case 11 Flashcards
what are the 4 main muscles of mastication?
Temporalis
Masseter
Lateral pterygoid
Medial pterygoid
what are the muscles of mastication innervated by?
the Mandibular division of the Trigeminal nerve (CNV3).
the oral cavity can be split into…
the oral vestibule (in front of the teeth)
the oral cavity proper.
what is the arterial supply to the pharynx?
branches of the external carotid artery: Ascending pharyngeal artery Branches of the facial artery Branches of the lingual artery Branches of the maxillary artery
what is the venous drainage of the pharynx?
pharyngeal venous plexus, which drains into the internal jugular vein.
what are the symptoms of recurrent laryngeal nerve damage and why?
weakened/rough voice (hoarsness), loss of voice, changes in voice pitch or pitch range.
muscles responsible for moving the vocal folds are innervated by the recurrent laryngeal nerve.
what is the main route of transmission for h.pylori?
oral-faecal or faecal-oral.
how does the stomach protect itself from its acid?
anatomical barrier-resistant epithelium-apical membrane and tight junctions between cells in gastric glands are relatively impermeable to H+.
physiological barrier-Mucus gel layer (50-200μm thick overlying mucosal surface); HCO3- microclimate (unstirred layer adjacent to cell surface).
how does peptic ulcer disease typically present?
typically presents with intermittent episodes of nonradiating epigastric abdominal pain (dyspepsia), which is often described as dull or “gnawing.”
what are the factors that can lead to imbalance between mucosal protection and acid secretion?
H pylori
NSAIDs
Alcohol
Smoking
what is gastritis?
Inflammation of the lining of the stomach - Defect ABOVE the muscularis mucosa.
what is a peptic ulcer?
open sore in the lining of the stomach (gastric) or duodenum (duodenal). A breach in the mucosa of the alimentary tract, which extends through (BELOW) the muscularis mucosa into the submucosa or deeper.
what actually is dyspepsia?
a term used to describe a complex of upper gastrointestinal tract symptoms which are typically present for four or more weeks, these include upper abdominal pain or discomfort, heartburn, acid reflux, nausea and/or vomiting.
what is a Mallory-Weiss tear?
refers to bleeding from a laceration in the mucosa at the junction of the stomach and esophagus. usually caused by severe vomiting because of alcoholism or bulimia.
what is metoclopramide?
A medication commonly used to treat nausea and vomiting, but also used with GORD. It works through D3 receptors, promoting release of acetylcholine, which in turn leads to increased lower oesophageal sphincter (LOS) and gastric tone, increased intragastric pressure, improved antroduodenal coordination and accelerated gastric emptying.
what is the definition of barrett’s oesophagus?
an oesophagus in which any portion of the normal distal squamous epithelial lining has been replaced by metaplastic columnar epithelium, which is clearly visible endoscopically (>1 cm) above the gastro-oesophageal junction and confirmed histopathologically from oesophageal biopsies.
what are the possible complications for a gastric ulcer?
perforation
haemorrhage
gastric outlet obstruction
gastric malignancy
what hormone stimulates the release of bile from the gallbladder?
cholecystokinin (CCK)
how does biliary colic present?
severe upper abdominal pain usually after eating
radiation to the back
(remember it’s a gallstone blocking the cystic duct)
what are the added symptoms (to biliary colic) that occur with acute cholecystitis?
inflammation of the gallbladder:
fever
raised WCC
irritation of peritoneum
what is the classic triad of acute cholangitis symptoms?
jaundice
fever/rigors
RUQ pain
what happens in gallstone-related pancreatitis?
gallstones block release of pancreatic enzymes
causes digestion of the tissues
severe epigastric pain that can radiate to the back
what are some symptoms of decompensated liver disease?
jaundice
confusion
ascites
what is alpha fetoprotein and its clinical significance?
protein produced by fetus’ liver and yolk sac, levels greatly reduced by age 1 and should only be in adults in tiny amounts
you can test for it in blood and high levels can be a sign of some tumours (liver, ovaries, testes) or liver diseases (cirrhosis, hepatitis).
