15. Salivary glands and tonsils

Salivary glands and tonsils

Learning objectives

Key terms

Alveolus or acinus

Amylase

B cells

Buccal and labial glands

Epidermal growth factor (EGF)

Excretory portion

Exocytosis

Germinal centers

Glossopalatine glands

Intercalated ducts

Interlobular excretory ducts

Intralobular duct system

Lingual glands

Lingual tonsils

Lobes

Lobules

Major glands

Memory cells

Merocrine glands

Minor glands

Mixed glands

Mucin

Nerve growth factor

Palatine glands

Palatine tonsils

Parotid glands

Pharyngeal tonsil or adenoid

Pure mucous glands

Salivary corpuscles

Secretory end piece or intercalated duct

Secretory portion

Serous demilunes

Serous glands

Serous or mucous cells

Stensen duct

Striated duct

Sublingual glands

Submandibular glands

T cells

Waldeyer ring

Wharton duct

Zymogen granules

Overview

This chapter discusses the structure and function of the salivary glands, saliva, and tonsils. Despite different structures and functions, these soft tissues all contribute significantly to oral health. Saliva is a balanced secretion resulting from both the composition of the secretion and the location of the salivary gland secretions into the oral cavity. The two cell types are serous, which is high protein and low carbohydrate, and mucous, which is low protein and high carbohydrate. Glands of the lips, cheeks, and anterior floor of the mouth produce a watery mixture of a serous and mucous secretion, whereas other glands of the posterior palate, pharynx, and tongue contribute a viscous mucous solution that protects the membranes in those regions. The major salivary glands contribute 85% to 90% of the saliva into the more anterior area of the mouth. In addition to protein and carbohydrate, the parotid gland, which is the largest gland, secretes the enzyme amylase, which aids in digestion of carbohydrates. Therefore, the buffering ability of saliva results from ionic secretions by the salivary glands. These secretions are collected and modified through an elaborate secretory duct system.

Tonsils, like the salivary glands, have locations that maximally affect and protect the oral environment. These lymph node–like organs are positioned in the oropharynx at the entrance to the alimentary canal. They produce lymphocytes and, with the assistance of macrophages, protect against microbes, foreign cells, and cancer cells. Lymphocytes can recognize foreign cells and respond to them either by becoming T cells, which destroy the foreign cells directly, or by forming B cells, which transform into plasma cells that secrete antibodies to eliminate the foreign cells.

Classification of salivary glands

Salivary glands are classified as either major or minor depending on their size and the amount of their secretion. The major glands carry their secretion some distance to the oral cavity by means of a main duct. The smaller minor glands empty their products directly into the mouth by means of short ducts. Both are composed, however, of the same type of cells, either serous or mucous cells or a combination of the two called serous demilunes (Fig. 15-1).

image CLINICAL COMMENT

The salivary glands are also important for the production of growth factors including nerve growth factor (NGF) and epidermal growth factor (EGF), which belongs to a family of growth factors that stimulates cell growth, proliferation, and differentiation.

The functional unit of the salivary gland is the alveolus or acinus. An acinus is a cluster of pyramidal cells, either mucous or serous or a combination of the two, that secretes into a terminal collecting duct (see Fig. 15-1). The collecting duct is termed the secretory end piece or intercalated duct. Both the large and small glands are composed of many acini, although the larger glands contain more acini or units arranged in lobules and lobes (Fig. 15-2). Each cell type provides a different type of secretion. Serous cells secrete mostly proteins and small amounts of carbohydrates. Their secretion also contains zymogen granules, precursors of the enzyme amylase, which functions in the breakdown of carbohydrates. Serous cell secretion has a watery consistency. Mucous cells are high in carbohydrates and low in proteins and discharge a viscous product called mucin (Fig. 15-3). When mucin mixes with watery oral fluids, it becomes mucous, causing the saliva to be thick and viscous.

Both types of acinar cells are pyramidal. The nucleus of the serous cell is oval to round, and that of the mucous cell is oval to spindle shaped (see Fig. 15-1). In each of these cell types, the nuclei appear in the basal part of the cell. The cytoplasm of the serous cell stains deeply because it is filled with albumin, whereas the mucous cell appears light and foamy because of the presence of carbohydrates in mucin (see Fig. 15-3 and Fig. 15-4).

Ultrastructurally, the serous cell is filled with secretory granules in the apical region, rough-surface endoplasmic reticulum, a Golgi apparatus, mitochondria, and an oval nucleus (Fig. 15-5). The mucous cells contain larger droplets of mucin apically and a prominent Golgi apparatus and rough endoplasmic reticulum around the flattened nucleus (Fig. 15-6). A third cell-type arrangement is a terminal alveolus of mucous cells with a cap of serous cells (see Fig. 15-4). This configuration is termed a serous demilune, with the secretion of the serous cells passing down a duct between the terminal mucous cells to the lumen of the alveolus (see Fig. 15-1).

Major salivary glands

The major salivary glands are present as three bilateral pairs. The parotid glands are located on the sides of the face in front of the ears; the second pair, the submandibular glands, are inside the angle of the mandible; and the third pair, the sublingual glands, are on either side of the midline beneath the mucosa of the anterior floor of the mouth (Fig. 15-7 and Table 15-1).

Table 15.1

Major salivary glands and contribution to saliva

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Gland Size Location Type cells Amount secretion (%) Duct type: striated/intercalated
Parotid Largest Anterior ear Serous 25 Long/long
Submandibular Intermediate Angle of mandible Mixed serous demilune 60 Long/short
Sublingual Smallest Anterior floor of mouth Mucous 5

Jan 4, 2015 | Posted by in General Dentistry | Comments Off on 15. Salivary glands and tonsils
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