|Human salivary glands.|
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, mucous.
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).
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.
The parotid gland are a pair of major salivary glands wrapped around the mandibular ramus in humans. It is one of a pair being the largest of the salivary glands, it secretes saliva to facilitate mastication and swallowing and to begin the digestion of starches. The secretion produced is mainly serous in nature and enters the oral cavity via the parotid duct or Stensen duct. It is located posterior to the mandibular ramus and anterior to the mastoid process of temporal bone. This gland is 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.
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 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 (on a man) and about two inches apart under the chin.
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 mucus 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 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. 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). The minor salivary glands are innervated by the seventh cranial or facial nerve.
Von Ebner glands
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.
- 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. The sympathetic nervous system also affects salivary gland secretions indirectly by innervating the blood vessels that supply the glands.
- A sialogram is a radiocontrast study of a salivary duct.
- 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). 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.
- Tumors of the salivary glands may occur.
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. 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.
- Salivary Gland Disorders at intelihealth.com
- Illustration at merck.com
- Illustration at .washington.edu
- eMedicine - "Parotid Tumors, Benign"
- Medical Encyclopedia Medline Plus: Salivary gland