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GB > 2. Swallowing > Flashcards

2. Swallowing Flashcards

1
Q

What are the functions of mastication?

A

Lubricates food
Mixes food with salivary amylase
Mechanically breaks up food

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2
Q

Which three glands are important for salivation?

A

Sublingual
Submandibular
Parotid

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3
Q

What type of fluid does the parotid gland secrete?

A

Serous, watery

Contains amylase

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4
Q

What type of fluid does the sublingual gland secrete?

A

Mucous

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5
Q

What type of fluid does the submandibular gland secrete?

A

Mixed serous and mucous

Contains mucins

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6
Q

How much saliva do we secrete per day?

A

1 litre

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7
Q

What is the composition of saliva?

A

Mucins (glycoproteins)
Alpha-amylase, lingual lipase
Immunoglobulins, lysozyme
Na+, K+, Ca++, Mg++, Cl-, HCO3-, PO4—

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8
Q

What are the functions of saliva?

A
  1. Facilitates swallowing and speech
  2. Solubilizes food for tasting
  3. Digestion of starch
  4. Oral hygiene
  5. Buffering
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9
Q

What are the symptoms of xerostomia?

A

Dental carries
Mouth infection
Difficulty with speech, taste, swallowing

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10
Q

How does the stimulation of parasympathetics affect secretion of saliva?

A

Increases secretion of amylase and mucus, blood flow, growth

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11
Q

Which cranial nerves are involved in the secretion of saliva?

A

7, 9

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12
Q

How does the stimulation of sympathetics affect secretion of saliva?

A

Increases secretion of amylase and mucus

Decreases blood flow

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13
Q

Why does stress cause xerostomia?

A

Stimulation of sympathetics cuts off blood supply due to vasoconstriction
Not enough water or oxygen

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14
Q

What is the more technical name for swallowing?

A

Deglutition

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15
Q

What are the 3 phases of swallowing?

A

Oral
Pharyngeal
Esophageal

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16
Q

What are the layers of the gut tube from inside out?

A 
Mucosa (epithelium, lamina propia)
Muscularis mucosae
Submucosa
Muscularis externa (circular and longitudal)
Serosa
17
Q

Explain the intrinsic control of the gut

A
  1. Contents of the tube present the gut with stimuli into chemo, osmo and mechanoreceptors near epithelium
  2. Info fed into Auerbach’s plexus
  3. Autonomic motor nerves control endocrine and exocrine glands (local reflex)
  4. Info gets carried back to the CNS
18
Q

Which afferents relay to the swallowing centre that food is present in the oesophagus?

A

5,9,10

19
Q

Where is the swallowing centre located?

A

Pons and medulla

20
Q

Which efferent cranial nerves control the pharyngeal stage of swallowing?

A

5,7,9,10,12

21
Q

Describe the mechanism of the pharyngeal phase

A
  1. Soft palate raises
  2. Larynx shuts off and raises
  3. Epiglottis swings back
  4. UES relaxes
  5. Superior pharyngeal constrictor causes a peristaltic wave
22
Q

Why does the soft palate raise when we swallow?

A

Prevents food going into the nasopharynx

23
Q

Why is breathing inhibited when we swallow?

A

Stops us getting air in the oesophagus or food in the trachea

24
Q

Describe the mechanism of the esophageal phase

A
  1. UES contracts and a primary wave of peristalsis moves to the LES
  2. Secondary waves are triggered if any food remains: allows oesophagus to collapse when not eating
25
Q

What controls the esophageal phase?

A

Vagus and intrinsic reflexes

26
Q

What prevents reflux at the LES?

A

Tonically active due to vagal cholinergic activity

High pressure

27
Q

What does the vagal nerves release to inhibit smooth muscle ahead of peristalsis?

A

VIP

NO

28
Q

What causes achalasia?

A

Excess LES tone

Weak esophageal peristalsis and LES relaxation

29
Q

What afferents go to the vomiting centre?

A

Sympathetics

10

30
Q

Which efferents come from the vomiting centre?

A

5,7,9,10,12

31
Q

What is vomiting preceded by?

A 
Nausea
Salivation
Sweating
Pallor
Mydriasis
Irregular heart rate
32
Q

What are the causes of vomiting?

A
  1. Distension of the stomach or duodenum
  2. Emetics
  3. Motion
  4. Psychic stimuli
  5. Pain
  6. Increased intracranial pressure
  7. Tactile stimulus at back of throat
  8. Pregnancy
33
Q

What is the chemoreceptor trigger zone?

A

Area prostrema in the medulla
Nerves are exposed to blood, no BBB in place
This is why emetics can cause vomiting

34
Q

What is the mechanism of vomiting?

A
  1. Antiperistalsis in the small intestine
  2. Relaxation of pylorus and stomach
  3. Muller’s manoeuvre
  4. Elevation of soft palate
  5. Contraction of abdominal muscles
    (stomach is squished between abdominal muscles and diaphragm)
  6. Relaxation of LES, oesophagus and UES
35
Q

What is Muller’s Manoeuvre?

A

Forced inspiration against closed glottis
Larynx closes and elevates
Inspiratory muscles contract

GB (15 decks)

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