Submandibular region

Submandibular region (trigonum submandibulare) - submandibular triangle, limited from above by the edge of the lower jaw, front, bottom, and rear - front and rear belly digastric muscle (m. digastrici). The bottom of the triangle are oral sublingual (m. mylohyoideus) and sublingual-speaking (so hyoglossus) muscles (printing. 1); the latter also serves as the bottom of the triangle N. I. Pirogov (see Pirogov triangle).

submandibular region
Fig. 1. Submandibular and sublingual region (the right half of the lower jaw removed, the skin and the muscles are drawn). 1 - lingua; 2 - gl. lingualis ant.; 3 - a. profunda linguae; 4 - ductus submandibularis; 5 - gl. sublingualis; 6 - mandibula (partially removed); 7 - m. mylohyoideus; 8 - m. geniohyoideus; 9 - gl. submandibularis; 10 - a. facialis; 11 - v. facialis; 12 - ramus descendens n. hypoglossi (BNA); 13 - m. sternocleidomastoideus; 14 - v. jugularls int.; 15 - a., carotis int.; 16 - a. carotis ext.; 17 - n. hypoglossus; 18 - venter post. m. digastrici; 19 - m. stylohyoideus; 20 - gl. parotis; 21 - m. masseter; 22 - v. profunda llngyiae; 23 - ramus mandibulae (partially removed); 24 - n. lingualis; 28 - m. hyoglossus; 30 - v. retromandibularis; 35 - nodi lymphatici submandibulares; 36 - nodi lymphatici cervicales profundi.

Within submandibular region lie: submandibular salivary gland (glandula submandibularis), facial artery and vein (a. et v. facialis), popodrobnee artery and vein (a. et. v. suimaentalis), sublingual and oral sublingual nerves (nn. hypoglossus, mylohyoideus), lymph nodes and the tissue surrounding these education. The last reported with fiber sublingual region, kryloviana-jaw, okolorotova spaces, side of the face and neck. Submandibular lymph nodes are regional nodes of the maxillofacial area, the oral cavity.
Pathology. In submandibular region are observed purulent processes odontogenic or tonsillar of origin in the form of adenomegaly and purulent lesion of fiber. Abscesses (see) and cellulitis (see) this area is most likely to occur when the disease is lower molars, osteomyelitis of the mandible, and the children after a previous infection (measles, scarlet fever, diphtheria).
In abscesses and phlegmon submandibular region should not delay the operation because of possible breakthroughs ulcer in the underlying tissues. Cut a length of 4-5 cm spend 2-3 cm below the top of the lower jaw. Acute by cut through the skin, subcutaneous tissue, platysma and fascia, followed by a blunt way. After revision by the finger of the anterior and posterior submandibular region enter drainage, dressings and administered antibiotics.
Along with acute purulent processes in P. O. observed tuberculosis, syphilis, actinomycetaceae lymphadenitis, metastatic tumors (cancer of lower lip, tongue, mouth), cysts and other tumors (angiomas, lymphangioma, or fibroids. Treatment of specific lymphadenitis, malignant tumors - combined, and benign - operative.