The Digestive system

Lecture III

Dr. Ghassan Balousha

Department of Pathology
Faculty of Medicine
Al-Quds University
 Major glands
⚫Parotid: so-called watery serous saliva rich in
amylase, proline-rich proteins
⚫Stenson’s duct
⚫Submandibular gland: more mucinous
⚫Wharton’s duct
⚫Sublingual: viscous saliva
⚫ducts of Rivinus; duct of Bartholin
 Minor glands
⚫Minor salivary glands are not found within
gingiva and anterior part of the hard palate
⚫Serous minor glands, von Ebner below the sulci of
the circumvallate and folliate papillae of the
tongue.
⚫Glands of Blandin-Nuhn: ventral tongue
⚫Palatine, glossopalatine glands are pure mucus
⚫Weber glands
 Functions
⚫I- Protection
⚫Lubricant (glycoprotein)
⚫Barrier against noxious stimuli; microbial toxins and
minor traumas
⚫Washing non-adherent and acellular debris
⚫Formation of salivary pellicle
⚫ Calcium -binding proteins: tooth protection; plaque
 Functions
⚫II- Buffering (phosphate ions and bicarbonate)
⚫Bacteria require specific pH conditions
⚫Plaque microorganisms produce acids from sugars.
⚫III-Digestion
⚫Neutralizes esophageal contents
⚫Dilutes gastric chyme
⚫Forms food bolus
⚫Brakes starch
Functions
⚫IV- Antimicrobial
⚫Lysozyme hydrolyzes cell walls of some bacteria
⚫Lactoferrin binds free iron and deprives bacteria of this
essential element
⚫IgA agglutinates microorganisms
⚫V- Maintenance of tooth integrity
⚫Calcium and phosphate ions
⚫ Ionic exchange with tooth surface
Functions
⚫VI-Tissue repair
⚫Bleeding time of oral tissues shorter than other tissues
⚫Resulting clot less solid than normal
⚫Remineralization
⚫VII-Taste
⚫Solubilizing of food substances that can be sensed by
receptors
⚫Trophic effect on receptors
 Embryonic development
⚫The parotid: ectoderm (4-6 weeks of embryonic
life)
⚫The sublingual-submandibular glands:
endoderm
⚫The submandibular gland around the 6th week
⚫The sublingual and the minor glands develop
around the 8-12 week
⚫Differentiation of the ectomesenchyme
⚫Development of fibrous capsule
⚫Formation of septa that divide the gland into
lobes and lobules
 I- Serous cells
⚫Seromucus cells: secrete also polysaccharides
⚫They have all the features of a cell specialized
for the synthesis, storage, and secretion of
protein such as:
⚫Rough endoplasmic reticulum (ribosomal sites--
>cisternae)
⚫Prominent Golgi-->carbohydrate moieties are added
Secretory granules-->exocytosis
Serous cells
⚫The secretory process is continuous but cyclic
⚫There are complex foldings of cytoplasmic
membrane
⚫The junctional complex consists of:
⚫Tight junctions (zonula occludens)-->fusion of outer
cell layer
⚫Intermediate junction (zonula adherens)--
>intercellular communication
⚫Desmosomes-->firm adhesion
 II-Mucous cells
⚫Production, storage, and secretion of proteinaceous
material with smaller enzymatic component
-more carbohydrates.
- mucins=more prominent Golgi
-less prominent (conspicuous) rough endoplasmic
reticulum, & mitochondria
-less interdigitations
 Formation and Secretion of Saliva
⚫Primary saliva
⚫Serous and mucous cells
⚫Intercalated ducts
⚫Modified saliva
⚫Striated and terminal ducts
⚫End product is hypotonic
 Macromolecular component
⚫Synthesis of proteins
⚫RER, Golgi apparatus
⚫Ribosomes 🡪 RER 🡪 posttranslational modification (N-
& O-linked glycosylation) 🡪 Golgi apparatus 🡪
Secretory granules
⚫Exocytosis
⚫Endocytosis of the granule membrane
 Fluid and Electrolytes
⚫Parasympathetic innervation
⚫Binding of acetylcholine to muscarinic receptors
⚫Activation of phospholipase 🡪 IP3 🡪 release of Ca2+ 🡪
opening of channels K+, Cl- Na+ in
⚫K+ and Cl- in
⚫Also another electrolyte transport mechanism through
HCO3-
⚫Noepinephrine via alpha-adrenergic receptors
⚫Substance P activates the Ca2+
 III- Myoepithelial cells
⚫One, two or even three myoepithelial cells in each
salivary and piece body
⚫Four to eight processes
⚫Desmosomes between myoepithelial cells and
secretory cells
⚫Myofilaments frequently aggregated to form dark
bodies along the course of the process
Myoepithelial cells
⚫The myoepithelial cells of the intercalated ducts
are more spindled-shaped and fewer processes
⚫Ultrastructurally very similar to that of smooth
muscle cells
⚫Functions of myoepithelial cells
⚫Support secretory cells
⚫Contract and widen the diameter of the intercalated
ducts
⚫Contraction may aid in the rupture of acinar cells of
epithelial origin
 Intercalated Ducts
⚫Small diameter
⚫Lined by small cuboidal cells
⚫Nucleus located in the center
⚫Well-developed RER, Golgi apparatus,
occasionally secretory granules, few microvilli
⚫Myoepithelial cells are also present
⚫Intercalated ducts are prominent in salivary
glands having a watery secretion (parotid).
 Striated Ducts
⚫Columnar cells
⚫Centrally located nucleus
⚫Eosinophilic cytoplasm
⚫Prominenty striations
⚫Indentations of the cytoplasmic membrane with
many mitochondria present between the folds
⚫Some RER and some Golgi, short microvilli
⚫Modify the secretion
⚫Hypotonic solution=low sodium and chloride
and high potassium
⚫Basal cells
 Terminal excretory ducts
⚫Near the striated ducts they have the same
histology as the striated ducts
⚫As the duct reaches the oral mucosa the lining
becomes stratified
⚫Goblet cells, basal cells, clear cells.
⚫Alter the electrolyte concentration and add mucoid
substance.
 Ductal modification
⚫Autonomic nervous system
⚫Striated and terminal ducts
⚫Modofication via reabsorption and secretion of
electrolytes
⚫Final product is hypotonic
⚫Rate of salivary flow
⚫High: Sodium and chlorine up; potassium down
 Connective tissue

⚫Fibroblasts
⚫Inflammatory cells
⚫Mast cells
⚫Adipose cells
⚫Extracellular matrix
⚫Glycoproteins and proteoglycans
⚫Collagen and oxytalan fibers
⚫Blood supply
 Nerve supply
⚫No direct inhibitory innervation
⚫Parasympathetic and sympathetic impulses
⚫Parasympathetic are more prevalent.
⚫Parasympathetic impulses may occur in isolation,
evoke most of the fluid to be excreted, cause
exocytosis, induce contraction of myoepithelial cells
(sympathetic too) and cause vasodilatation.
 Nerve supply

⚫There are two types of innervation: Epilemmal and

hypolemmal
⚫beta-adrenergic receptors that induce protein
secretion
⚫L-adrenergic and cholinergic receptors that induce
water and electrolyte secretion
Hormones can influence the function of the salivary
glands.
They modify the salivary content but cannot
iniate salivary flow.
 Age changes
⚫Fibrosis and fatty degenerative changes
⚫Presence of oncocytes (eosinophilic cells containing
many mitochondria)
 Clinical Considerations
⚫Obstruction
⚫Role of drugs
⚫Systemic disorders
⚫Bacterial or viral infections
⚫Therapeutic radiation
⚫Formation of plaque and calculus