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Physiology > GI Exam VI > Flashcards

GI Exam VI Flashcards

1
Q

Digestive system components:

A
  1. alimentary canal (GI Tract)
  2. Accessory organs
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2
Q

The alimentary canal (GI tract) travels from:

A

mouth to anus

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3
Q

The luminal contents within the alimentary canal are considered:

A

outside the body

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4
Q

How long is the alimentary canal?

A

30 feet in length

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5
Q

When are substances within the alimentary canal, when are they considered inside the body?

A

after they have been absorbed across the epithelial layer that lines the GI tract

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6
Q

____ are in place to keep digested food contents moving in one direction:

A

sphinctors

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7
Q

The spinchtor located between the located between the esophagus and stomach; failure leads to GERD

A

lower esophageal

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8
Q

Failure of the lower esophageal sphincter leads to:

A

acid reflux

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9
Q

Spinster located between the stomach and all intestine

A

pyloric valve

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10
Q

sphincter located between the small intestine and colon:

A

ileocecal valve

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11
Q

Sphincter located at the end of the colon; made of smooth muscle and INVOLUNTARY:

A

internal anal sphinctor

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12
Q

Sphincter located at the end of the colon; made of VOLUNTARY MUSCLE:

A

External anal sphincter

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13
Q

sphincter that controls the release of contents from the pancreas and liver into the small intestine

A

sphincter of oddi

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14
Q

List the 6 functions of the GI system:

A
  1. digestion
  2. secretion
  3. absorption
  4. motility
  5. excretion
  6. defense
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15
Q

Describe digestion:

A

break down of ingested macromolecules into their building blocks

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16
Q

What are the two types of digestion?

A

mechanical and chemical

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17
Q

physically breaking down food into smaller pieces such as chewing

A

mechanical digestion

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18
Q

motility patterns of the digestive tract particularly the ones in the stomach are designed for:

A

mechanical digestion

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19
Q

breaking down food through the use of enzymes:

A

chemical digestion

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20
Q

What components are involved in GI secretion?

A
  1. digestive enzymes
  2. acid/base
  3. bile
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21
Q

Involves the passive and active transport processes across an epithelial layer:

A

absorption

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22
Q

In the absorption seen in the GI system, substances move from ____ to ___.

A

lumen of gut to blood

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23
Q

Looking at the starling’s forces governing capillary exchange outside of the small intestine, overall we have ____ along the entire length of the capillary

A

net absorption

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24
Q

The contractile patterns of the GI system:

A

motility

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25
Q

Motility aspect of the digestive system involves what 3 components?

A
  1. Mixing
  2. Mechanical Digestion
  3. Propulsion
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26
Q

movement of materials through the digestive tract:

A

proprolsion

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27
Q

Removal of metabolic waste:

A

excretion

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28
Q

There is very little ____ in feces

A

true waste

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29
Q

Any undigested products to be excreted from the body:

A

metabolic waste

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30
Q

What gives the feces color?

A

bile pigements

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31
Q

The defense system of the GI tract involves:

A

Gut associated lymphoid tissue

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32
Q

What defensive organ monitors the entrance point of the digestive tract?

A

tonsils

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33
Q

List the path of food travel through the GI tract

A
  1. mouth
  2. esophagus
  3. stomach
  4. small intestine
  5. colon
  6. rectum
  7. anus
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34
Q

As food enters into the body, it is stored in the ____, which will slowly release it into the ____.

A

stomach; small intestine

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35
Q

Describe the processes that occur in the stomach:

A

not much absorption, mainly secretion (acid secretion)

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36
Q

What is the purpose of the acid secretion in the stomach?

A

to sterilize the meal

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37
Q

Describe the size of the contents as it goes through the digestive tract:

A

starts large, gets smaller and smaller until it reaches the colon where compaction occurs to resolidify the material

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38
Q

Describe the processes that occur early on in the small intestine:

A

massive amounts of secretion and absorption

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39
Q

Describe the processes that occur later on in the small intestine:

A

Still have absorption and secretion but much less later on

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40
Q

The substances in the small intestine are being absorbed by the:

A

hepatic portal vein

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41
Q

Because the hepatic portal vein is the location where the absorbed substances from the small intestine go, describe what happens to these absorbed substances:

A

Everything being absorbed from the small intestine will go to the liver before it gets dumped into general circulation

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42
Q

Under normal circumstances almost ALL of the meal is digested and absorbed by:

An exception to this is:

A

the first 25% of the small intestine

exception= fats take a bit longer

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43
Q

Functions to compact the small fragments of material following digestion:

How does it do this?

A

colon; reabsorption of a lot of salt and water to concentration the feces

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44
Q

List the ingested substances that serve as nutrients (7):

A
  1. carbs
  2. fats
  3. proteins
  4. DNA & RNA
  5. Water
  6. electrolytes
  7. vitamins
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45
Q

amount of water and solids ingested per day:

A

1200ml water & 500-800g solids

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46
Q

Amount of salivary secretions & gastric secretions per day:

A

1500 mL & 2000mL

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47
Q

amount of bile secreted by liver per day:

amount of pancreatic secretions per day:

A

bile= 500mL

pancreatic secretions= 1500mL

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48
Q

Amount absorbed into the blood in the small intestine:

A

6700mL per day

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49
Q

amount of intestinal secretions primarily into the small intestine:

A

1500mL

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50
Q

Amount of absorption into the blood that occurs in the large intestine per day:

A

1400mL

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51
Q

what amount of solid an water are exerted into the feces per day (on average)

A

100mL of water & 50 g of solids

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52
Q

movement in contents too quickly through the digestive tract will result in:

A

diarrhea

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53
Q

movement of contents too lowly through the digestive tract will result in:

A

constipation

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54
Q

What four layers comprise the GI tract wall?

A
  1. mucosa
  2. submucosa
  3. muscularis externa
  4. serosa
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55
Q

What layer of the GI tract wall is being described?

  • simple columnar epithelium
  • lamina propria
  • muscularis mucosa for the movement of villi
A

mucosa

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56
Q

What layer of the GI tract wall is being described?

  • connective tissue layer
    -blood vessels and lymph
  • submucosal plexus
A

submucosa

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57
Q

What layer of the GI tract wall is being described?

  • circular muscle
  • longitudinal muscle
  • myenteric plexus
A

muscularis externa

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58
Q

What layer of the GI tract wall is being described?

  • connective tissue covering
  • support GI tract and abdominal activity
A

Serosa

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59
Q

Describe the epithelium that comprises the mucosa layer of the GI tract wall?

A

simple columnar epithelium, heterogenous

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60
Q

What does it mean that the epithelium comprising the mucosal layer is “heterogeneous”

A

some of the cells of the epithelium actively absorb nutrients of the lumen, some of these cells actively secrete hormones into the blood, and some of these cells may be stem cells that are dividing and replacing

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61
Q

What is the innermost layer of the GI tract wall?

A

mucosa

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62
Q

Located in the mucosa layer of the GI tract wall, just beneath the epithelial layer:

A

lamina propria

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63
Q

Blood and nerve supply and nerve supply come up through which portion of the mucosa layer of the GI tract wall?

A

lamina propria

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64
Q

Innermost layer of the mucosa layer of the GI tract wall, functions to move the villi:

A

muscularis mucosa

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65
Q

major blood and lymph vessels of the GI tract travel through the:

A

submucosa

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66
Q

network of neurons located within the submucosa:

A

submucosal plexus

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67
Q

The submucosal plexus is receiving input from another nervous system plexus that is deeper in the wall called the ____, and the submucosal plexus will also send info to this plexus.

A

myenteric plexus

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68
Q

Describe the muscular makeup of the muscularis externa layer of the GI tract wall:

A

muscularis externa is made of smooth muscle arranged into circular muscle and longitudinal muscle

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69
Q

Muscle fibers arranged concentrically around the lumen that functions in luminal diameter:

A

circular muscle

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70
Q

contraction of concentric muscle=
relaxation of concentric muscle=

A

narrowing of the lumen; dilation of the lumen

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71
Q

muscle fibers arranged along the long axis o the tube and allows fro coordinated contraction of different areas of the tube to occur together:

A

longitudinal muscle

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72
Q

What dose longitudinal muscle allow for?

A

coordinated contraction of different areas of the tube

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73
Q

In between the circular and longitudinal muscle layers is the:

A

myenteric plexus

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74
Q

the myenteric is a network of neurons in the ____ that receives input from the ____.

A

muscularis externa; autonomic nervous system

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75
Q

The myenteric plexus has projections into the:

A

submucosal plexus, circular muscle & longitudinal muscle

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76
Q

Submucosal and myenterical plexus; “little brain”

A

enteric nervous system

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77
Q

The digestive tract is the only organ in the body that has its own:

A

brain

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78
Q

What types of cells are located in the epithelial layer of the GI tract?

A
  1. simple columnar (with microvilli)
  2. Goblet cells
  3. enteroendocrine cells
  4. stem cells
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79
Q

The simple columnar cells found in the epithelial layer have:

A

microvilli

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80
Q

Unicellular exocrine gland that secretes mucus:

A

goblet cell

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81
Q

Why is it important to have goblet cells within the epithelial layer?

A

Mucus protects the GI lining from the acidic environment

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82
Q

Enteroendocrine cells located within the epithelial layer are located at the:

A

base of villi

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83
Q

found within the epithelial layer and function to secrete hormone into the blood:

A

enteroendocrine cells

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84
Q

Stems cells within the epithelial layer are located:

A

within crypts

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85
Q

What components allow for the tremendous surface area available for the absorption of nutrients from the lumen?

A
  1. circular folds
  2. villi
  3. microvilli
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86
Q

Circular folds increase the surface area of the:

A

intestinal lining

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87
Q

Villi are extensions off ____ & increase the surface area of the ____.

A

circular folds; circular folds

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88
Q

Another name for microvilli

A

brush border

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89
Q

Microvilli are located on the ____ and increase the surface area of the ____

A

apical membrane of villi; apical membrane

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90
Q

Together, circular folds, villi, and microvilli increase SA ____x over flat surface

A

600x

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91
Q

What two components are present inside the villus?

A
  1. lacteals (lymph vessels)
  2. capillary network
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92
Q

Substances absorbed across the epithelium will either enter _____ also known as _____ or will enter _____.

A
  1. lacteals also known as lymph vessels
  2. capillary network
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93
Q

What moves the villus?

A

muscularis mucosa

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94
Q

Venous drainage and lacteal movement can be described as ____ processes

A

passive

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95
Q

Venous drainage and lacteal movement can be described as ____ processes

A

passive

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96
Q

Since venous drainage and lacteal movement are passive processes they require:

A

skeletal muscle contractions & one-way valves

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97
Q

The process of the muscularis mucosa contraction causing the villus to move up and down and this movement allowing the absorbed digestates to move through the capillaries, through the veins, and then back to the general circulation:

A

milking the villus

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98
Q

When looking at hormone levels in the GI system, changes in hormones levels are the response of changes in the _____, NOT the ____.

A

lumen; ECF

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99
Q

Control systems of GI regulate systems in ____.

A

lumen of tract

100
Q

Control mechanisms are governed by ____ & ____ of luminal contents

A

volume and composition

101
Q

When changes in the gut lumen initiate the secretion of a hormone into the blood:

A

endocrine secretion

102
Q

When changes in the gut lumen will cause paracirnes to be secreted into interstitial fluid & affect cells close by:

A

paracrine secretion

103
Q

Autonomic nerve function that will stimulate an endocrine gland to secrete a hormone into the blood:

A

neurocrine secretion

104
Q

When two cells actually have to make contact with each other for secretion to occur:

A

immune/juxtacrine secretion

105
Q

Name two examples of cells displaying immune/juxtacrine secretion:

A

ECL cells & D-cells

106
Q

What do ECL cells secrete?

A

histamine

107
Q

What do D-cells secrete?

A

somatostatin

108
Q

The gut innervation responsible for sensory

A

Afferent neurons

109
Q

The gut innervation responsible for secretomotor:

A

efferent neurons

110
Q

Reflex receptors that respond to stretch, inflammation, nutrients, and endocrine factors:

A

Afferent sensory

111
Q

Afferent sensory neurons respond to:

A
  1. stretch
  2. inflammation
  3. nutrients
  4. endocrine factors
112
Q

Afferent sensory neurons form synapses in:

A
  1. enteric nervous system
  2. pre vertebral ganglia
  3. spinal cord
  4. brainstem
113
Q

Vagal nerves are mainly ____ to the brainstem

A

afferent

114
Q

Sensory info going TO the brainstem will be carried by:

A

vagal sensory neurons

115
Q

When a vagal nerve carries the sensory info in, and a vagal nerve carries the parasympathetic commands out:

A

vagal-vagal reflex

116
Q

What are categories of efferent (secretomotor) control?

A
  1. somatic
  2. sympathetic
  3. parasympathetic
117
Q

_____ control occurs for muscles of the tongue, and for muscles of chewing & swallowing

A

somatic motor control

118
Q

Cranial nerve responsible for the following:

  • muscles of the tongue
  • muscles of chewing
  • muscles of swallowing
A

tongue= CN 12

chewing= CN5

swallowing= CN9 & 10

119
Q

The pudendal nerve is a _____ nerve that controls both the external urethral sphincter as well as the external anal sphincter:

A

somatic nerve

120
Q

Both the external urethral sphincter and external anal sphincter can be described as:

A

voluntary

121
Q

we have voluntary muscles at the start of the digestive tract and voluntary muscle at the end of the digestive tract but ____ muscle in between that is controlled by ____.

A

smooth muscle; autonomic nervous system

122
Q

what is the majority of the autonomics that make up the middle of the digestive tract and why?

A

mostly sympathetic post-ganglionic fibers because they form in the pre-vertebral foramen and will extend to the digestive tract

123
Q

The post-ganglionic nerve fibers that form in the pre-vertebral foramen and extend to the digestive tract will release ____ to ____.

A

norepinephrine; to enteric nervous system, vasculature, ducts, and cells of the tissue

124
Q

The sympathetic nervous system is mostly ____ to the digestive system

A

inhibitory

125
Q

Digestion is dominated by _____ function

A

parasympathetic

126
Q

The parasympathetic motor neurons of the digestive tract:

A
  1. vagus nerve
  2. pelvic nerves
127
Q

parasympathetic nervous control can be stimulatory or inhibitory depending on:

A

the final neurotransmitter

128
Q

post-ganglionic fibers (NEpi) to enteric nervous sytem, vasculature, ducts, parenchyma; usually inhibitory

A

sympathetic

129
Q

ENS functions as post-ganglionic fibers, action are stimulatory or inhibitory, depending on final neurotransmitter receptor

A

parasympathetic

130
Q

Monitor the conditions of the lumen of the gut:

A

sensory neurons

131
Q

What are some things that a sensory neuron might monitor?

A

stretch, nutrients, etc.

132
Q

When a sensory neuron is stimulated, sensory information can then go activate the ____ OR the sensory information can go to the ____.

A

enteric nervous system; prevertebal ganglia, spinal cord, or brainstem

133
Q

Following the sensory transmitting the stimuli to the appropriate area (ENS, PV ganglia, spinal cord, or brainstem), we will then have:

A

sympathetic and parasympathetic outflow from the brain

134
Q

If the response to the stimulus is sympathetic outflow from the brain, these are mostly _______ fibers that are going to secrete _____ as their NT.

A

post-ganglionic fibers; norepinephrine

135
Q

Parasympathetic fibers are all going to be ____

A

preganglionic

136
Q

Describe the length of sympathetic post-ganglionic fibers:

A

short

137
Q

Describe the length of parasympathetic pre-ganglionic fibers:

A

long

138
Q

The synapse between the pre-ganglionic & post-ganglionic fibers occur in the:

A

wall of an organ

139
Q

Parasympathetic pre-ganglionic fibers release ____, and its going to influence the function of neurons in the ___.

A

acetylcholine; enteric nervous system

140
Q

What neurotransmitter is released by the parasympathetic nerve fiber?

What does this influence?

A

acetylcholine

enteric nervous system

141
Q

When the enteric nervous system is influenced by the parasympathetic nerve fibers releasing acetylcholine, the response to the digestive system will be:

A

either stimulating or inhibiting??

142
Q

In general terms, the myenteric plexus is involved in:

A

coordinated function all along the length of the digestive tract

143
Q

the submucosal plexus and the myenteric plexus can both be directly stimulated by: (4)

A
  1. Acetylcholine
  2. Amines
  3. Nitric Oxide
  4. Many other peptides
144
Q

When a sensory neuron is stimulates, it can either act on the ____ or travel up and act on the ____, or ____

A
  1. submucosal plexus
  2. myenteric plexus
  3. pre-vertebral ganglia , spinal cord and brainstem
145
Q

Neurotransmitters for:

  1. Sympathetic motor neurons:
  2. Parasympathetic motor neurons:
A
  1. Norepinephrine
  2. Acetylcholine
146
Q

Linear chain of neurons that extend the entire length of GI Tract:

A

myenteric plexus

147
Q

The myenteric plexus is a linear chain of neurons that extends:

A

the entire length of the GI tract

148
Q

The myenteric plexus controls:

A

the muscle of muscularis externa

149
Q

What occurs when the myenteric plexus is stimulated? (5)

A
  1. increase tone of gut wall
  2. increase intensity of rhythmic contractions
  3. slight increase in rate of rhythmic contractions
  4. increase conduction velocity of electrical waves along gut wall
  5. inhibition of sphincter contraction
150
Q

Why is sphincter contraction inhibited when the myenteric plexus is stimulated?

A

the sphincter have to relax to move contents from one area to another

151
Q

The enteric systemic is considered:

A

The brain of the gut

152
Q

Controls the function of each minute segment of GI tract:

A

submucosal plexus

153
Q

What plexus is involved in local control?

A

submucosal plexus

154
Q

The local control of the submucosal plexus involves control of:

A
  1. intestinal secretions
  2. absorption
  3. contraction of smooth muscle
155
Q

Stimuli that can occur INSIDE the GI lumen include:

A

changes in chem, osmolarity, or some sort of mechanical change like stretch

156
Q

The stimulus sensed by sensory neurons will activate sensory receptors such as:

A

chemoreceptors, osmoreceptors, and mechanoreceptors

157
Q

Describe the pathway of a short loop reflex:

A
  1. stimulus
  2. chemo/mechano/osmoreceptors in GI wall
  3. ^^ these receptors stimulate the enteric NS inside the GI wall
  4. The enteric NS activates smooth muscles and glands
  5. Response in GI lumen
158
Q

Describe the speed and CNS involvement in short loop reflex

A

Very rapid and doesn’t involve CNS

159
Q

Describe the pathways of a long loop reflex:

A
  1. simulus
  2. chemo/mechano/osmoreceptors in GI wall
  3. Afferent neurons to CNS
  4. Vagal efferent autonomic neurons
  5. Enteric nervous plexus
  6. Smooth muscle or gland activation
  7. GI response
160
Q

Describe the speed and CNS involvement in long loop reflex:

A

long and involves CNS

161
Q

In many instances, both short and long loop reflexes:

A

occur at the same time

162
Q

CNS stimulation can cause changes in the GI tract by stimuli arising:

A

OUTSIDE the GI lumen

163
Q

What are some examples of CNS stimulations outside of the GI tract?

A

site of food, smell of food, taste of food, emotional state, hunger levels

164
Q

Site of food, smell of food, tase of food, emotional state, and hunger levels can affect the:

A

enteric NS function

165
Q

The chemoreceptors, osmoreceptors, and mechanoreceptors will all be activated by stimuli:

A

within the GI lumen

166
Q

True or false: Many of the neurons in the ENS also function as parasympathetic post ganglionic fibers

A

true

167
Q

True or false: the submucosal plexus functions to inhibit sphincter contraction:

A

False- myenteric plexus

168
Q

True or false: Local control of the GI tract is mediated by the function of the submucosal plexus:

A

true

169
Q

True or false: Vagal sensory neurons monitoring the gut are activated by changes in the GI lumen or wall

A

true

170
Q

True or false: Sensory info arising from the gut must be process through the CNS

A

Fase- can have short loop reflex

171
Q

Endocrine cells scattered in gut mucosa:

A

unicellular endocrine glands

172
Q

Unicellular endocrine cells are considered ____ cells with ___.

A

specialized cells with one hormone

173
Q

Describe the secretion of hormones from specialized endocrine cells:

A

usually secrete one hormone

174
Q

When looking at endocrine cells in the digestive system, specific cell types are:

A

localized to regions of the gut

175
Q

When and where do the unicellular endocrine glands secrete their hormone?

A

When they “taste” the luminal contents and into the blood

176
Q

Hormones are secreted by the unicellular endocrine glands based on:

A

responses to changes in the LUMEN

177
Q

The secretory products of the endocrine cells will be secrete out of the ____ where the blood supply is & will be secreted response to changes in the lumen

A

basolateral surface

178
Q

Paracrine factors are similar to endocrine but instead of being released into the blood, they are released into the _______, where it will diffuse to target cells

A

interstitial fluid

179
Q

Paracrine factors are released into the interstitial fluid, which diffuses to the target cell but some of these paracrine factors may:

A

Overflow into circulation

180
Q

Two established gut paracrine factors include:

A
  1. histamine
  2. somatostatin
181
Q

Histamine is released by ____ cells

Somatostatin is released by ____ cells

A

ECL cells

D cells

182
Q

Both histamine and somatostatin are:

A

paracrines

183
Q

paracrine secrete their substances across the ____ into the interstitial space

A

basolateral surface

184
Q

Histamine is mainly released by:

A

gastrin

185
Q

Somatostatin is mainly related by:

A

luminal H+

186
Q

Patterns of motility include:

A
  1. chewing
  2. swallowing
  3. esophageal transport
  4. gastric storage, trituration, & emptying
  5. vomiting
  6. gallbladder storage & emptying
  7. small intestinal mixing & transport
  8. colonic storage & defecation
187
Q

Mixing of the contents with gastric juice to make a homogenous solution; to break things down

A

trituration

188
Q

one of the most complex reflexes the body has due to reversal of all motility:

A

vomiting

189
Q

A protective reflex mediated by the brain stem:

A

vomiting

190
Q

List the skeletal (voluntary, striated), gut musculature:

A
  1. mouth
  2. oropharynx
  3. upper esophageal sphincter
  4. upper 1/3 of esophagus
  5. external anal sphincter
191
Q

The mouth, oropharynx, upper esophageal sphincter, upper 1/3 of esophagus, and external anal sphincter can all be described as:

A

Skeletal, voluntary, striated muscle

192
Q

List the smooth (involuntary), gut musculature:

A
  1. lower 2/3 of esophagus
  2. stomach
  3. small intestine
  4. large intestine
  5. gallbladder
  6. billiary & pancreatic ducts
193
Q

The lower 2/3s of the esophagus, stomach, small and large intestine, gallbladder, and billiary & pacnreactic ducts can all be described as:

A

Smooth involuntary muscle

194
Q

Collects all venous outflow for most GI organs:

A

portal vein

195
Q

All portal outflow goes to ___ before entering ___

A

liver; vena cava

196
Q

Nutrients, hormones, drugs, and toxins are scanned by the:

A

liver

197
Q

Describe the hypothalamic pituitary portal system:

A

portal system between the hypothalamus & anterior pituitary

198
Q

The hypothalamic pituitary portal system allows for:

A

direct delivery of tropic hormones from hypothalamus to anterior pituitary

199
Q

The portal system in the digestive tract is between:

A

the organs of digestion and the liver

200
Q

Each organ in the digestive tract gets its own:

A

blood supply

201
Q

Everything along the digestive system that gets absorbed will first be absorbed into the:

A

portal vein

202
Q

After everything in the digestive system first gets absorbed into the portal vein, the portal vessel will then carry that blood to the:

A

liver

203
Q

Types of saliva include:

A
  1. serous
  2. mucus
204
Q

Serous saliva is a ___ secretion containing ___.

A

watery secretion; ptyalin (alpha-amylase)

205
Q

Another name for ptyalin is:

A

alpha amylase

206
Q

What is the function of serous saliva?

A

moisten & dissolve food

207
Q

Alpha-amylase is a digestive enzyme that is responsible for:

A

small amount of chemical digestion of carbohydrates in the mouth

208
Q

Describe mucus saliva:

A

thick secretions containing mucin

209
Q

Mucus saliva is responsible for:

A

lubrication an protection of surfaces

210
Q

List the types of salivary glands and their products:

A
  1. parotid: serous
  2. submandibular: mixed
  3. sublingual: mixed
  4. many tiny buccal glands: mucus
211
Q

List the components that make up saliva:

A
  1. water
  2. bicarb
  3. mucins
  4. amylase
  5. lysozyme, lactoferrin, IgA
  6. Epidermal and nerve growth factors
212
Q

Name the component of saliva being described:

Facilitates taste and dissolution of nutrients, aids in swallowing:

A

water

213
Q

Name the component of saliva being described:

Neutralizes refluxed gastric acid:

A

bicarbonate

214
Q

Name the component of saliva being described: lubrication

A

mucins

215
Q

Name the component of saliva being described:

Starch digestion:

A

amylase

216
Q

Name the component of saliva being described:

Innate and acquired immunity:

A

lysozyme, lactoferrin, and IgA

217
Q

Name the component of saliva being described:

Mucosal growth and protection:

A

Epidermal and nerve growth factors

218
Q

How much saliva do we produce per day?

A

1.5 L/ day

219
Q

Describe the control of saliva secretion:

A

secretion strictly under neural reflex control

220
Q

What is the predominate regulator of saliva secretion?

A

Parasympathetic NS

221
Q

The parasympathetic NS is the predominate regulator of saliva production and it releases ____ which binds to ____.

A

acetylcholine; muscarinic receptors

222
Q

Critical for the initiation of saliva secretion:

A

parasympathetic NS

223
Q

The parasympathetic NS is critical for what aspects of saliva secretion:

A
  1. initiation of saliva secretion
  2. sustaining high levels of saliva secretion
  3. vasodilation of blood vessels supply salivary glands
224
Q

What is the parasympathetic nervous systems effect on the blood vessels supplying salivary glands?

A

vasodilation

225
Q

When the blood vessels supplying salivary glands are dilated by the parasympathetic NS, there is up to a ___ increase in saliva production by ____.

A

20x; acing cells

226
Q

As flow rate increases, the saliva: (3)

A
  1. less time for ductal modification
  2. saliva more closely resembles the plasma
  3. saliva becomes more basic
227
Q

As the flow rate of saliva increases, the amounts of what ions will increase?

A

Na+, HCO3-, and Cl-

228
Q

Why does saliva look closer to plasma at high secretion rates?

A

because the ductal cells are responsible for resorbing salt, water, and bicarb, but at high flow rates this does not allow enough time for this to take place (less reabsorption occurs)

229
Q

What are 5 modes of reflex activation of parasympathetic stimulated saliva production?

A
  1. taste (especially sour)
  2. tactile stimuli (presence of smooth objects) on tongue surface
  3. Smell of food (especially stanky food)
  4. Ingestion of irritating foods
  5. nausea
230
Q

Why does nausea initiate reflex activation of parasympathetic stimulated saliva production?

A

The parotid glands will secrete a basic solution that will prepare the esophagus and mouth for the upcoming vomit

231
Q

The sympathetic NS role in saliva secretion:

A
  1. minor role
  2. enhances parasympathetic effects
232
Q

For the minor control of saliva secretion, the sympathetic nervous system secretes ____ which binds to ____.

A

Norepinephrine; adrenergic receptors

233
Q

In unstimulated saliva secretion:

  • submandibular: ____%
  • parotid glands: ____%
  • sublingual glands: ___%
A
  • 69% submandibular
    -26% parotid
    -5% sublingual
234
Q

In stimulated saliva secretion:

  • parotid glands: ____%
  • submandibular: ____%
  • sublingual glands: ___%
A
  • 69% parotid
  • 26% submandibular
  • 5% sublingual
235
Q

saliva production is inhibited by:

A
  1. fear
  2. sleep
  3. fatigue
  4. dehydration
236
Q

saliva production is stimulated by:

A
  1. autonomic (primarily PNS)
  2. thinking/seeing/smelling food
  3. conditioned salivation
  4. chewing
  5. nausea
237
Q

Thinking/seeing/smelling food which stimulates saliva production is in the ____ phase.

A

cephalic

238
Q

True or false: Rates of saliva production are not dependent on age, flow rates remain constant in spite of acinar degeneration:

A

True

239
Q

subjective feeling of a dry mouth:

A

xerostomia

240
Q

What are the most common causes of xerostomia: (5)

A
  1. polypharmacy (greater than 4 drugs per day)
  2. anxiety & depression (and meds used to treat these)
  3. insufficient hydration
  4. head and neck radiation
  5. Sjogren syndrome
241
Q

Describe Sjogren syndrome:

A
  • autoimmune destruction of mucous membranes and moisture-secreting glands
  • decreased production of tears and saliva
  • dry eyes and mouth
242
Q

What are the consequences of xerostomia? (7)

A
  1. Increased caries
  2. Halitosis
  3. Disrupted sleep
  4. Difficulty lubricating and swallowing food
  5. Dry mouth
  6. Impaired taste
  7. Heartburn
243
Q

Why might someone with xerostomia have increased caries?

A

Due to reduced oral clearance of sugars, dietary acids, and oral bacteria

244
Q

In a patient with xerostomia, what symptoms may be accompanied by the dry mouth feeling?

A
  • feeling thirsty
  • dry cracked lips
  • burning mouth sensation
  • dry/sore oral mucosa
245
Q

Why might someone with xerostomia have heart burn?

A

Saliva is supposed to buffer and gastric acid that gets up into the esophagus, and if you don’t have enough saliva the acid does not get buffered

246
Q

What other things might accompany heart burn in an individual with xerostomia?

A
  1. Decreased buffering
  2. Loss of protective growth factors in saliva
  3. lengthened healing time for ulcers
247
Q

Management of xerostomia includes: (4)

A
  1. avoid acidic, spicy, crunchy, and coarse foods
  2. alcohol free toothpaste and rinses
  3. oral moisturizers (sips of water and sugarless chewing gum)
  4. Sialogogues such as pilocarpine & cevimeline before meals

Physiology (10 decks)

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