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3 Gastrointestinal System > 6 Salivation and Swallowing > Flashcards

6 Salivation and Swallowing Flashcards

1
Q

What are the components that make up saliva?

A
  1. Water (mostly) (hypotonic)
  2. Potassium and bicarbonate (pH alkaline-protect teeth)
  3. Mucins (make up mucus) (glycoproteins)
  4. Amylase
  5. Lingual lipase (secreted by lingual glands)
  6. Immune proteins (IgA, lysozyme, lactoferrin)
    1. Lactoferrin- sequesters iron- helps prevent infection
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2
Q

What are the functions of saliva?

A
  • Hydrate food- form bolus
  • Moisten mouth- enable us to speak
  • Solvent- dissolve flavour molecules
  • Begin process of digestion
  • Prevent infection
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3
Q

What is xerostomia?

A

Dry mouth- insufficient saliva production

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4
Q

Name some consequences (symptomatic) of having xerostomia.

A
  • Loss of all functions of saliva (see flashcard 2)
    • Dental cavities
    • Bad breath- overgrowth of bacteria
    • Ulcers- mucosa not moist
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5
Q

What are some causes of xerostomia?

A
  • Side effect of drugs eg antidepressants
  • Blocked nose- breathing through mouth
  • Radiotherapy to head
  • Salivary gland removal
  • ANYTHING REDUCING PARASYMPATHETIC INNERVATION
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6
Q

Label glands 1-3:

A
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7
Q

How would you clinically examine the sublingual glands?

A

Compress finger and thumb- in mouth and under chin

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8
Q

What muscle does the parotid duct pierce through?

A

Buccinator

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9
Q

Where do the sublingual and submandibular ducts open in the floor of the mouth? (lateral or medial)

A
  • Sublingual: laterally
  • Submandibular: medially
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10
Q

How is salivary secretion regulated?

A

Autonomic (primarily)

  • Parasympathetic (main driver)
    • Stimulate salivary
  • Sympathetic
    • Stimulate small amount of secretion
    • BUT cause vasoconstriction if too well stimulated
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11
Q

Which nerves supply the salivary glands with parasympathetic input?

A
  • 9th Cranial: Glossopharyngeal nerve
    • Parotids
  • 7th Cranial: Facial nerve
    • Sublingual and submandibular
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12
Q

What is the diagnosis? Why is this condition so painful?

A

Mumps- inflamed parotid glands

Painful: Parotid gland has tight capsule surrounding it

Capsule innervated by trigeminal- sensory innervation- very sensitive to stretch

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13
Q

What is parotid sialography?

(Sialo=salivary glands)

A

Contrast study to parotid gland

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14
Q

What symptoms might be caused by stones in the parotid gland/duct?

A

Pain on eating/anticipating eating/swelling of parotid gland on anticipation of eating

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15
Q

Name the 3 phases of swallowing:

A
  1. Oral preparatory phase
  2. Pharyngeal phase
  3. Oesophageal phase

Become less voluntary

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16
Q

Describe the first phase of swallowing (oral preparatory). (3)

A
  1. Voluntary
  2. Pushes bolus down towards pharynx
  3. Phase ends once bolus touches pharyngeal wall (initiates swallowing reflex)
  4. Hypoglossal nerve XII- muscles of tongue
17
Q

Describe the second phase of swallowing (pharyngeal). (7)

A
  1. Involuntary
  2. Soft palette elevates, seals off nasopharynx
  3. Pharyngeal sphincters push bolus down
  4. Larynx elevates (suprahyoids), closes epiglottis and moves anteriorly, to open oesophagus
  5. Vocal cords adduct- protect airway
  6. Phrenic nerve switches off- temporarily cease breathing
  7. Open upper oesophageal sphincter

Tongue against hard palate- food can’t reenter mouth

Involves CNs V3, VII, IX, X, XII

18
Q

Describe the third phase of swallowing (oesophageal). ()

A
  1. Involuntary
  2. Closure of upper oesophageal sphincter
  3. Peristaltic wave carries bolus downwards into oesophagus
19
Q

How is swallowing controlled neurally? (reflex arc) (5)

A
  1. Mechanoreceptors in pharygeal wall- detect presence of bolus
  2. Glossopharyngeal nerve
  3. Medulla
  4. Vagus nerve
  5. Pharyngeal constrictors
20
Q

At what age does the hyperactive gag reflex begin to be inhibited (baby can be given food) ?

A

6 months

21
Q

What is dysphagia?

A

Difficulty swallowing

22
Q

What is important to remember when looking after stroke patients with regards to their swallowing?

A

May have dysphagia (difficulty swallowing)

Need to check that it is safe before giving water/food

May need to be nil by mouth

If given water- enters trachea may cause pneumonia

23
Q

What is shown here in the oesophagus? How might this patient present?

A

Presentation:

Solid food will stick in oesophagus

Drink will pass fine

24
Q

At what points does the oesophagus narrow? (4)

A
  1. Junction of esophagus with pharynx
  2. Where esophagus crossed by arch of aorta
  3. Where esophagus compressed by left main bronchus
  4. At esophageal hiatus (piercing diaphragm)
25
Q

What is the first line of treatment for a bolus stuck at the junction of the esophagus and the pharynx?

A

Drug designed to relax wall of oesophagus

(Then esophagoscapy)

26
Q

What structures in the GI tract prevent gastro-oesophageal reflux?

A
  • Lower oseophageal sphincter (muscle contraction is due to diaphragm)
  • Flap valve formed due to oesophagus entering stomach at oblique angle

3 Gastrointestinal System (19 decks)

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