Utilitarian ethics

• Utilitarian Ethics, formulated by John Stuart Mill and Jeremy Bentham, states that the rightness and wrongness of actions are determined by the goodness and badness of their consequences
• The Utilitarian principle of utility asserts that actions are good if they tend to promote happiness and bad if they tend to promote unhappiness
• In Utilitarianism, consequences should benefit the majority for an action to be considered morally right
• Two types of Utilitarianism:

  • Act Utilitarianism: determines rightness and wrongness by weighing the consequences of the act itself, considering the possible results of each particular act, case, or decision
  • Rule Utilitarianism: appeals to a set of criteria, norms, or rules to settle what is the right, just, and ethical decision to make, even if one doesn't agree with the rule
• In a medical context, Utilitarian Ethics provide a system for formulating, testing, and evaluating hospital policies and regulations, leading to the enactment of laws, directives, guidelines, and codes of conduct
• Utilitarianism justifies the imposition of discomfort or suffering on a few for the sake of the many, and it may overlook the motives behind some moral decisions
• Salivary glands


  Glands that produce saliva
• Submandibular gland


  • Paired glands
  • Composed of more serous than mucous acini
  • Lies beneath the lower border of the mandible
  • Produces 65% of daily output of saliva
  • Divided into superficial and deep parts by the mylohyoid muscle
• Submandibular gland divisions


  1. Superficial part

  2. Deep part
• Submandibular duct (Wharton's duct)

  • Emerges from the anterior end of the deep part of the gland
  • Opens into the mouth on a small papilla, which is situated at the side of the frenulum of the tongue
• Submandibular gland blood supply

  • Comes from the branches of the facial and lingual artery
• Submandibular gland venous drainage

  • Comes from the branches of the facial and lingual vein
• Submandibular gland lymph drainage


  • Submandibular and deep cervical lymph nodes
• Submandibular gland nerve supply

  • Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani, and the submandibular ganglion
• The submandibular salivary gland is a common site of calculus formation → SIALOLITHIASIS
• Presence of a tense swelling below the body of the mandible, which is greatest before or during a meal and is reduced in size or absent between meals, is diagnostic of submandibular gland calculous formation
• Examination of the floor of the mouth will reveal absence of ejection of saliva from the orifice of the duct of the affected submandibular gland
• A stone can be palpated in the duct of the submandibular gland, which lies below the mucous membrane of the floor of the mouth
• Sublingual gland


  • Smallest
  • Almond shaped
  • 4 gm in weight
  • Contains more mucous acini than serous
  • Lies beneath the mucous membrane (sublingual fold) of the floor of the mouth , close to the frenulum of the tongue
• Sublingual duct (duct of Rivinus)

  • 8 to 20 in number
  • Open into the mouth on the summit of the sublingual fold
• Sublingual gland blood supply

  • Comes from the branches of the facial artery, submental branch and lingual artery
• Sublingual gland venous drainage

  • Comes from the branches of the facial artery, submental branch and lingual artery
• Sublingual gland lymph drainage

  • Submandibular and deep cervical lymph nodes
• Sublingual gland nerve supply

  • Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani, and the submandibular ganglion
• Blockage of one of the sublingual ducts is believed to be the cause of cysts under the tongue
• Parotid gland


  • Largest salivary gland
  • 25 gm in weight
  • Composed mostly of serous acini
  • Irregular, lobulated, yellowish mass
  • Wedge-shaped when viewed externally, with the base above and the apex behind the angle of the mandible
  • Lies in a deep hollow below the external auditory meatus, behind the ramus of the mandible, and in front of the sternocleidomastoid muscle
• Parotid duct (Stensen's duct)


  • Emerges from the anterior border of the gland and passes forward over the lateral surface of the masseter
  • Enters the vestibule of the mouth upon a small papilla opposite the upper second molar tooth
• Parotid gland divisions


  • Superficial lobe
  • Deep lobe
• Parotid gland nerve supply

  • Parasympathetic secretomotor supply arises from the glossopharyngeal nerve
• The parotid duct, which is a comparatively superficial structure on the face, may be damaged in injuries to the face or may be inadvertently cut during surgical operations on the face
• A benign parotid neoplasm rarely, if ever, causes facial palsy
• A malignant tumor of the parotid is usually highly invasive and quickly involves the facial nerve, causing unilateral facial paralysis
• The parotid gland may become acutely inflamed as a result of retrograde bacterial infection from the mouth via the parotid duct
• The swollen glenoid process, which extends medially behind the temporomandibular joint, is responsible for the pain experienced in acute parotitis when eating
• The parotid gland may also become infected via the bloodstream, as in mumps Caused by a virus (Paramyxovirus)
• Frey's syndrome is an interesting complication that sometimes develops after penetrating wounds of the parotid gland
• When the patient eats, beads of perspiration appear on the skin covering the parotid in Frey's syndrome
• Frey's syndrome is caused by damage to the auriculotemporal and great auricular nerves → During the process of healing, the parasympathetic secretomotor fibers in the auriculotemporal nerve grow out and join the distal end of the great auricular nerve → a stimulus intended for saliva production produces sweat secretion instead
• The submandibular space is a potential space in the neck
• Most cases of Ludwig's angina are derived from dental infections, especially the 2nd and 3rd molars