- lubrication - maintenance of oral hygiene - early stages of digestion - protection from infection - taste - (transmission of infection)

Anatomy Of Salivation + Swallowing Flashcards by Emily Stephens

Functions of saliva

lubrication
maintenance of oral hygiene
early stages of digestion
protection from infection
taste
(transmission of infection)

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What is the composition of saliva?

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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Where is amylase secreted form?

Salivary glands

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Where is lingual lipase secreted from?

Lingual glands

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What is xerostomia?

Dry mouth

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What are the teeth from front to back?

central incisor
lateral incisor
canine
first + second premolar
first, second + third(wisdom) molar

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

32
(28 + 4 wisdom teeth)

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What is the inner surface on the gum called?

Lingual surface of gum

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What is the outer surface of the gum called?

Buccle surface of gum

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What type of glands are salivary glands?

Exocrine gland

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Where does the parotid gland enter the mouth?

Penetrate buccinator opposite 2nd upper molar tooth

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What are the types of salivary glands?

parotid
sublingual
submandibular

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Where is the sublingual gland?

Below the tongue

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Where is the submandibular gland?

Below the mandible

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Why do you get a dry mouth when youre anxious?

Sympathetic nervous system causes vasoconstriction of vessels > decreases of saliva

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How do you image the salivary glands?

Sialography

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What are the phases of swallowing?

Oral preparatory phase
Pharyngeal phase
Oesophageal phase

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Define bolus

Food in mouth ready to be swallowed

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Outline the oral preparatory phase

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

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When does the pharyngeal phase of swallowing begin?

Once bolus touches pharyngeal wall

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Outline the pharyngeal phase

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

Outline the oesophageal phase

involuntary
closure of upper oesophageal sphincter
peristaltic waves moves bolus down

Outline the neural control of swallowing + gag reflex

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

What is the sensory component of the swallow reflex?

Glossopharyngeal nerve

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

Vagus nerve

What is dysphagia?

Difficulty swallowing

Where are there narrowings in the oesophagus?

- junction of oesophagus with pharynx - crossed by arch of aorta - compressed by left main bronchus - passes through diaphragm

What prevents gastro-oesophageal reflux?

- mucosal rosette - acute angle of entry of oesophagus - lower oesophageal sphincter

What is barrett oesophagus?

- 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

What is the tonicity of salvia at average flow rates?

Hypotonic

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

- 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

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

Increases (unlike others)

Location of the parotid gland

- in front of ear - below zygomatic arch - massester muscle is anterior - lower border: inferior border of mandible

How much saliva is produced by each gland?

Submandibular 70% Parotid 25% Sublingual 5%

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

Serous Lots of enzymes 25% of saliva Darker

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

Mucous Less enzyme 5% of saliva Lighter staining

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

Serous + mucous Mix of dark + light staining

What is the tonicity of intial saliva?

Isotonic

When is saliva the most hypotonic?

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

Nerve supply to the salivary glands

Glossopharyngeal nerve - parotid Facial nerve - sublingual + submandibular

What is mumps?

Viral infection of the parotid glands

What is Sjögren’s syndrome?

Autoimmune disease of the salivary glands

What is sialoliths?

Calcified salivary stones Most commonly in the submandibular gland

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

Harder to swallow fluids

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

Harder to swallow solids Liquids can pass around the blockage

Causes of dysphasia due to problems coordinating swallowing

- cerebrovascular accident - stroke - Parkinson’s disease - multiple sclerosis

Cause of dysphagia due to a blockage

- fibrous rings - oesophageal cancer - achalasia

What is achalasia?

Failure of lower oesophageal sphincter to relax

Difference in mucous + serous cell staining

Mucous - lighter Serous - darker (more proteins)

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

Submandibular gland Higher conc. of calcium in saliva