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Gastrointestinal > Anatomy Of Salivation + Swallowing > Flashcards

Anatomy Of Salivation + Swallowing Flashcards

1
Q

Functions of saliva

A
  • lubrication
  • maintenance of oral hygiene
  • early stages of digestion
  • protection from infection
  • taste
  • (transmission of infection)
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2
Q

What is the composition of saliva?

A
  • mostly water
  • hypotonic
  • rich in potassium + bicarbonate
  • mucin: helps with lubrication
  • amylase
  • lingual lipase
  • immune proteins e.g. IgA, lysozyme, lactoferrin
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3
Q

Where is amylase secreted form?

A

Salivary glands

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4
Q

Where is lingual lipase secreted from?

A

Lingual glands

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5
Q

What is xerostomia?

A

Dry mouth

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6
Q

What are the teeth from front to back?

A
  • central incisor
  • lateral incisor
  • canine
  • first + second premolar
  • first, second + third(wisdom) molar
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7
Q

What is the maximum number of teeth an adult can have?

A

32
(28 + 4 wisdom teeth)

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8
Q

What is the inner surface on the gum called?

A

Lingual surface of gum

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9
Q

What is the outer surface of the gum called?

A

Buccle surface of gum

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10
Q

What type of glands are salivary glands?

A

Exocrine gland

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11
Q

Where does the parotid gland enter the mouth?

A

Penetrate buccinator opposite 2nd upper molar tooth

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12
Q

What are the types of salivary glands?

A
  • parotid
  • sublingual
  • submandibular
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13
Q

Where is the sublingual gland?

A

Below the tongue

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14
Q

Where is the submandibular gland?

A

Below the mandible

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15
Q

Why do you get a dry mouth when youre anxious?

A

Sympathetic nervous system causes vasoconstriction of vessels > decreases of saliva

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16
Q

How do you image the salivary glands?

A

Sialography

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17
Q

What are the phases of swallowing?

A

Oral preparatory phase
Pharyngeal phase
Oesophageal phase

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18
Q

Define bolus

A

Food in mouth ready to be swallowed

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19
Q

Outline the oral preparatory phase

A
  • voluntary
  • pushes bolus towards pharynx (back of mouth)
  • once bolus touches pharyngeal wall, pharyngeal phase begins
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20
Q

When does the pharyngeal phase of swallowing begin?

A

Once bolus touches pharyngeal wall

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21
Q

Outline the pharyngeal phase

A
  • involuntary
  • soft palate seals off nasopharynx
  • pharyngeal constrictors push bolus down
  • larynx elevates + closes epiglottis
  • vocal cords adduct + breathing stops temporarily
  • opening of upper oesophageal sphincter
22
Q

Outline the oesophageal phase

A
  • involuntary
  • closure of upper oesophageal sphincter
  • peristaltic waves moves bolus down
23
Q

Outline the neural control of swallowing + gag reflex

A

Mechanoreceptors => innervated by glossopharyngeal nerve => medulla => vagus nerve => pharyngeal constrictors

24
Q

What is the sensory component of the swallow reflex?

A

Glossopharyngeal nerve

25
Q

What nerve innervates most of the muscles in the swallow reflex?

A

Vagus nerve

26
Q

What is dysphagia?

A

Difficulty swallowing

27
Q

Where are there narrowings in the oesophagus?

A
  • junction of oesophagus with pharynx
  • crossed by arch of aorta
  • compressed by left main bronchus
  • passes through diaphragm
28
Q

What prevents gastro-oesophageal reflux?

A
  • mucosal rosette
  • acute angle of entry of oesophagus
  • lower oesophageal sphincter
29
Q

What is barrett oesophagus?

A
  • Reversible change (metaplasia) of stratified squamous epithelia into gastric columnar
  • due to repeated exposure of gastric contents
    .
  • risk of adenocarcinoma due to increased risk of dysplasia
30
Q

What is the tonicity of salvia at average flow rates?

A

Hypotonic

31
Q

How does the tonicity of saliva change as flow rates increase and why?

A
  • at higher flow rates, saliva becomes less hypotonic
  • as the flow rate increases the contact time with initially isotonic solution is less > less modification of the composition (removal of Na+ and Cl-) occurs
32
Q

What happens to the conc. of bicarbonate ions at higher flow rates of salvia?

A

Increases
(unlike others)

33
Q

Location of the parotid gland

A
  • in front of ear
  • below zygomatic arch
  • massester muscle is anterior
  • lower border: inferior border of mandible
34
Q

How much saliva is produced by each gland?

A

Submandibular 70%
Parotid 25%
Sublingual 5%

35
Q

Composition of saliva from the parotid gland
How does this affect staining?

A

Serous
Lots of enzymes
25% of saliva
Darker

36
Q

Composition of saliva from the sublingual gland
How does this affect staining?

A

Mucous
Less enzyme
5% of saliva
Lighter staining

37
Q

Composition of saliva from the submandibular gland
How does this affect staining?

A

Serous + mucous
Mix of dark + light staining

38
Q

What is the tonicity of intial saliva?

A

Isotonic

39
Q

When is saliva the most hypotonic?

A

At rest/low flow rates
Increased contact time with ductal cells

40
Q

Nerve supply to the salivary glands

A

Glossopharyngeal nerve - parotid
Facial nerve - sublingual + submandibular

41
Q

What is mumps?

A

Viral infection of the parotid glands

42
Q

What is Sjögren’s syndrome?

A

Autoimmune disease of the salivary glands

43
Q

What is sialoliths?

A

Calcified salivary stones
Most commonly in the submandibular gland

44
Q

Is it harder to swallow fluids or solids if a patient has problems with coordination swallowing?

A

Harder to swallow fluids

45
Q

Is it harder to swallow fluids or solids if a patient has a blockage?

A

Harder to swallow solids
Liquids can pass around the blockage

46
Q

Causes of dysphasia due to problems coordinating swallowing

A
  • cerebrovascular accident
  • stroke
  • Parkinson’s disease
  • multiple sclerosis
47
Q

Cause of dysphagia due to a blockage

A
  • fibrous rings
  • oesophageal cancer
  • achalasia
48
Q

What is achalasia?

A

Failure of lower oesophageal sphincter to relax

49
Q

Difference in mucous + serous cell staining

A

Mucous - lighter
Serous - darker (more proteins)

50
Q

What salivary gland is most commonly affected with stones and why?

A

Submandibular gland
Higher conc. of calcium in saliva

Gastrointestinal (28 decks)

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