Functions of the mouth and oesophagus and associated diseases Flashcards

1
Q

Name functions of the mouth

A
Mastication
Protection (through taste)
Addition of saliva
Lubrication
Formation of bolus
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2
Q

What is the purpose of mastication?

A

Increases surface area for digestion

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3
Q

What process starts in the mouth?

A

Initial digestion of fats and carbohydrates by amylase and lipase

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4
Q

What kind of glands are salivary glands?

A

Exocrine glands

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5
Q

Name the three salivary glands

A

Parotid gland
Submandibular gland
Sublingual gland

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6
Q

What two cell types are found in salivary glands?

A

Acinar cells

Ductal cells

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7
Q

What does an acinar cell do?

A

Produce enzymes

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8
Q

What does a ductal cell do?

A

Produce mucous
Secrete water
Secrete electrolytes

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9
Q

How much saliva is secreted in 24 hours

A

1.5L

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10
Q

Which gland produces the most saliva?

A

Submandibular

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11
Q

Which gland produces watery saliva?

A

Parotid gland

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12
Q

Which gland produces the most viscous saliva?

A

The sublingual gland

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13
Q

Name the three roles of saliva

A

Lubrication
Hydration
Cytoprotection

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14
Q

What three contents of saliva give it immune function?

A

IgA antibodies
Lactoferrin
Lysozyme

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15
Q

Is saliva alkaline or acidic?

A

Alkaline

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16
Q

Is saliva hypotonic or hypertonic?

A

Hypotonic

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17
Q

Name two benefits of saliva being alkaline

A

It neutralises gastric acid that refluxes into the oesophagus
It protects teeth from bacterial acid

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18
Q

What is Sjogren’s syndrome?

A

An autoimmune disease
Attacks salivary and tear glands
Results in dry mouth and eyes

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19
Q

Which salivary gland is affected by mumps?

A

The parotid gland

20
Q

Which nervous system predominantly controls secretion of saliva?

A

The parasympathetic system

21
Q

Which nerve stimulates secretion by the parotid gland?

A

IX glossopharyngeal

22
Q

Which nerve stimulates secretion by the submandibular gland?

A

VII facial

23
Q

Which nerve stimulates secretion by the sublingual gland?

A

VII facial

24
Q

What are the four phases to swallowing?

A

Oral preparatory phase
Oral phase
Pharyngeal phase
Oesophageal phase

25
Q

Describe the oral preparatory phase

A

Food is manipulated in the mouth and masticated to a consistency which can be swallowed

26
Q

Describe the oral phase

A

The tongue propels food posteriorly until the pharyngeal swallow is triggered

27
Q

Describe the pharyngeal phase

A

Bolus is transported through the pharynx
Co-ordinated closure of the glottis by the epiglottis
Cessation of breathing
Relaxation of upper oesophageal sphincter

28
Q

Describe the oesophageal phase

A

Oesophageal peristalsis carries the bolus through the oesophagus

29
Q

What is the oesophageal hiatus?

A

The hole in the diagram through which the oesophagus and vagus nerve pass

30
Q

Name the layers of the oesophagus

A

Mucosa
Inner circular
Outer longitudinal muscle

31
Q

What is gastro-oesophageal reflux disease?

A

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

32
Q

What causes GORD?

A
Obesity
Hiatus hernia
Certain drugs
Pregnancy
Zollinger Ellison syndrome
33
Q

What are the symptoms of GORD?

A

Heartburn
Regurgitation
Dysphagia

34
Q

What are the outcomes of GORD?

A

Oesophagitis
Stricture
Barrett’s metaplasia
Oesophageal adenocarcinoma

35
Q

How is GORD diagnosed?

A

24 hour pH monitoring
Contrast swallow
Endoscopy

36
Q

What are the three options for GORD treatment?

A

Conservative
Medical
Surgical

37
Q

What is conservative treatment of GORD?

A

Weight loss
Not eating close to bedtime
Reduced alcohol consumption
Raise head of bed

38
Q

What is medical treatment of GORD?

A

Proton pump inhibitors
H2 blockers
Antacids
Alignates

39
Q

What is surgical treatment of GORD?

A

Fundoplication
Repair hiatus hernia
Vagotomy

40
Q

What is Barrett’s metaplasia?

A

A change of epithelial type in response to environmental stress

41
Q

Describe the change to cells of the oesophagus with Barrett’s metaplasia

A

Stratified squamous to simple columnar

42
Q

How likely is it for Barrett’s metaplasia to advance to cancer

A

1% of cases each year become cancerous

43
Q

What cancer does Barrett’s metaplasia advance to?

A

Adenocarcinoma

44
Q

What is achalasia?

A

Failure to relax

Motor disorder of the oesophagus

45
Q

What causes achalasia?

A

Loss of myenteric plexus at the lower oesophageal sphincter

Cause unknown

46
Q

What are the symptoms of achalasia?

A

Dysphagia
Regurgitation
Chest discomfort
Halitosis

47
Q

How can achalasia be treated?

A

Oesophageal dilation
Surgery
Botox injection