A.

Discuss salivary Gland secretion, the structures involve and how it is controlled
(sympathetic and parasympathetic influence)

Saliva is produced in and secreted from salivary glands. The basic secretory units of salivary
glands are clusters of cells called an acini. These cells secrete a fluid that contains water,
electrolytes, mucus and enzymes, all of which flow out of the acinus into collecting ducts.

Physiology of Salivary Secretion:

- Production : 1l/day (0.1 – 4ml/min) varying from rest to stiulation
Constituents:
- Water: 94-99.5%
- Solids: 0.5-6%
1. Inorganic
2. Organic
-Organic Micromolecules
- Gases
Functions of Saliva
 Lubrication and protection
 Buffering and clearance
 Maintenance of tooth integrity
 Antibacterial activity
 Taste and digestion
 Excretion of certain drugs and inorganic ions
Mechanism of Salivary Secretion
- Active transport process neuronal control
- Osmotic process
1. Acinar cells: K, Na, and HC03 along with Cl to preserve neutrality
Primary secretion: Isotonic
Duct cells
- Reabsorption of Na ions
- Secretion of HCO3 and K ions
Final salivary secretion: Hypotonic

Salivary gland: The salivary glands are of the type called racemose, from the Latin racemosus
(“full of clusters”), because of the clusterlike arrangement of their secreting cells in rounded
sacs, called acini, attached to freely branching systems of ducts. The walls of the acini surround a
small central cavity known as an alveolus. In the walls of the acini are pyramidal secreting cells
and some flat, star-shaped contractile cells called myoepithelial, or basket, cells. The latter cells
are thought to contract, like the similar myoepithelial cells of the breast, which by their
contraction expel milk from the milk ducts.

Classification of salivary glands

According to size:
 Major Salivary Glands: Parotid, Submandibular, Sublingual
 Minor Salivary Glands: Carmalt’s glands, Glands of Von Ebner
According to nature of secretion:
 Pure serous: Parotid, Glands of Von Ebner
 Pure Mucous: Anterior Lingual Glands of Blandin and Nuhn
 Mixed: Submandibular and Sublingual
According to ductal systems:
 Simple: Minor Salivary glands
 Compound: Major Salivary glands

Structures:
Major Salivary Glands: These are the largest, bilaterally paired, and situated extraorally, but
their secretion reaches the oral cavity by variable long ducts.
Parotid glands
- The parotid glands, the largest of the pairs, are located at the side of the face, below
and in front of each ear. The parotid glands are enclosed in sheaths that limit the
extent of their swelling when inflamed, as in mumps.
- Weighs around 15 grams
- Resembles a 3 sided pyramid with apex directed downwards
4 surfaces
- Superior
- Superficial
- Anteromedial
- Posteromedial
Separated by 3 borders:
- Anterior
 - Posterior
- Medial

Submandibular glands
- The submandibular glands, which are rounded in shape, lie near the inner side of the
lower jawbone, in front of the sternomastoid muscle (the prominent muscle of the
jaw).
Superficial part
- Larger Part, filling up the gastric triangle
- Extends up till the mylohyoid line
- It has inferior, medial and lateral surfaces
- Partially enclosed between 2 layers of deep cervical fascia
Deep Part
- Small sized, lies deep to mylohyoid, superficial to hyoglossus and styloglossus

Sublingual glands
- The sublingual glands lie directly under the mucous membrane covering the floor of
the mouth beneath the tongue.
- Smallest of the 3 salivary glands
- About 15 ducts emerges from this gland
- Almond-shaped and weighs 3-4 grams

Minor Salivary Glands: The minor salivary glands are placed below the epithelium in almost
all parts of the oral cavity. These glands comprise numerous small groups of secretory units
opening via short ducts directly into the mouth. They lack a distinct capsule, instead mixing with
the connective tissue of the submucosa or muscle fibers of the tongue or cheeks.

Labial and buccal glands

- These glands are present on the lips and cheeks and comprise of mucous tubules with
serous demilunes
Glossopalatine glands
 - These are located to the region of the isthmus in the glossopalatine fold but may
extend from the posterior extension of the sublingual gland to the glands of the soft
palate
Palatine glands
- These are located in the glandular aggregates present in the lamina propria of the
posterolateral aspect of the hard palate and in the submucosa of the soft palate and
uvula
Lingual Glands
- The glands of the tongue can be divided into various groups. The anterior lingual
glands (glands of Blandin and Nuhn) are present near the apex of the tongue. The
ducts open on the ventral surface of the tongue near the lingual frenulum. The
posterior lingual mucous glands are present lateral and posterior to vallate papillae
and in association with lingual tonsil. The ducts of these glands open on the dorsal
surface of the tongue. The posterior lingual serous glands (von Ebner’s glands) are
located between the muscle fibers of the tongue below the vallate papillae, and the
ducts open into the trough of circumvallate papillae and at the rudimentary folate
papillae on the sides of the tongue.

Sympathetic and Parasympathetic

The salivary glands are controlled by the two divisions of the autonomic nervous system, the
sympathetic and the parasympathetic. The parasympathetic nerve supply regulates secretion by
the acinar cells and causes the blood vessels to dilate. Functions regulated by the sympathetic
nerves include secretion by the acinar cells, constriction of blood vessels, and, presumably,
contraction of the myoepithelial cells. Normally secretion of saliva is constant, regardless of the
presence of food in the mouth. The amount of saliva secreted in 24 hours usually amounts to 1–
1.5 liters. When something touches the gums, the tongue, or some region of the mouth lining, or
when chewing occurs, the amount of saliva secreted increases. The stimulating substance need
not be food—dry sand in the mouth or even moving the jaws and tongue when the mouth is
empty increases the salivary flow. This coupling of direct stimulation to the oral mucosa with
increased salivation is known as the unconditioned salivary reflex. When an individual learns
that a particular sight, sound, smell, or other stimulus is regularly associated with food, that
stimulus alone may suffice to stimulate increased salivary flow. This response is known as the
conditioned salivary reflex.

B. In tubular form. List the major and minor salivary glands. Indicate the following:
location, type of secretion, name of its duct, innervation
Major
Gland Location Type of Duct Innervation
Secretion
Parotid Corner of Serous, watery Stensen’s Duct Glossopharyngeal
stomodium secretion nerve
Submandibular Floor of mouth Mixed serous Wharton’s Duct Submandibular
and mucous ganglion
secretion (serous
units
predominate)
Sublingual Lateral to sub Mixed serous Ducts of Submandibular
mandibular and mucous Rivinus and ganglion
primordium secretion Bartholin’s duct
(mucous
secretory units
predominates)

Minor
Gland Location Type of Duct Innervation
Secretion
Labial and buccal Present on the lips Mixed, mucous Intercalated
glands and cheeks tubules with ducts and
serous Intralobular
demilunes duct
Glossopalatine Region of the Mucous
glands isthmus in the
glossopalatine
fold but may
extend from the
posterior
extension of the
sublingual gland
to the glands of
the soft palate
Palatine glands Under the mucous Mucous
membrane non
each side of the
midline of the
palate.
Lingual glands The anterior In anterior
lingual glands lingual glands,
(glands of Blandin the anterior
and Nuhn) are portion of the
present near the glands is chiefly
apex of the mucous in
tongue. nature, whereas
 The posterior the posterior
lingual mucous portions are
glands are present mixed. The
lateral and posterior
posterior to vallate lingual glands
papillae and in are purely
association with mucous glands,
lingual tonsil. but von Ebner’s
glands are
purely serous
gland.

2.
A. Trace the course of the lingual nerve including the associated structures along its
path
The lingual nerve lies at first beneath the lateral pterygoid muscle, medial to and in front of the
inferior alveolar nerve, and is occasionally joined to this nerve by a branch which may cross the
internal maxillary artery.

The chorda tympani (a branch of the facial nerve, CN VII) joins it at an acute angle here,
carrying taste fibers from the anterior two thirds of the tongue and parasympathetic fibers to the
submandibular ganglion.

The nerve then passes between the medial pterygoid muscle and the ramus of the mandible, and
crosses obliquely to the side of the tongue beneath the constrictor pharyngis superior and
styloglossus, and then between the hyoglossus and deep part of the submandibular gland; it
finally runs from laterally to medially inferiorly crossing the duct of the submandibular gland,
and along the tongue to its tip becoming the sublingual nerve, lying immediately beneath the
mucous membrane.

Or ito gayahin mo
The lingual nerve, a branch of the mandibular nerve, provides somatosensory innervation of the
lingual mucosa through its wide range of mechanosensitive, nociceptive and thermosensitives
afferent fibers. Jointly with the chorda tympani nerve fibers, a branch of the facial nerve, it
provides information to the anterior two thirds of the dorsum of the tongue and preganglionic
parasympathetic innervation of submandibular and sublingual secretory glands. Its location is
medial and anterior to the inferior alveolar nerve in its passage between the medial pterygoid
muscle and the ramus of the mandible, where the fibers meet the chorda tympani nerve. It
continues under the gingival sulcus of the lingual mucosa superficially to the surface of the gland
and submandibular ganglion. It ends as a sublingual nerve located immediately below the tongue
mucosa. Its proximity to the third molar lingual cortical plate, separated from the cortex only by
the periosteum, and its variable anatomy.
B. The journal mentioned this statement “The persistence of fungiform papillae atrophy
is an important severity indicator of nerve injury” Why is this so?

- The persistence of papillary atrophy appears to be an indicator of the extent of lingual

nerve injury and can be prognostic of functional recovery. This implies that the
lingual nerve developed collaterals to keep neural support for some taste buds.
Alternatively, the chorda tympany nerve might play a role in maintaining epithelial
and connective tissue integrity. The maintenance of papillary structure is probably
dependent on various trophic factors secreted by the lingual nerves and chorda
tympani nerves. This shows that when the sensory function of the tongue did not
recover more than six months or much longer after lingual nerve injury, there was
also a noticeable loss of fungiform papillae on that side. Similarly, transient atrophy
with the return to normal morphology can coincide with the return of normal
sensation and initial paresthesias in the absence of atrophy usually herald a complete
recovery.