Transcript 15-Submandibular Region-II.ppt

By:
Prof. Saeed Makarem
By the end of this session the students
should know:
Salivary Glands
Submandibular & Sublingual
Parasympathetic Ganglion
Submandibular
Lymph Nodes
Submandibular group
Submandibular Gland
•It consists of a mixture of serous
and mucous acini.
•It lies beneath the lower border
of the body of the mandible.
•It is divided into superficial and
deep parts by the mylohyoid
muscle.
•The deep part of the gland lies
beneath the mucous membrane
of the floor of the mouth.
•The submandibular duct
emerges from the anterior end of
the deep part of the gland &
runs forward beneath the
mucous membrane of the mouth.
•The duct opens into the floor of
the mouth on a small papilla,
which is situated at the side of
the frenulum of the tongue.
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Anteriorly:
anterior belly of digastric.
Posteriorly:
posterior belly of digastric ,
stylohyoid &
parotid gland.
Medially:
mylohyoid,
hyoglossus,
lingual nerve,
submandibular ganglion
hypoglossal nerve.
Laterally:
submandibular fossa of the
mandible.
NB. Inferolaterally, it is
covered by the investing
layer of deep cervical
fascia, platysma & skin.
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Anteriorly:
sublingual gland.
Posteriorly:
posterior belly of digastric &
stylohyoid,
parotid gland.
Medially:
hyoglossus &
styloglossus.
Laterally:
mylohyoid muscle &
superficial part of the gland.
Superiorly:
lingual nerve &
submandibular ganglion.
It is covered by the mucous
membrane of floor of the
mouth.
Inferiorly:
hypoglossal nerve.
The hyoglossus is a flat, quadrilateral muscle.
 Origin: from the upper border of the body and greater cornu of the
hyoid bone.
 Insertion: to the side of the tongue.
 Action: depression of tongue.
 Nerve supply: hypoglossal nerve.
Prof. Makarem
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It emerges from the anterior end of the deep part of the gland.
It passes forward along the side of the tongue, beneath the mucous membrane of the floor
of the mouth.
It is crossed laterally by the lingual nerve.
It then lies between the sublingual gland and the genioglossus muscle.
It opens at the summit of a small papilla, situated at the side of the frenulum of the tongue.
The duct and the deep part of the gland could be palpated through the mucous membrane
of the floor of the mouth.
Sublingual Gland
•The sublingual gland lies beneath
the mucous membrane (sublingual
fold) of the floor of the mouth, close
to the frenulum of the tongue
•It has both serous and mucous
acini.
•The sublingual ducts (8 to 20 in
number) open into the mouth on
the summit of the sublingual fold.
Nerve Supply
Parasympathetic secretomotor
supply is from the facial nerve via
the chorda tympani, and the
submandibular ganglion.
Postganglionic fibers pass directly
to the gland.
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Relations:
› Anteriorly : the gland of
the opposite side
› Posteriorly:
› deep part of the
submandibular gland
› Medially:
› genioglossus muscle,
›lingual nerve &
› submandibular duct
› Laterally:
› sublingual fossa of the
mandible
› Superiorly:
› mucous membrane of
the floor of the mouth.
The gland forms the
sublingual fold.
› inferiorly:
› mylohyoid muscle.
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Blood supply:
facial and lingual
arteries.
Venous
drainage:
into the facial
and lingual veins.
Lymph
drainage:
submandibular &
deep cervical
lymph nodes.
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Small parasympathetic
ganglion
Location:
on the lateral surface of the
hyoglossus muscle.
Suspended from the lingual
nerve by several branches;
Preganglionic
parasympathetic fibers
reach the ganglion from the
superior salivary nucleus of
the facial nerve via the
chorda tympani & lingual
nerves.
 The pre-ganglionic fibers
synapse within the
ganglion, and the postganglionic fibers pass to
the submandibular &
sublingual salivary glands.
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Prof. Makarem
Parasympathetic
secretomotor supply
from the superior
salivary nucleus of
the seventh cranial
nerve.
The nerve fibers
pass
› to the
submandibular
ganglion via
› the chorda
tympani nerve
and
› the lingual
nerve.
Postganglionic
parasympathetic
fibers pass to the
gland via the lingual
nerve.
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Postganglionic
sympathetic fibers
reach the gland
as a plexus of
nerves around the
facial and lingual
arteries.
Prof. Makarem
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The submandibular lymph nodes are
situated on the superficial surface of the
submandibular salivary gland.
They can be palpated just below the
lower border of the body of the mandible.
They receive lymph from a wide area,
including the anterior two thirds of the
tongue (except the tip); the floor of the
mouth & vestibule; and the gums.
The efferent lymph vessels drain into the
deep cervical lymph nodes.
The submental lymph nodes are
situated in the submental triangles.
They receive lymph from
tip of the tongue,
floor of the mouth beneath the tip of the
tongue,
incisor teeth and the associated gums,
center part of the lower lip,
skin over the chin.
The efferent lymph vessels drain into the
submandibular and deep cervical lymph
nodes.
The deep cervical lymph
nodes form a chain along the
course of the internal jugular
vein, from the skull to the root
of the neck.
They are embedded in the
fascia of the carotid sheath
and the tunica adventitia of the
internal jugular vein;
Most lie on the anterolateral
aspect of the internal jugular
vein.
Two of the nodes are often
referred to clinically and are
called the jugulodigastric
node and the juguloomohyoid node.
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The jugulodigastric
node lies just below
the posterior belly of
the digastric muscle
and is located just
below and behind the
angle of the mandible.
It is chiefly concerned
with the lymph
drainage of the tonsil
and the tongue.
The juguloomohyoid node is
related to the
intermediate tendon
of the omohyoid
muscle and is
associated mainly
with the lymph
drainage of the
tongue.
The sublingual
salivary gland,
opens into the
mouth by
numerous
small ducts.
 Blockage of
one of these
ducts is
believed to be
the cause of
cyst (Ranula)
under the
tongue.
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