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Y2 - GI > Anatomy Of Salivation And Swallowing > Flashcards

Anatomy Of Salivation And Swallowing Flashcards

1
Q

What are the functions of saliva?

A

Lubrication
Maintains oral hygiene
Early stages of digestion
Protection from infection (innnate immunity)
Taste
Pathologically transmitting infection

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2
Q

What type of glands are salivary glands?

A

Exocrine glands

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3
Q

What is an exocrine gland?

A

Gland secreting its secretions into ducts

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4
Q

What is contained in saliva?

A

K+ and Bicarbonate (typically alkaline)

Mucins
Amylase
Lingual Lipase
Immune proteins

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5
Q

What type of molecule is mucin and what is its role?

A

Glycoprotein

Helps with lubrication

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6
Q

What gland secretes amylase?

What’s its role?

A

Salivary gland

Breaks down starch into sugars

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7
Q

What are some immune proteins found in saliva?

A

IgA
Lysozymes
Lactoferrin

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8
Q

What is the function of lactoferrin in the saliva?

A

It sequesters iron preventing bacteria using it for growth (e.coli)

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9
Q

What is the function of lysozymes?

A

Antimicrobrial (innate immunity)

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10
Q

What is Xerostomia?

A

Dry mouth due to no saliva production

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11
Q

What are some complications that can occur as a result of Xerostomia?

A

Poor nutrition (less amylase)
Infections in mouth (gingivitis, oral thrush)
Tooth decay, gum disease (acidic conditions not neutralised by alkaline saliva)
Halitosis
Poor sense of taste

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12
Q

What are the 2 types of gum in the mouth?

A

Lingual surface of gum

Buccal surface of gum

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13
Q

What is the lingual surface of gum?

A

The surface of the gum in contact with the tongue (so on the inside)

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14
Q

What is the Buccal surface of gum?

A

Surface of gum in contact with the cheek (outside)

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15
Q

What are deciduous teeth?

A

The milk teeth in children that will fall out

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16
Q

What is the biggest salivary gland?

A

Parotid gland (meaning near the ear gland)

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17
Q

How does the parotid duct travel?

A

It penetrates the Buccinator muscle draining into the oral cavity around the 2nd upper molar tooth

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18
Q

Where are the sublingual salivary glands located?

A

Above the floor of the mouth

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19
Q

What 2 salivary glands ducts are found on the floor of the mouth?

A

Submandibular salivary glands duct (seen the gland in DR)

Sublingual salivary gland

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20
Q

How are salivary secretions regulated?

A

Autonomic nervous system (neural)

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21
Q

What part of the autonomic nervous system is the main DRIVER of salivary secretion?

A

Parasympathetic nervous system

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22
Q

How does the sympathetic nervous system affects salivary production?

How does it do this?

A

Reduces salivary production

Vasoconstriction of blood vessels supplying salivary glands

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23
Q

What is an example of a drug that can cause a dry mouth as a side effect?

A

Atropine

24
Q

What viral infection can infect the parotid gland leading to its inflammation and can also cause meningitis, testicular swelling, ovarian swelling?

A

MUMPs

25
Q

Why is an inflamed parotid gland very painful?

A

The surrounding capsule is very tight so isn’t much room for expansion

26
Q

What is parotid sialography?

A

Imaging of the parotid salivary gland

27
Q

What is parotid sialography useful to see?

A

If a stone (calculus) or tumour is blocking the salivary flow

28
Q

What does the prefix sialo- mean?

A

Salivary gland

29
Q

What is a bolus?

A

Food that’s been chewed in the mouth and is ready to be swallowed

30
Q

How do the lungs sit in relation to the oesophagus?

A

Lungs sit anteriorly to the oesophagus

31
Q

What are the 3 phases to swallowing?

A

Oral preparatory phase

Pharyngeal phase

Oesophageal phase

32
Q

What is the pharynx?

A

Muscular tube connecting the mouth to the oesophagus

33
Q

State whether each of the 3 phases of swallowing is voluntary or involuntary?

A

Oral prepatory phase = Voluntary

Pharyngeal phase = involuntary

Oesophageal phase = involuntary

34
Q

What occurs in the oral preparatory phase of swallowing?

A

Bolus pushed to back of mouth
Once it touches the pharyngeal wall the pharyngeal phase begins (swallow reflex starts)

35
Q

What occurs during the Pharyngeal phase of swallowing?

A

Soft palate lifts up sealing nasopharynx (stops bolus entering nasal cavity)

Pharyngeal constrictors push bolus downwards (peristaltic)

Larynx elevates, epiglottis closes sealing trachea
Vocal cords Adduction help protect the air way

Upper oesophageal sphincter opens allowing bolus down

36
Q

What is the epiglottis?

A

Elastic cartilage flap that’s closes protecting the airway/trachea

37
Q

What are the vocal cords?

A

2 flaps of mucosa that are open when talking

38
Q

What occurs during the Oesophageal phase of swallowing?

A

Upper oesophageal sphincter closes

Peristaltic wave carries bolus down into oesophagus

39
Q

What are the pharyngeal constrictors?

A

Muscles at the top of the oesophagus

40
Q

What are the sensory receptors in the swallow and gag reflex?

Where are they located?

A

Mechnoreceptors

In pharynx at back of throat

41
Q

What nerve transmits the sensory input fro the mechanoreceptors in the back of the pharynx in the swallow/gag reflex?

A

Glossopharyngeal nerve = Cranial nerve IX

42
Q

What part of the brain does the Glossopharyngeal nerve (Cranial nerve IX) transmit impulse from mechanoreceptors in the swallow/gag reflex?

A

Medulla

43
Q

Once the information has been processed by the medulla in the swallow/gag reflex, what motor neurone transmits the impulse?

A

Vagus nerve (Cranial nerve X)

44
Q

What muscles does the Vagus nerve (Cranial Nerve X) transmit impulses to in the swallow/gag reflex?

What do these muscles do?

A

Pharyngeal constrictors

Pushes bolus down to oesophagus

45
Q

What is the swallow/gag reflex pathway from sensory neurone all the way to the motor response?

A

Mechnoreceptors in pharynx -> Glossopharyngeal nerve (IX) -> medulla -> Vagus nerve (X) -> pharyngeal constrictors

46
Q

What determines whether the gag reflex or swallow reflex will be triggered if they are the same pathway?

A

Context

Age of individual (children under 3months will gag all food up)

47
Q

What is Dysphagia?

A

Difficulty swallowing

48
Q

Why may you be concerned about a patients swallowing whos had a stroke?

A

Stroke causes muscle weakness so muscles of pharynx can be weakened leading to poor coordination

49
Q

How May oesophageal tumours affect swallowing?

A

Dysphagia

Make it harder to swallow solid boli

50
Q

How does the oesophagus run through the body?

A

Runs from neck, through thoracic cavity into abdomen

Runs through posterior mediastinum posteriorly to the heart

51
Q

What imaging technique of the heart can be done thanks to the oesophagus running through the posterior mediastinum posteriorly to the Heart?

A

Transoesophageal echocardiogram

52
Q

What are the 4 narrowings of the oesophagus from most superior to inferior?

A

Junction of oesophagus with pharynx

Where aortic arch crosses oesophagus

Where oesophagus compressed by left main bronchus

At oesophageal hiatus where the oesophagus penetrates the diaphragm

53
Q

What are the 4 narrowings of the oesophagus from most superior to inferior?

A

Junction of oesophagus with pharynx

Where aortic arch crosses oesophagus

Where oesophagus compressed by left main bronchus

At oesophageal hiatus where the oesophagus penetrates the diaphragm

54
Q

What condition does continual gastro-oesophageal reflux cause in the lower oesophagus?

A

Metaplastic changes called Barrett’s Oesophagus

55
Q

What helps prevent Gastro-oesophageal reflux?

A

Lower oesophgeal sphincter in distal oesophagus

Narrowing where oesophagus crosses diaphragm

Intrabdominal oesophagus gets compressed when abdominal pressure rises

Mucosal rosette at cardia

Acute angle of entry of oesophagus creates a flap which closes when pressure in stomach increases

56
Q

What are the Mucosal rosette at the cardia?

A

Puckered mucosae that increase SA helping maintain the closure of the lower oesophageal sphincter

Y2 - GI (35 decks)

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