1	Salivary gland diseases Dr .Khurram Zafar
2	Salivary glands “An introduction to there anatomy and physiology”
3	Introduction Salivary glands are exocrine gland ( they have duct system to flow there secretions) The saliva that is produced by these glands is brought to the oral cavity. The main function of the saliva is the lubrication of the food that is being chewed and assisting in deglutition Saliva also performs digestion of the carbohydrates by the enzyme it has
4	"Major salivary gland" Major salivary gland parotid glands submandibular glands sublingual glands Minor salivary glands Labial & buccal glands Glossopalatine glands Palatine glands Lingual glands
5	Major salivary glands
6	Major salivary glands
7	Parotid gland It is enclosed in a well defined connective tissue capsule with its superficial part lying in front of the ear and the deeper part lying in the retromandibular fossa. Its secretory duct is the stanson’s duct which opens in the buccal mucosa oppsite to the 2^nd maxillary molar It’s a pure serous gland All the five terminal branches of the facial nerve pass through the parotid gland .
8	Parotid gland
9	Parotid gland
10	Submandibular gland This gland is also enveloped by a well developed capsule. It is located in the submandibular triangle behind and below the free border of the mylohyoid muscle with its small extension lying above the mylohyoid. Its has a wharton’s duct, which opens at the lingual freenum on the floor of the mouth. It has a mixed secretion both serous and mucous
11	Submandibular gland
12	Sublingual gland It lies in between the floor of the mouth and the mylohyoid muscle,it is composed of large main part and small numerous glands. Its duct is the Bartholin’s duct which opens with in or adjacent to the wharton’s duct. Iis a mixed gland too.
13	Minor salivary glands LABIAL & BUCCAL GLANDS: These are present on the lips and the cheeks and are of the mixed type. GLOSSOPALATINE GLANDS: They are pure mucous glands, there location is the isthmus of the glossopalatine fold
14	Minor salivary glands PALATINE GLANDS: they are also pure mucous in variety,they consist of hundreds of glandular aggregations in the lamina propria of the postro-lateral region of the hard palate and in the submucosa of the soft palate and the uvula.
15	Minor salivary glands LINGUAL GLANDS They can be divided into several groups. the anterior group is near the apex of the tongue and are of the mucous character. and the posterior group is of the mixed type. There ducts open on the ventral surface of the tongue near the lingual frenum.
16	Physiology of salivary glands Salivary glands produce serous sections and mucous secretions or mixed secretions. SEROUS SERETIONS: There are serous cells which specialized for the synthesis, storage and secretions of the proteins. The typical serous cell is pyramidical in shape with its broad base resting on the basal lamina and its narrow apex broadening on the lumen. The prominent feature of the serous cells ia the accumlation of the secretery granules in the apical cytoplasm.
17	Mucous cells These cells are also specialized for the synthesis, storage and secretion of secretory product. The apex of these cells appear empty except for some thin strands of cytoplasm forming trabacular network. The nucleus and some cytoplasm is pushed towards the base of the cell.
18	Mucous cells The secretory product of the mucous cells differ from the serous cells in two important respect. 1. they have little or no enzymatic activity and only serve the purpose of lubrication. 2. the ratio of carbohydrate is greater to that of the protein with large amount of sialac acid.
19	Myoepithelial cells These cells are closely related to the secretory and the intercalated duct system. The body of the cell is small filled with a flattened nucleus and numerous branching cytoplasmic processes. These cells are considered to have a contractile function helping to expel secretions from the lumina of the secretory units and the ducts.
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21	Classification Of salivary glands
22	Reactive lesions Mucocele Mucus retention cysts Sialolitiasis Chronic sclerosing sialadenitis Necrotizing sialometaplasia
23	Salivary infections Acute parotitis Viral endemic parotitis(Mumps) Bacterial sialadenitis
24	Immune related diseases Lymphoepithelial sialadenitis Sjogren Syndrome.
25	Salivary gland tumors BENIGN Pleomorphic adenoma Monomorphic adenoma Papillary cystadenoma Oncocytoma Other adenomas
26	Salivary gland tumors MALIGNANT Mucoepidermoid carcinoma. Adenoid cystic carcinoma Acinic cell carcinoma Polymorphous low grade adenocarcinoma Other adenocarcinomas