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DIG > Functions of Mouth/oesophagus and associated diseases > Flashcards

Functions of Mouth/oesophagus and associated diseases Flashcards

1
Q

What are the functions of mouth and oropharynx?

A
  • Chewing food- mastication -increases S.A.
  • Initiation of carbohydrate and fat metabolism- salivary amylase and lipase
  • Lubrication
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2
Q

What is the function of oesophagus?

A

conduit

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3
Q

What does salivary glands contain?

A

exocrine glands

secretory organs

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4
Q

What does exocrine glands secrete?

A

amylase

lipase

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5
Q

What does secretary organs secrete?

A
  1. Mucous
  2. Fluid
  3. IgA
  4. Lysozyme
  5. Lactoferrin
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6
Q

What cells does salivary glands contain?

A
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7
Q

What is the total volume of secretion by salivary glands per 24 hrs?

A

1.5 L

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8
Q

What does parotid gland secrete?

A

Water. Serous histologic type. 20 % of total secretion

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9
Q

Describe the type of saliva produced by each salivary gland. Which salivary gland produces saliva in the greatest volume?

A

Parotid - serous cells, water
Submandibular - mixed cells, slightly viscous
Sublingual - mucous cells, very viscous

greatest volume = submandibular

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10
Q

What does submandibular gland secrete?

A

Viscous secretion. Mixed histologic type. 70 % total secretion

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11
Q

What does sublingual gland secrete?

A

Very viscous secretion. Mucous histologic type . 10 % total secretion

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12
Q

What is the function of salivary glands?

A

Lubrication Hydration- keeps oral mucosa moist and prevents dehydration and cell death Cytoprotection- protects oral and oesophageal mucosa from damage

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13
Q

What is the role of IgA in immune function

A

IgA antibodies bind to pathogenic antigen

Bind and neutralise protein toxin

Block attachment of virus to cells

Opsonize bacteria

Activate complement

Activate NK cells

Taken up by M cells in the bowel to stimulate lymphoblasts and subsequent secretion of more IgA

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14
Q

What is the role of Lactoferrin on immune function

A

binds iron and is bactericidal

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15
Q

What is the role of lysozyme on immune function

A

attacks bacterial cell wall - cell lysis

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16
Q

What is the function of salivary duct?

A

Salivary duct cells modify the secretion of acinar cells:

extracts Na+ and Cl-

secretes K+ and HCO3-

Saliva is therefore hypotonic and alkaline

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17
Q

What is the purpose of alkaline saliva?

A

Protects teeth from bacterial acid

neutralises gastric acid that refluxes into the oesophagus

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18
Q

What is Sjogrens sysndrome?

A

Autoimmune attack of salivary and tear glands which results in dry mouth and eyes

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19
Q

Who does Sjogren’s commonly affect?

A

women, associated with rheumatoid factor

20
Q

What is Xerostomia?

A

dry mouth and eyes

21
Q

What are the diagnostic tests for Sjogren’s?

A

ANA and rheumatoid factor

22
Q

What are the symptoms of Mumps virus- parotitis?

A

Prodrome of headache and fever

painful swelling on one or both sides of face

23
Q

What is mumps virus associated with?

A

orchitis- inflammation of testicles

24
Q

How is Mumps prevented?

A

MMR vaccine

25
Q

How is salivary glands secretion controlled predominantly?

A

Autonomic nervous system- predominantly via parasympathetic

26
Q

Which nerves are involved in the parasympathetic control of secretion?

A

VIIth cranial nerve- facial nerve

IXth cranial nerve- glossopharybgeal nerve

27
Q

What is the effect of VIIth cranial nerve of secretion?

A

secretion of submandibular and sublingual gland

28
Q

What ganglion does the VIIth cranial nerve pass through before innervating the submandibular and sublingual gland?

A

Submandibular gland

29
Q

What is the effect of IXth cranial nerve on secretion?

A

secretion of parotid gland

30
Q

What ganglion does the IXth cranial nerve pass through before innervating the parotid gland?

A

Otic ganglion

31
Q

What the source of sympathetic innervation for salivary glands secretion

A

Thoracic sympathetics

32
Q

What is the effect of thoracic sympathetics stimulation

A

Thick mucous secretion of all glands. Vasocontriction

33
Q

What are the 4 phases involved in swallowing?

A
  • Oral Preparatory Phase - food is manipulated in the mouth and masticated (chewed) to reduce to a consistency which can be swallowed
  • Oral Phase - the tongue propels food posteriorly until the pharyngeal swallow is triggered
  • Pharyngeal Phase - once the pharyngeal swallow is triggered, the bolus is transported through the pharynx
    • with co-ordinated closure of the glottis via movement of the epiglottis
    • and cessation of breathing
    • and relaxation of the upper oesophageal sphincter (UOS)
  • Oesophageal Phase - oesophageal peristalsis carries the bolus from the cricopharyngeal juncture (the UOS) through the oesophagus to the Lower oesophageal Sphincter (LOS)
34
Q

What happens in Oral preparatory phase?

A

food is manipulated in the mouth and masticated to reduce to a consistancy which can be swallowed

35
Q

What happens in Oral phase?

A

the tongue propels food posteriorly until the pharyngeal swallow is triggered

36
Q

What happens in Pharyngeal phase?

A

Once the pharyngeal swallow is triggered , the bolus is transported through the pharynx

Co-ordinated closure of glottis via movement of the epiglottis

cessation of breathing

relaxation of the UOS

37
Q

What happens in Oesophageal phase?

A

Oesophageal peristalsis

Bolus from UOS to LOS

38
Q

How is swallowing controlled?

A

Swallowing centre in medulla

39
Q

Which nerves are involved in the swallowing centre in medulla

A

Trigeminal (V) Glossopharyngeal (IX) Vagus (X) Hypoglossal (XII)

40
Q

What are the layers in oseophagus, from inner to outer?

A

Mucosa

Submucosa

meissners, submucosal plexus

Inner circular muscle

Myenteric plexus

Outer longitudinal muscle NO serosa NO mesentery

41
Q

Histology of Oesophagus

A

Stratified squamous to GOJ- Z line

42
Q

Oesophagus embryology

A

the trachea develops as lung buds from the oesophagus

as development progresses, the trachea matures and lies anterior to oesophagus

43
Q

What are the congenital problems involving oesophagus?

A

Tracheoesophageal fistula- oseophagus joins the trachea

Oesophageal atresia- oesophagus closing off

44
Q

What are involved in the physiological maintenance of GOS competance?

A

Lower Oesophageal sphincter tone intra-abdominal length of oesophagus

45
Q

What is involved in the maintenance of LOS tone?

A

CCK, gastrin, vagal stimulation

46
Q

Pathology of LOS tone

A

effects of proximal vagotomy loss of CCK in pregnancy

DIG (22 decks)

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