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
What happens in the oral preparatory phase?
Tongue pushes bolus back onto pharynx
26
What happens in the pharyngeal phase?
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
What happens in the oesophageal phase?
Peristaltic wave carries bolus down, co-ordinated by extrinsic nerves from swallowing centre
28
What types of muscle are there in the oesophagus?
Upper 1/3rd is voluntary striated (somatic) | Lower 2/3rds is smooth (PSNS)
29
What allows babies to swallow and breath at the same time?
Epiglottis extends up to nasopharynx
30
How would you investigate oesophageal dysphagia?
Barium swallow or endoscopy
31
How would you investigate oropharyngeal dysphagia?
Flexible endoscopy | Video fluoroscopy
32
What can cause difficult swallowing liquids?
Stroke or damage to brain, can't co-ordinate muscles or epiglottis
33
Where are the 4 narrowings in oesophagus where food can lodge?
Junction with pharynx Where it is crossed by arch of aorta Compressed by left main bronchus Oesophageal hiatus
34
What is odynophagia?
Pain when swallowing, usually caused by infection