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DIG > Function of the Mouth and Oesophagus and Associated Diseases > Flashcards

Function of the Mouth and Oesophagus and Associated Diseases Flashcards

1
Q

Functions of the mouth

A
  • Mastication
  • Initiation of carbohydrate and fat metabolism
  • Lubrication of bolus
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2
Q

Which enzymes allow for initiation of carbohydrate and fat metabolism in the mouth?

A
  • Salivary amylase
  • Salivary lipase
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3
Q

What type of gland are salivary glands?

A

Exocrine glands

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4
Q

What is the role of IgA, lysozyme and lactoferrin in the saliva?

A

Antibacterial function

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5
Q

Types of cell in salivary glands

A
  • Acinar cells
  • Ductal cells
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6
Q

Function of acinar cells

A

Produce enzymes

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7
Q

Function of ductal cells

A
  • Produce mucous
  • Secrete water and electrolytes
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8
Q

Which ductal cells specifically produce mucous?

A

Goblet cells

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9
Q

3 major salivary glands

A
  • Parotid
  • Submandibular
  • Sublingual
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10
Q

How much saliva is secreted every 24h?

A

1.5L

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11
Q

Histologically, what type of gland is the parotid gland?

A

Serous

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12
Q

Histologically, what type of gland is the submandibular gland?

A

Mixed

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13
Q

Histologically, what type of gland is the submandibular gland?

A

Mixed

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14
Q

Histologically, what type of gland is the sublingual gland?

A

Mucous

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15
Q

What viscosity is the saliva produced by the parotid gland?

A

Watery

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16
Q

What viscosity is the saliva produced by the submandibular gland?

A

A little viscous

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17
Q

What viscosity is the saliva produced by the sublingual gland?

A

Very viscous

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18
Q

What percentage of total saliva secretion is produced by each major gland?

A
  • Parotid = 20%
  • Submandibular = 70%
  • Sublingual = 10%
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19
Q

Functions of mucous

A
  • Lubrication
  • Hydration
  • Cytoprotection
  • Immune
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20
Q

What percentage of total saliva secretion is produced by each major gland?

A
  • Parotid = 20%
  • Submandibular = 70%
  • Sublingual = 10%
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21
Q

How does IgA have a role in protection against pathogens?

A

IgA antibodies bind to pathogenic antigens

22
Q

How does lactoferrin have a role in protection against pathogens?

A

Binds iron and is bactericidal

23
Q

How does lysozyme have a role in protection against pathogens?

A

Attacks bacterial cell wall

24
Q

What is the primary isotonic fluid produced by acinar cells rich in?

A

NaCl

25
Q

How do duct cells modify secretions of acinar cells?

A
  • Extract Na+ and Cl-
  • Secrete K+ and HCO3-
  • Therefore makes saliva hypotonic and alkaline
26
Q

Alkaline function of saliva

A
  • Protect teeth from bacterial acid
  • Neutralise gastric acid that refluxes into oesophagus
27
Q

What is Sjögren’s syndrome?

A

Autoimmune attack of salivary and tear glands

28
Q

Symptoms of Sjögren’s syndrome

A
  • Dry mouth
  • Dry eyes
29
Q

Which division of the autonomic nervous system predominantly controls saliva secretion?

A

Parasympathetic

30
Q

4 phases of swallowing

A
  • Oral preparatory phase
  • Oral phase
  • Pharyngeal phase
  • Oesophageal phase
31
Q

What happens in the oral preparatory phase of swallowing?

A

Food is masticated to reduce to a consistency which can be swallowed

32
Q

What happens in the oral phase of swallowing?

A

Tongue propels food posteriorly until pharyngeal swallow is triggered

33
Q

What happens in the pharyngeal phase of swallowing?

A

Bolus transported through pharynx with:
- Closure of epiglottis
- Cessation of breathing
- Relaxation of upper oesophageal sphincter

34
Q

What happens in the oesophageal phase of swallowing?

A

Oesophageal peristalsis carries bolus from upper to lower oesophageal sphincter

35
Q

Which muscle is found in the upper, middle and lower thirds of the oesophagus

A
  • U = striated
  • M = striated + smooth
  • L = smooth
36
Q

What is gastro-oesophageal reflux disease (GORD)?

A

Chronic symptoms or mucosal damage produced by abnormal reflux in the oesophagus

37
Q

Causes of GORD

A
  • Obesity
  • Hiatal hernia
  • Drugs that lower tone at lower oesophageal sphincter
  • Pregnancy
  • Zollinger Ellison syndrome
38
Q

Which drugs can lower tone at lower oesophageal sphincter?

A
  • Anticholinergic
  • Beta agonist
  • Benzodiazepines
39
Q

What is Zollinger Ellison syndrome?

A

A gastrin-secreting tumour

40
Q

Symptoms of GORD

A
  • Heartburn
  • Regurgitation
  • Dysphagia
  • Cough
  • Hoarseness
  • Chronic earache
41
Q

What does GORD cause?

A
  • Oesophagitis
  • Stricture
  • Barrett’s metaplasia
  • Oesophageal adenocarcinoma
42
Q

Diagnosis of GORD

A
  • 24h pH monitoring
  • Endoscopy
43
Q

Types of treatment for GORD

A
  • Conservative
  • Medical
  • Surgical
44
Q

Conservative treatments of GORD

A
  • Weight loss
  • Avoid food/alcohol close to bedtime
  • Decrease alcohol
  • Raise head of bed 20-30cm
45
Q

Medical treatments of GORD

A
  • Decrease acid (proton pump inhibitor/H2 blocker)
  • Antacids (increase pH)
  • Alginates
46
Q

Surgical treatments of GORD

A
  • Anti-reflux surgery (fundoplication)
  • Repair hiatus hernia
47
Q

What is metaplasia?

A

Change in epithelial type in response to environmental stress

48
Q

Management of Barrett’s metaplasia

A
  • Manage symptoms of reflux like GORD (conservative, medical, surgical)
  • Surveillance endoscopy for risk of malignant progression
49
Q

Types of oesophageal cancer

A
  • Squamous cell carcinoma
  • Adenocarcinoma
50
Q

What is achalasia?

A

Motor disorder of the oesophagus resulting from loss of myenteric plexus at lower oesophageal sphincter

51
Q

Symptoms of achalasia

A
  • Dysphagia
  • Regurgitation
  • Chest discomfort
  • Halitosis (bad breath)
52
Q

Treatment of achalasia

A
  • Botox injection at LOS
  • Oesophageal dilation
  • Surgery (Hellers myotomy)

DIG (19 decks)

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