3 Functions of the mouth and oesophagus

Question 1

What are the 3 main salivary glands?

Answer 1

Submandibular
Sublingual
Parotid

Question 2

What 2 digestive enzymes would salivary glands secrete?

Answer 2

Amylase

Lipase

Question 3

What 3 substances would salivary glands secrete with antibacterial function?

Answer 3

IgA
Lysozyme
Lactoferrin

Question 4

What is the antibacterial function of lysozyme?

Answer 4

it attacks the bacterial cell wall (stimulating cell lysis)

Question 5

What is the antibacterial function of lactoferrin?

Answer 5

binds iron and its’ bacterial acid, preventing the bacteria from culminating

Question 6

What 2 cell types does a salivary gland contain?

Answer 6

Acinar cells

Duct cells

Question 7

In what 2 ways would salivary secretions lubricate the mouth?

Answer 7

hydration

protection of mucosa (cytoprotection)

Question 8

What type of secretions do the 3 main salivary glands secrete, and which one comprises the largest proportion?

Answer 8

Parotid - serous
Submandibular - mixed (MOST)
Sublingual - mucous

Question 9

What is the function of duct cells, and how do they achieve this?
What is the significance of this?

Answer 9

modify acinar secretions
extract Na+ and Cl-
secrete K+ and HCO3-
(alkaline saliva protects teeth from acids and neutralises gastric acid in reflux)

Question 10

What is Sjogern’s syndrome, and how would it present?

Answer 10

Autoimmune attack on salivary and tear glands

Presents as dry mouth and eyes (xerostomia)

Question 11

What are the 3 symptoms of Mumps?

Answer 11

headache
fever
swelling around neck

Question 12

How do each of the slaivary glands receive their parasympathetic innervation?

Answer 12

Submandibular and sublingual (Facial nerve 7 - submandibular ganglion)
Parotid (Glossopharyngeal nerve 9 - Otic ganglion)

Question 13

What are the effects of parasympathetic and sympathetic innervation on salivary glands?

Answer 13

parasympathetic - increased secretion

sympathetic - vasoconstriction, thick mucous secretion

Question 14

What are the 4 phases of swallowing?

Answer 14

Oral preparatory phase
Oral phase
pharyngeal phase
oesophageal phase

Question 15

What are the features of the pharyngeal phase of swallowing?

Answer 15

bolus transported through the pharynx
coordinated closure of glottis via movement of epiglottis
cessation of breathing
relaxation of the upper oesophageal sphincter

Question 16

Where does the oesphagus pass through the diaphragm?

Answer 16

The oesophageal hiatus at T10

Question 17

Name 6 potential causes of GORD

Answer 17

obesity
hiatus hernia
drugs lowering LOS tone
pregnancy
Zollinger Ellison syndrome
Gastrin secreting tumour

Question 18

Name 3 symptoms of GORD

Answer 18

Heartburn
Dysphagia
Laryngopharyngeal reflux

Question 19

How might you treat GORD?

Answer 19

conservative - weight loss
medical - decrease acid PPI’s, H2 blockers, Antacids
Surgical - fundoplication

Question 20

What is fundoplication?

Answer 20

anti-reflux surgery

Question 21

What is one complication of GORD?

Answer 21

Barrett’s Metaplasia, the pre-malignant condition for oesophageal adenocarcinoma

Question 22

What happens in Barret’s Metaplasia?

Answer 22

Change in mucosa type from stratified squamous epihtelia to simple columnar epithelia, with many basal mucous secreting glands

Question 23

Where is oesophageal adenocarcinoma most likely to occur?

Answer 23

close to the gastro-oesophageal junction

Question 24

What is achlasia?

Answer 24

the failure to relax
motor disorder of the oesophagus
loss of myenteric plexus at the lower oesophageal sphincter
a poorly relaxing LOS
(basically makes it hard for stuff to get into the stomach)

Question 25

How might you treat achlasia?

Answer 25

botox injection
balloon
heller’s myotomy