L3/4

Question 1

Salivary secretion stimulated by

Answer 1

CN IX (and CN VII, VIII technically)

Question 2

2 digestive enzymes in salivary secretion

Answer 2

salivary amylase, lingual lipase

Question 3

Xerostomia

Answer 3

Dry mouth - impaired salivary secretion, decreased pH tooth problems…swallowing problems

Question 4

What nerve supplies the chewing muscles?

Answer 4

CN V

Question 5

Example of inflammatory infection of salivary glands

Answer 5

mumps

Question 6

bradykinin

Answer 6

vasodilator

Question 7

salivary secretion is

Answer 7

hypotonic

Question 8

What two factors account for the hypotonicity of final saliva?

Answer 8

1. ductal cells are water impermeable

2. Net absorption of solute (more NaCl absorbed than KHCO3 secreted)

Question 9

What cells secrete “initial” isotonic saliva?

Answer 9

Acinar cells

Question 10

As flow rate increases, final saliva becomes

Answer 10

similar to plasma

Question 11

As flow rate decreases, final saliva becomes

Answer 11

more dissimilar to plasma

Question 12

T/F: HCO3- secretion is flow dependent

Answer 12

False. It is selectively stimulated by parasympathetics.

Question 13

T/F: acinar and ductal cells are innervated by sympathetics only

Answer 13

F: symp and para! Para is more dominant.

Question 14

Does CNX innervate salivary glands?

Answer 14

No; CN VII and IX

Question 15

Sympathetic stimulation of acinar or ductal cells increases intracellular:

A. IP3
B. Ca2+
C. cAMP

Answer 15

c. cAMP

Question 16

CN VII and CN IX stimulation of acinar or ductal cells increases intracellular:

A. IP3
B. Ca2+
C. cAMP
D. IP3 and Ca2+

Answer 16

D. IP3 and Ca2+

Question 17

Nerves from T1-T3 act on what receptors of acinar/duct cells?

Answer 17

T1-T3 are sympathetic adrenergic. So they land on B-adrenergic receptors, which increase cAMP, to promote saliva production in acinar or ductal cells

Question 18

CN VII and IX bind _____ receptors on acinar or ductal cells, promoting saliva production

Answer 18

Muscarinic

Question 19

What does atropine do?

Answer 19

Competitive inhibitor of muscarinic AChR’s

Question 20

Cell bodies of vagal preganglionic neurons, that prepare GI tract in response to food stimuli, are located where?

Answer 20

DMN - dorsal motor nucleus X

Question 21

What’s a secratagogue?

Answer 21

Any substance that stimulates secretion

Question 22

Predominantly serous secretion - which salivary gland?

Answer 22

Parotid

Question 23

Predominantly mucous secretion - which salivary gland?

Answer 23

Sublingual

Question 24

Mixed serious/mucous secretions - which salivary gland?

Answer 24

Submandibular

Question 25

What cells, upon neural input from CNIX, contract to expel saliva from acini and ducts?

Answer 25

Myoepithelial cells

Question 26

Does the rate of salivary flow affect the tonicity?

Answer 26

No, it's always hypotonic! Though it becomes less hypotonic (more hypertonic) as flow increases, but still hypotonic compared with plasma.

Question 27

Name the 3 phases of swallowing

Answer 27

Oral, pharyngeal, and esophageal

Question 28

esophageal lining cell type?

Answer 28

Stratified squamous epithelium

Question 29

What kind of cell in stomach lining?

Answer 29

Columnar epithelial

Question 30

GERD promotes Metaplasia, which involves

Answer 30

change from squamous to simple columnar epithelia

Question 31

Are there goblet cells in stomach?

Answer 31

no

Question 32

Contrast Barrett's Esophagus disease with Metaplasia, in terms of histological changes. This was a hinted exam question ("if I ask you such and such...")

Answer 32

Metaplasia: changes from one type of epithelium to another type (eg. stratified squamous to simple columnar epithelium) Barrett's Esophagus: changes from esophageal to intestinal type (stratified squamous epithelium to simple columnar epithelial with goblet cells

Question 33

GERD corrodes the esophagus due to what gastric contents?

Answer 33

HCL and gastrin

Question 34

What 2 ways can you mess up the duodenum?

Answer 34

1. not enough bicarb from pancreas | 2. emptying gastric contents too fast

Question 35

2 main therapies for GERD

Answer 35

1. H2 receptor antagonists | 2. Proton pump inhibitor (PPI) - omeprazole

Question 36

Which is more effective for GERD? Ranitidine or omeprazole?

Answer 36

Omeprazole since its a PPI. Ranitidine is an H2 receptor antagonist but there are many other H2 receptors that still aren't antagonized.

Question 37

Hiatal Hernia

Answer 37

Reflux disease, improper LES function. Stomach tries to emerge above the diaphragm. 60% of 60+ yo suffer from this.

Question 38

Achalasia

Answer 38

Motility disorder. Myenteric nerve plexus damage. LES won't open properly in response to swallowing. Treatment: Atropine (for pain and some LES relaxation). BOTOX in LES.

Question 39

What sphincter is NOT relaxed, during retching?

Answer 39

UES