Lacrimal gland

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Lacrimal gland
Gray896.png
Lacrimal apparatus of the right eye. The lacrimal gland is to the upper left. The right side of the picture is towards the nose.
Tear system.svg
Tear system.

a = lacrimal gland
b = superior lacrimal punctum
c = superior lacrimal canal
d = lacrimal sac
e = inferior lacrimal punctum
f = inferior lacrimal canal
g = nasolacrimal canal
Details
Artery lacrimal artery
Vein superior ophthalmic vein
Nerve lacrimal nerve
Identifiers
Latin glandula lacrimalis
TA98 A15.2.07.057
TA2 6846
FMA 59101
Anatomical terminology

The lacrimal glands are paired exocrine glands, one for each eye, found in most terrestrial vertebrates and some marine mammals, that secrete the aqueous layer of the tear film. [1] In humans, they are situated in the upper lateral region of each orbit, in the lacrimal fossa of the orbit formed by the frontal bone. [2] Inflammation of the lacrimal glands is called dacryoadenitis. The lacrimal gland produces tears which are secreted by the lacrimal ducts, and flow over the ocular surface, and then into canals that connect to the lacrimal sac. From that sac, the tears drain through the lacrimal duct into the nose.

Contents

Anatomists divide the gland into two sections, a palpebral lobe, or portion, and an orbital lobe or portion. [3] The smaller palpebral lobe lies close to the eye, along the inner surface of the eyelid; if the upper eyelid is everted, the palpebral portion can be seen.

The orbital lobe of the gland, contains fine interlobular ducts that connect the orbital lobe and the palpebral lobe. [4] They unite to form three to five main secretory ducts, joining five to seven ducts in the palpebral portion before the secreted fluid may enter on the surface of the eye. Tears secreted collect in the fornix conjunctiva of the upper lid, and pass over the eye surface to the lacrimal puncta, small holes found at the inner corner of the eyelids. These pass the tears through the lacrimal canaliculi on to the lacrimal sac, in turn to the nasolacrimal duct, which dumps them out into the nose. [5]

Lacrimal glands are also present in other mammals, such as horses.

Structure

Histology

The lacrimal gland is a compound tubuloacinar gland, it is made up of many lobules separated by connective tissue, each lobule contains many acini. The acini composed of large serous cells which, produce a watery serous secretion, serous cells are filled with lightly stained secretory granules and surrounded by well-developed myoepithelial cells and a sparse, vascular stroma. Each acinus consists of a grape-like mass of lacrimal gland cells with their apices pointed to a central lumen.

The central lumen of many of the units converge to form intralobular ducts, and then they unite to form interlobular ducts. The gland lacks striated ducts.

Blood supply

The lacrimal gland receives blood from the lacrimal artery, which is a branch of the ophthalmic artery. Blood from the gland drains to the superior ophthalmic vein.

Lymphatic drainage

No lymphatic vessels have been observed draining the lacrimal gland.

Nerve supply

The lacrimal gland is innervated by the lacrimal nerve, which is the smallest branch of the ophthalmic nerve, itself a branch of the trigeminal nerve (CN V). After the lacrimal nerve branches from the ophthalmic nerve it receives a communicating branch from the zygomatic nerve. This communicating branch carries postganglionic parasympathetic axons from the pterygopalatine ganglion. The lacrimal nerve passes anteriorly in the orbit and through the lacrimal gland providing parasympathetic and sympathetic innervation to it.

Parasympathetic innervation

Depicts nerve branches that are involved in the autonomic innervation of the lacrimal gland. The terminal parts of the pathway are variable between individuals and differ for the other glands of the deep face. Autonomic Innervation to the Lacrimal Gland (and other glands of the deep face).svg
Depicts nerve branches that are involved in the autonomic innervation of the lacrimal gland. The terminal parts of the pathway are variable between individuals and differ for the other glands of the deep face.

The parasympathetic innervation to the lacrimal gland is a complex pathway which traverses through numerous structures in the head. Ultimately this two-neuron pathway involving both a preganglionic and postganglionic parasympathetic neuron increases the secretion of lacrimal fluid from the lacrimal gland. The preganglionic parasympathetic neurons are located in the superior salivatory nucleus. They project axons which exit the brainstem as part of the facial nerve (CN VII). Within the facial canal at the geniculate ganglion the axons branch from the facial nerve forming the greater petrosal nerve. This nerve exits the facial canal through the hiatus for the greater petrosal nerve in the petrous part of the temporal bone. It emerges to the middle cranial fossa and travels anteromedially to enter the foramen lacerum. Within the foramen lacerum it joins to the deep petrosal nerve to form the nerve of the pterygoid canal and then passes through this canal. It emerges in the pterygopalatine fossa and enters the pterygopalatine ganglion where the preganglionic parasympathetic axons synapse with the postganglionic parasympathetic neurons. The postganglionic neurons then send axons which travel with the zygomatic nerve to enter the inferior orbital fissure. As the zygomatic nerve travels anteriorly in the orbit it sends a communicating branch to the lacrimal nerve which carries the postganglionic parasympathetic axons. The lacrimal nerve completes this long pathway by travelling through the lacrimal gland and sending branches to which it provides parasympathetic innervation to increase the secretion of lacrimal fluid.

Sympathetic innervation

Sympathetic innervation to the lacrimal gland is of less physiologic importance than the parasympathetic innervation, however there are noradrenergic axons found within the lacrimal gland. Their cell bodies are located in the superior cervical ganglion.

Clinical significance

In contrast to the normal moisture of the eyes or even crying, there can be persistent dryness, scratching, itchiness and burning in the eyes, which are signs of dry eye syndrome (DES) or keratoconjunctivitis sicca (KCS). With this syndrome, the lacrimal glands produce less lacrimal fluid, which mainly occurs with ageing or certain medications. The Schirmer test, conducted by placing a thin strip of filter paper at the edge of the eye, can be used to determine the level of dryness of the eye. Many medications or diseases that cause dry eye syndrome can also cause hyposalivation with xerostomia. Treatment varies according to aetiology and includes avoidance of exacerbating factors, tear stimulation and supplementation, increasing tear retention, eyelid cleansing, and treatment of eye inflammation. [6]

In addition, the following can be associated with lacrimal gland pathology:

Additional images

See also

Related Research Articles

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<span class="mw-page-title-main">Facial nerve</span> Cranial nerve VII, for the face and tasting

The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue. The nerve typically travels from the pons through the facial canal in the temporal bone and exits the skull at the stylomastoid foramen. It arises from the brainstem from an area posterior to the cranial nerve VI and anterior to cranial nerve VIII.

Articles related to anatomy include:

<span class="mw-page-title-main">Orbit (anatomy)</span> Cavity or socket of the skull in which the eye and its appendages are situated

In anatomy, the orbit is the cavity or socket/hole of the skull in which the eye and its appendages are situated. "Orbit" can refer to the bony socket, or it can also be used to imply the contents. In the adult human, the volume of the orbit is 30 millilitres, of which the eye occupies 6.5 ml. The orbital contents comprise the eye, the orbital and retrobulbar fascia, extraocular muscles, cranial nerves II, III, IV, V, and VI, blood vessels, fat, the lacrimal gland with its sac and duct, the eyelids, medial and lateral palpebral ligaments, cheek ligaments, the suspensory ligament, septum, ciliary ganglion and short ciliary nerves.

<span class="mw-page-title-main">Pterygopalatine ganglion</span> Parasympathetic ganglion in the pterygopalatine fossa

The pterygopalatine ganglion is a parasympathetic ganglion in the pterygopalatine fossa. It is one of four parasympathetic ganglia of the head and neck,.

<span class="mw-page-title-main">Ciliary ganglion</span> Bundle of nerves, parasympathetic ganglion

The ciliary ganglion is a bundle of nerves, parasympathetic ganglion located just behind the eye in the posterior orbit. It is 1–2 mm in diameter and in humans contains approximately 2,500 neurons. The ganglion contains postganglionic parasympathetic neurons. These neurons supply the pupillary sphincter muscle, which constricts the pupil, and the ciliary muscle which contracts to make the lens more convex. Both of these muscles are involuntary since they are controlled by the parasympathetic division of the autonomic nervous system.

<span class="mw-page-title-main">Greater petrosal nerve</span> Nerve in the skull

The greater petrosal nerve is a nerve of the head mainly containing pre-ganglionic parasympathetic fibres which ultimately synapse in the pterygopalatine ganglion. It branches from the facial nerve and is derived from the parasympathetic part of the nervus intermedius component of CN VII, with its cell bodies located in the superior salivary nucleus. In the connective tissue substance of the foramen lacerum, the greater petrosal nerve unites with the (sympathetic) deep petrosal nerve to form the nerve of the pterygoid canal which proceeds to the pterygopalatine ganglion.

<span class="mw-page-title-main">Maxillary nerve</span> Branch of the trigeminal nerve responsible for the mid-face

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<span class="mw-page-title-main">Zygomatic nerve</span> Nerve of the face

The zygomatic nerve is a branch of the maxillary nerve. It arises in the pterygopalatine fossa and enters the orbit through the inferior orbital fissure before dividing into its two terminal branches: the zygomaticotemporal nerve and zygomaticofacial nerve.

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The zygomaticotemporal nerve (zygomaticotemporal branch, temporal branch) is a cutaneous (sensory) nerve of the head. It is a branch of the zygomatic nerve (itself a branch of the maxillary nerve (CN V2)). It arises in the orbit and exits the orbit through the zygomaticotemporal foramen in the zygomatic bone to enter the temporal fossa. It is distributed to the skin of the side of the forehead. It also contains a parasympathetic secretomotor component for the lacrimal gland which it confers to the lacrimal nerve (which then delivers it to the gland).

<span class="mw-page-title-main">Superior cervical ganglion</span> Largest of the cervical ganglia

The superior cervical ganglion (SCG) is the upper-most and largest of the cervical sympathetic ganglia of the sympathetic trunk. It probably formed by the union of four sympathetic ganglia of the cervical spinal nerves C1–C4. It is the only ganglion of the sympathetic nervous system that innervates the head and neck. The SCG innervates numerous structures of the head and neck.

<span class="mw-page-title-main">Lacrimal apparatus</span> Physiological system containing the orbital structures for tear production and drainage

The lacrimal apparatus is the physiological system containing the orbital structures for tear production and drainage.
It consists of:

<span class="mw-page-title-main">Deep petrosal nerve</span>

The deep petrosal nerve is a post-ganglionic branch of the (sympathetic) internal carotid (nervous) plexus that enters the cranial cavity through the carotid canal, then passes perpendicular to the carotid canal in the cartilaginous substance which fills the foramen lacerum to unite with the (parasympathetic) greater petrosal nerve to form the nerve of pterygoid canal.

<span class="mw-page-title-main">Nerve of pterygoid canal</span>

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<span class="mw-page-title-main">Intermediate nerve</span> Portion of the facial nerve

The intermediate nerve, nervus intermedius, nerve of Wrisberg or Glossopalatine nerve, is the part of the facial nerve located between the motor component of the facial nerve and the vestibulocochlear nerve. It contains the sensory and parasympathetic fibers of the facial nerve. Upon reaching the facial canal, it joins with the motor root of the facial nerve at the geniculate ganglion. Alex Alfieri postulates that the intermediate nerve should be considered as a separate cranial nerve and not a part of the facial nerve.

<span class="mw-page-title-main">Salivatory nuclei</span>

The salivatory nuclei are two parasympathetic general visceral efferent cranial nerve nuclei - the superior salivatory nucleus and the inferior salivatory nucleus - that innervate the salivary glands. Both are located in the pontine tegmentum of the brainstem.

<span class="mw-page-title-main">Accessory visual structures</span> External parts of the eye including eyebrow, eyelid, and lacrimal apparatus

The accessory visual structures are the protecting and supporting structures (adnexa) of the eye, including the eyebrow, eyelids, and lacrimal apparatus. The eyebrows, eyelids, eyelashes, lacrimal gland and drainage apparatus all play a crucial role with regards to globe protection, lubrication, and minimizing the risk of ocular infection. The adnexal structures also help to keep the cornea moist and clean.

<span class="mw-page-title-main">Roots of the ciliary ganglion</span>

The ciliary ganglion is a parasympathetic ganglion located just behind the eye in the posterior orbit. Three types of axons enter the ciliary ganglion but only the preganglionic parasympathetic axons synapse there. The entering axons are arranged into three roots of the ciliary ganglion, which join enter the posterior surface of the ganglion.

References

  1. Schwab, Ivan R. (2012). Evolution's Witness : How Eyes Evolved. New York. p. 245. ISBN   9780195369748.{{cite book}}: CS1 maint: location missing publisher (link)
  2. Moore, Keith (2018). Clinically oriented anatomy. Wolters Kluwer. pp. 897–900. ISBN   9781496347213.
  3. Machiele, R (November 2018). "Anatomy Head and Neck". StatPearls [Internet]. PMID   30422509.
  4. Machiele, R (November 2018). "Anatomy, Head and Neck, Eye Lacrimal Gland". StatPearls(Internet). PMID   30422509.
  5. "eye, human."Encyclopædia Britannica. 2010. Encyclopædia Britannica 2010 Ultimate Reference Suite DVD 2010
  6. Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 153.