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Digestion and Renal Sciences > Functions of the Mouth and Oesophagus > Flashcards

Functions of the Mouth and Oesophagus Flashcards

1
Q

What is the aim of mastication?

A

to increase SA for digestion

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2
Q

Where does carbohydrate and fat metabolism start?

A

in the mouth and oropharynx with salivary lipase and amylase

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3
Q

Whats the difference between endocrine and exocrine glands?

A

endocrine secrete directly into the blood whereas exocrine release into ducts which lead to their target tissues

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4
Q

What do the salivary glands secrete?

A
  • mucous
  • fluid
  • IgA
  • lysozymes
  • lactoferrrin
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5
Q

What is the function of IgA, lysozyme and lactoferrin?

A

antibacterial

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6
Q

What do the acinar cells of the salivary glands produce?

A

enzymes

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7
Q

What do ductal cells of salivary glands produce and secrete?

A
  • produce mucous in the goblets cells

- secrete water and electrolytes

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8
Q

What are the three types of salivary gland?

A

parotid
submandibular
sublingual

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9
Q

What are the roles of the secretions?

A
  • lubricates
  • hydrates (keeps oral mucosa moist, prevent dehydrations and cell death)
  • cytoprotection (protects oral and oesophageal mucosa from damage)
  • immune function
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10
Q

How does IgA work?

A

binds to pathogenic antigens

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11
Q

How does lactoferrin work?

A

binds iron and is a bactericidal

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12
Q

What is the role of lysozymes?

A

attack bacterial cell wall

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13
Q

How do the salivary secretions protect from pathogens?

A
  • bind and neutralise toxins
  • block viral attachment
  • opsonise bacteria
  • activate complement
  • activate NK cells
  • taken up by M cells in the bowel to simulate lymphoblasts and increase IgA secretion
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14
Q

What is the role of salivary duct cells?

A
  • modify secretions of acinar cells
  • extracts Na+ and Cl-
  • secretes K+ and HCO3-
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15
Q

What are the features of saliva?

A

hypotonic and alkaline

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16
Q

Why is saliva alkaline?

A
  • protect teeth from bacterial acid

- neuralises gastric acid reflux

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17
Q

Name two salivary gland diseases

A

Sjogren’s syndrome
mumps virus (parotitis)
(can learn about these on slides)

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18
Q

What source and ganglion parasympathetically innervates the submandibular and sublingual gland and what is the stimulation?

A
  • 7th cranial nerve (facial)
  • otic ganglion
  • secretion
19
Q

What source and ganglion parasympathetically innervates the parotid gland and what is the stimulation?

A
  • 9th cranial nerve
  • submandibular ganglion
  • glossopharyngeal nerve
  • secretion
20
Q

What source and ganglion innervates the glands sympathetically and what is the effect?

A
  • thoracic sympathetics
  • vasoconstriction
  • thick mucous secretion
21
Q

What are the four phases of swallowing?

A
  • oral preparatory phase (mastication)
  • oral phase (tongue propels food posteriorly until pharyngeal swallow is triggered)
  • pharyngeal phase (bolus transported through pharynx with co-ordinated closure of glottis, cessation of breathing and relaxation of oesophageal sphincter)
  • oesophageal phase (peristalsis moves bolus to lower oesophageal sphincter)
22
Q

What nerves cause swallowing?

A
  • centre in medulla
  • trigeminal nerve (V)
  • glossopharanygeal nerve (IX)
  • Vagus (X)
  • hypoglossal (XII)
23
Q

Swallowing diseases?

A

pseudo bulbar and bulbar palsies

24
Q

Symptoms of swallowing diseases?

A
  • difficulty swallowing
  • altered speech
  • loss of gag reflex
25
Q

What maintains the lower oesophageal sphincter tone?

A

CCK, gastrin and vagal stimulation

26
Q

What mechanisms prevent acid reflux?

A
  • lower sphincter tone
  • intra-abdominal length of oesophagus (protects oesophagus in changes in abdominal pressure)
  • crural sling (diaphragm fibres close the GO junction)
  • acute angle of His (accentuates sphincter and crural sling)
  • mucosal rossette (low pressure seal)
27
Q

Look at ways acid reflux can be caused

A

on slides

28
Q

What is GORD?

A

chronic symptoms pr mucosal damage produced by abnormal reflux in the oesophagus

29
Q

What are the causes of GORD?

A
  • obesity
  • hiatus hernia (stomach moving to wrong part of body)
  • drugs that lower LOS tone
  • pregnancy
  • gastrin secreting tumour (Zollinger Ellison syndrome)
30
Q

Symptoms of GORD?

A
  • heartburn
  • regurgitation
  • dysphagia
  • cough
  • hoarseness
  • chronic earache
31
Q

What is dysphagia?

A

swallowing difficulties

32
Q

What are the outcomes of GORD?

A
  • oesophagitis
  • stricture (narrowing)
  • Barrett’s metaplasia
  • Oesophageal adenocarcinoma
33
Q

How is GORD diagnosed?

A
  • 24 PH monitoring

- contrast swallow

34
Q

Three types pf GORD treatment?

A
  • conservative
  • medical
  • surgical
35
Q

Describe medical?

A
  • decrease acid by using proton pump inhibitors
  • use antacids to increase PH
  • alginates coat mucosa
36
Q

Describe conservative treatment

A
  • weight loss
  • avoid food close to bed
  • decrease alcohol
  • raise head
37
Q

Describe surgical

A
  • ant-reflux surgery

- repair hiatus hernia

38
Q

What is Barrett’s metaplasia?

A

change of epithelial cells in response to environmental stress

39
Q

What can BM lead to?

A

oesophageal adenocarcinoma

40
Q

What are the types of oesophageal cancer?

A
  • squamous cell carcinoma

- adenocarinoma

41
Q

What is the difference between the two types?

A

SCC is mid and upper whereas A is in lower, A is a premalignant lesion and SCC isn’t. A is only caused by reflux whereas SCC is caused by alcohol, tobacco, strictures etc…

42
Q

What is achalasia?

A

-motor disorder of the oesophagus-loss of myenteric plexus at LOS (LOS doesn’t relax)

43
Q

Symptoms of Achalasia?

A
  • dysphagia
  • regurgitation
  • chest discomfort
  • halitosis
44
Q

How is achalasia treated?

A
  • botox injection at LOS
  • oesophageal dialtion
  • surgery

Digestion and Renal Sciences (13 decks)

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