest of the sublingual fold

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16
Q

Blood supply and venous drainage of the sublingual gland?

A

Blood supply is via submental & sublingual arteries (branch of facial & lingual arteries)

Venous drainage is via submental veins (to lingual & facial veins) (similar to submandibular)

17
Q

Capsule o the sublingual gland?

A

No true fascial/fibrous capsule

18
Q

Describe the PS innervation to the sublingual and submandibular gland?

A

PS (i.e. secretomotor to produce saliva)

  • Preganglionic PS fibres to submandibular ganglion from the chorda tympani (Cn VII nervus intermedius) and via the lingual nerve (CN V3)
  • Post ganglionic PS fibres travel in lingual nerve (CN V3) to the sublingual gland or travel DIRECTLY to subL or subM glands (i.e. not in the nerve)
19
Q

Describe the sympathetic innervation to the sublingual and submandibular gland?

A

Sympathetic (vasoconstriction and reduction in saliva produce)

  • From superior cervical ganglia
  • From nerve plexus ont he external carotid artery
20
Q

What are the minor salivary glands?

A 
Minor salivary glands are found diffusely embedded throughout the submucosa of the oral cavity:
Buccal (cheek) 
Palatine (palate) 
Lingual (tongue)
Labial (lip)
21
Q

Innervation of the minor salivary glands?

A

CN VII and CN V

22
Q

What are the minor salivary glands at risk of?

A

These glands are susceptible to mucoceles (swelling due to blockage of associated ducts)

RARE

23
Q

Greater petrosal nerve from//

A

branch of the nervus intermedius of CN VII

24
Q

What provides the PS supply to the minor salivary glands above the oral fissure?

A 
Parasympathetic innervation (secretomotor innervation to produce saliva):
• Preganglionic parasympathetic fibres travel to the pterygopalatine ganglion in the GREATER PETROSAL NERVE (CN VII nervus intermedius)
• Postganglionic fibres travel to the palate via the palatine nerves
25
Q

What provides the PS supply to the minor salivary glands below the oral fissure?

A 
Parasympathetic innervation (secretomotor innervation to produce saliva):
• Preganglionic parasympathetic fibres travel to the submandibular ganglion from the CHORDA TYMPANI  (CN VII nervus intermedius) & via the lingual nerve (CN V3)
• Postganglionic parasympathetic fibres then travel in the lingual nerve (CN V3) to the glands OR travel directly to the glands not in a nerve
26
Q

3 common pathologies for the salivary glands and ducts?

A

Mumps
Salivary stones/calculi
Excessive salivation

27
Q 
Features of mumps as pathology of salivary gland:
What is it?
Common age?
Which gland?
Vaccine?
Treatment?
Spread?
A

Viral infection that presents in children as painful swellings over the salivary glands
Most commonly over parotid glands
MMR vaccine
Supportive treatment to relieve pain
Can spread to other parts of the body (viral meningitis)

28
Q 
Salivary stones and calculi as pathology of salivary gland:
Presentation?
Common gland?
Treatment?
Treatment? Risk?
A

Patients can present with pain, swelling & lack of salivation
Tend to be common in the submandibular duct due to its upward course into the oral cavity
Best treated with surgical resection, but care must be taken to avoid surrounding nerves (lingual nerve [CN V3] especially in the case of the submandibular duct)

29
Q 
Excessive salivation (ptyalism) as pathology of the salivary gland:
Common prior to??
A

Commonly occurs prior to vomiting, but can also be associated with several disease processes/ pathologies

30
Q

Ptyalism?

A

Excessive salivation

31
Q

Common salivary gland tumour?
Presentation?
Treatment

A

Pleomorphic adenoma

Presentation: Painless selling near gland + numbness/weakness in surrounding muscles

Treatment: Total Parotidectomy (risk of CN VII dysfunction)

MD4001 Week 4 (9 decks)

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