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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?

25
How do duct cells modify secretions of acinar cells?
- Extract Na+ and Cl- - Secrete K+ and HCO3- - Therefore makes saliva hypotonic and alkaline
26
Alkaline function of saliva
- Protect teeth from bacterial acid - Neutralise gastric acid that refluxes into oesophagus
27
What is Sjögren's syndrome?
Autoimmune attack of salivary and tear glands
28
Symptoms of Sjögren's syndrome
- Dry mouth - Dry eyes
29
Which division of the autonomic nervous system predominantly controls saliva secretion?
Parasympathetic
30
4 phases of swallowing
- Oral preparatory phase - Oral phase - Pharyngeal phase - Oesophageal phase
31
What happens in the oral preparatory phase of swallowing?
Food is masticated to reduce to a consistency which can be swallowed
32
What happens in the oral phase of swallowing?
Tongue propels food posteriorly until pharyngeal swallow is triggered
33
What happens in the pharyngeal phase of swallowing?
Bolus transported through pharynx with: - Closure of epiglottis - Cessation of breathing - Relaxation of upper oesophageal sphincter
34
What happens in the oesophageal phase of swallowing?
Oesophageal peristalsis carries bolus from upper to lower oesophageal sphincter
35
Which muscle is found in the upper, middle and lower thirds of the oesophagus
- U = striated - M = striated + smooth - L = smooth
36
What is gastro-oesophageal reflux disease (GORD)?
Chronic symptoms or mucosal damage produced by abnormal reflux in the oesophagus
37
Causes of GORD
- Obesity - Hiatal hernia - Drugs that lower tone at lower oesophageal sphincter - Pregnancy - Zollinger Ellison syndrome
38
Which drugs can lower tone at lower oesophageal sphincter?
- Anticholinergic - Beta agonist - Benzodiazepines
39
What is Zollinger Ellison syndrome?
A gastrin-secreting tumour
40
Symptoms of GORD
- Heartburn - Regurgitation - Dysphagia - Cough - Hoarseness - Chronic earache
41
What does GORD cause?
- Oesophagitis - Stricture - Barrett's metaplasia - Oesophageal adenocarcinoma
42
Diagnosis of GORD
- 24h pH monitoring - Endoscopy
43
Types of treatment for GORD
- Conservative - Medical - Surgical
44
Conservative treatments of GORD
- Weight loss - Avoid food/alcohol close to bedtime - Decrease alcohol - Raise head of bed 20-30cm
45
Medical treatments of GORD
- Decrease acid (proton pump inhibitor/H2 blocker) - Antacids (increase pH) - Alginates
46
Surgical treatments of GORD
- Anti-reflux surgery (fundoplication) - Repair hiatus hernia
47
What is metaplasia?
Change in epithelial type in response to environmental stress
48
Management of Barrett's metaplasia
- Manage symptoms of reflux like GORD (conservative, medical, surgical) - Surveillance endoscopy for risk of malignant progression
49
Types of oesophageal cancer
- Squamous cell carcinoma - Adenocarcinoma
50
What is achalasia?
Motor disorder of the oesophagus resulting from loss of myenteric plexus at lower oesophageal sphincter
51
Symptoms of achalasia
- Dysphagia - Regurgitation - Chest discomfort - Halitosis (bad breath)
52
Treatment of achalasia
- Botox injection at LOS - Oesophageal dilation - Surgery (Hellers myotomy)

DIG (19 decks)

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