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Gastrointestinal Tract > 2) Salivation and Swallowing > Flashcards

2) Salivation and Swallowing Flashcards

1
Q

State some functions of saliva:

A

Lubricates mouth and food to form a bolus
Initiates digestion
Protects teeth and mucosa (antibacterial and wet)
Solvent for taste molecules

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2
Q

What tonicity does saliva have and how does it vary?

A

Hypotonic

Depends on flow rate, more isotonic at high flow

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3
Q

Describe the composition of saliva:

A 
Mostly water 
Rich in K+ and HCO3-
Mucins
Amylase and Lipase
Diversity of immune proteins (IgA, lysozyme, lactoferrin)
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4
Q

What are the mucins in saliva for?

A

Help with lubrication

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5
Q

Where are amylase and lipase secreted from respectively?

A

Salivary glands and lingual glands

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6
Q

What do duct cells do in process of modifying saliva?

A

Remove Na+ and Cl-

Add HCO3- and K+

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7
Q

How do duct cells create a hypotonic salvia?

A

Gaps between duct cells are tight so water can’t follow into saliva

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8
Q

What happens to pH of saliva at higher flow rates?

A

More alkaline as more HCO3- secreted into saliva

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9
Q

What is xerostomia?

A

Dryness of mouth, may be associated with change in composition of saliva or reduced salivary flow.

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10
Q

What are the consequences of xerostomia?

A

Teeth and mucosa can degrade due to dry conditions

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11
Q

What type of secretions come from parotid gland?

A

Serous secretions, 25% of saliva

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12
Q

What type of secretions come from sub-mandibular gland?

A

Both serous and mucous secretion, 70% of saliva

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13
Q

What type of secretions come from sublingual gland?

A

Secretions rich in mucus, 5% of saliva

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14
Q

What is salivary secretion mainly controlled by?

A

Autonomic nervous system

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15
Q

Where do the parasympathetic nerves that supply salivary glands originate?

A

Otic ganglion

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16
Q

What is the effect of PSNS on salivary gland cells?

A

Stimulate acinar cells to produce more saliva

Stimulate duct cells to add more HCO3-

17
Q

What is the effect of SNS on salivary gland cells?

A

Vasoconstriction so reduced blood supply to gland, limiting salivary flow

18
Q

What nerve is the parotid gland innervated by?

A

Cranial nerve IX

19
Q

What nerve are the sublingual and submandibular glands innervated by?

A

Chords tympani of cranial nerve VII

20
Q

Why is the innervation of sublingual and submandibular glands clinically significant?

A

Chords tympani runs through middle ear so infection here could damage nerve and stop parasympathetic innervation.

21
Q

What effect does aldosterone have on the salivary glands?

A

Increases rate of ductal recovery of Na+

22
Q

What is sialography?

A

Radiological investigation of salivary glands

Inject contrast medium, look for stones/tumours

23
Q

What muscle is involved in mastication, and what’s its innervation?

A

Masetter muscle, trigeminal nerve

24
Q

What are the 3 phases of swallowing?

A

Oral preparatory (voluntary), pharyngeal and oesophageal

25
Q

What happens in the oral preparatory phase?

A

Tongue pushes bolus back onto pharynx

26
Q

What happens in the pharyngeal phase?

A

Afferent information from pressure receptors in palate and ant. pharynx reach swallowing centre in brain stem. Causes: inhibition of breathing, raising of larynx, closing of glottis, opening of upper oesophageal sphincter.
Pharyngeal constrictors push bolus down

27
Q

What happens in the oesophageal phase?

A

Peristaltic wave carries bolus down, co-ordinated by extrinsic nerves from swallowing centre

28
Q

What types of muscle are there in the oesophagus?

A

Upper 1/3rd is voluntary striated (somatic)

Lower 2/3rds is smooth (PSNS)

29
Q

What allows babies to swallow and breath at the same time?

A

Epiglottis extends up to nasopharynx

30
Q

How would you investigate oesophageal dysphagia?

A

Barium swallow or endoscopy

31
Q

How would you investigate oropharyngeal dysphagia?

A

Flexible endoscopy

Video fluoroscopy

32
Q

What can cause difficult swallowing liquids?

A

Stroke or damage to brain, can’t co-ordinate muscles or epiglottis

33
Q

Where are the 4 narrowings in oesophagus where food can lodge?

A

Junction with pharynx
Where it is crossed by arch of aorta
Compressed by left main bronchus
Oesophageal hiatus

34
Q

What is odynophagia?

A

Pain when swallowing, usually caused by infection

Gastrointestinal Tract (11 decks)

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