Submandibular Region

SUBMANDIBULAR
REGION
Introduction
• The region under cover of body of mandible.
• Extends between mylohyoid lines above and hyoid bone

below.
Deep Structures
Suprahyoid muscles.
Extrinsic muscles of the tongue.
Salivary glands-
• Submandibular and Sublingual.
Arteries-
• Facial and Lingual.
Nerves-
• Lingual.
• Hypoglossal.
• Glossopharyngeal.
Ganglion-
• Submandibular.
Key Muscle
• Hyoglossus
Muscular Planes
• 4
I- Digastric and Stylohyoid.
II-Mylohyoid.
III-Geniohyoid, Hyoglossus and

Styloglossus.
IV-Genioglossus and a part of

superior constrictor of pharynx.
Submandibular Gland
Introduction
• Size- about the size of a walnut.
PARTS
2
• Larger superficial part
• Smaller deep part.
 Two parts are continuous with each other around the posterior border of the
mylohyoid muscle.
Superficial Part
Presenting parts-
2 Ends—
 Anterior
 Posterior
3 Surfaces—
 Inferior
 Lateral
 Medial
Ends
• Anterior end extends upto
the anterior belly of
digastric muscle.
• Posterior end extends upto

stylomandibular ligament
which separates the
submandibular gland from
parotid gland.
Ends contd…
• Posterior end presents a groove for the ascending limb of facial
artery.
Inferior surface (Superficial surface)
Relations:
 Covered by:
• Skin
• Superficial fascia
• Deep cervical fascia
 Crossed by facial vein and

cervical branch of facial nerve,
under cover of platysma.
 Submandibular lymph nodes,

beneath the investing layer of
deep cervical fascia.
Lateral Surface
Relations:
• Submandibular fossa of the
mandible
• Medial pterygoid muscle close

to its insertion
• Facial artery
 Facial artery loops downward

and forward between the bone
and the gland, and winds
around the lower border of
body of the mandible at the
antero-inferior angle of the
masseter to reach the face.
Medial Surface
• Its relations are divided into three parts: anterior, middle and posterior.
Anterior part:
• Rests on mylohyoid muscle; separated by the mylohyoid vessels and nerves,
and submental branch of the facial artery.
Medial Surface contd…
Intermediate part:
Rests on:
• Hyoglossus muscle
• Lingual nerve
• Submandibular ganglion
• Hypoglossal nerve
Medial Surface contd…
Posterior part : related to
• Styloglossus muscle
• Stylohyoid ligament
• Glossopharyngeal nerve
• Wall of pharynx
Deep part
• Extends forward in the interval between the mylohyoid and
hyoglossus upto the posterior end of sublingual salivary
gland.
Relations of Deep part
Laterally-Mylohyoid
Medially-Hyoglossus
Above-Lingual nerve and submandibular ganglion
Below-Hypoglossal nerve accompanied by a pair of veins.
Submandibular duct (Wharton’s duct)
• ~ 5 cm long.
• Emerges at the anterior end of deep

part.
• Runs forward on the hyoglossus

between lingual and hypoglossal
nerves.
• Crossed by lingual nerve, near the

anterior border of hyoglossus.
• Continues forward between sublingual

gland and genioglossus muscle.
• Opens into the oral cavity on the

summit of sublingual papilla at the side
of frenulum of tongue.
Nerve Supply
Clinical Correlates
 Formation of calculi-
 It is more common in submandibular gland and its duct for two reasons:
• Secretion is more viscid.
• Duct takes a tortuous and upward course (against gravity).
 Skin incision for removal of calculus or tumour from submandibular gland-
• 4 cm below the angle of mandible.
 Bimanual Palpation of Submandibular gland-
•
Sublingual
It is the smallest of the three large salivary
Gland
glands.
• Mostly mucous in nature.
SHAPE-almond shaped.
WEIGHT- 3 to 4 gm
LOCATION-
• In the floor of the mouth between the
mucous membrane and mylohyoid muscle.
• Lodges in the sublingual fossa of the
mandible.
Ducts of Sublingual Gland
• The gland possesses about 8 to 20
ducts:
• Most of the ducts (ducts of

Rivinus) open separately in the
floor of the mouth on the summit
of the sublingual fold.
• Some ducts from the anterior part

of the gland unite to form the
sublingual duct (duct of Bartholin).
• Duct of Bartholin opens into the

submandibular duct.
Sublingual Gland contd…
Arterial supply:
• The gland is supplied by the sublingual and
submental arteries.
Lymphatic drainage:
• The lymphatics drain into submental and
submandibular nodes.
Submandibular Ganglion (Langley’s Ganglion)
• It is a parasympathetic
ganglion.
• A relay station for

secretomotor fibers of
submandibular and sublingual
salivary glands.
CONNECTIONS-
Topographically- with the lingual
nerve.
Functionally- with the facial nerve
(through its chorda tympani
branch).
Submandibular Ganglion contd…
LOCATION-
 On outer surface of hyoglossus muscle.
 It is suspended from the lingual nerve by two roots:
• Posterior.
• Anterior.
ROOTS- 3
•Parasympathetic.
•Sympathetic.
•Sensory.
Parasympathetic or motor root:

•Derived from lingual nerve.
•The preganglionic fibres arise from superior

salivatory nucleus in the pons.
•Preganglionic fibres pass successively through

the facial, chorda tympani and lingual nerves
and reach the submandibular ganglion.
•Preganglionic fibres relay in submandibular

ganglion.
Parasympathetic or motor root contd…
• Postganglionic fibres directly supply the submandibular gland by five
or more branches.
• Some postganglionic fibers join the lingual nerve through the anterior
root and supply the sublingual gland.
Sympathetic Root:
• It is derived from a plexus around
the facial artery which is formed by
postganglionic sympathetic fibres.
• Postganglionic sympathetic fibres

arise from superior cervical
sympathetic ganglion of the
sympathetic trunk.
• These fibres pass through the

submandibular ganglion without
relay.
• These fibres supply the blood

vessels of submandibular and
sublingual salivary glands.

Submandibular Region

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Submandibular Region

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SUBMANDIBULAR

• Extends between mylohyoid lines above and hyoid bone

Extrinsic muscles of the tongue.

I- Digastric and Stylohyoid.

III-Geniohyoid, Hyoglossus and

IV-Genioglossus and a part of

• Posterior end extends upto

 Crossed by facial vein and

 Submandibular lymph nodes,

• Medial pterygoid muscle close

 Facial artery loops downward

• Emerges at the anterior end of deep

• Runs forward on the hyoglossus

• Crossed by lingual nerve, near the

• Continues forward between sublingual

• Opens into the oral cavity on the

• Most of the ducts (ducts of

• Some ducts from the anterior part

• Duct of Bartholin opens into the

• A relay station for

Parasympathetic or motor root:

•The preganglionic fibres arise from superior

•Preganglionic fibres pass successively through

•Preganglionic fibres relay in submandibular

• Post­ganglionic sympathetic fibres

• These fibres pass through the

• These fibres supply the blood

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• Postganglionic sympathetic fibres