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Gastrointestinal > Lecture 6- Swallowing and saliva > Flashcards

Lecture 6- Swallowing and saliva Flashcards

1
Q

Function of saliva

A

lubrication

protection

digestion

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2
Q

lubrication

A
  • Mucus content
  • Essential for swallowing
  • Good for speech
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3
Q

protection

A
  • Protection from hot drinks and food
  • Cools it down
  • When we are about to be sick we will saliva to protect against acidic environments
  • Good for our teeth
    • Buffers acid
    • Washes away debris stuck in teeth
    • Antibacterial
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4
Q

antibacterial qualities of saliave

A
  • Lysozymes
  • Lactoferrin- reduces iron availability for bacteria
  • IgA
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5
Q
  • Digestion
A
  • Salivary amylase- carbs
    • Goes down into stomach and the food buffers the acidic stomach long enough for it to cause some digestion in the stomach
  • Lingual lipase- fat digestion
    • Can survive acidic environment of stomach and proximal part of the small intestine
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6
Q

3 main salivary glands

A

parotid

sublingual

submandibular

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7
Q

parotid gland location

A

paired x2)

  • in front of the ear
  • Below the zygomatic arch
  • posterior to masseter muscle
  • inferior border is the inferior border of the mandible
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8
Q

sublingual location

A

lie under hte tongue

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9
Q

submandibular

A

sits below the mandible

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10
Q

type of slavia produced by parotid gland

A

serous with lots of enzymes

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11
Q

type of saliva produce by submandibular

A
  • produces the most saliva (70%)
  • Produces a mixed saliva
    • Serous
    • Mucous
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12
Q

type of saliva produced by sublingual

A

mucous (produces the least)

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13
Q

which gland contributes the most saliva

A

submandibular (70%)

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14
Q

which gland produces the least saliva

A

sublingual (5%)

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15
Q

parotid produces how much of the total saliva

A

255

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16
Q

exocrine structure of salivary gland

A
  • Acinus is where the salvia is produced
  • ductal region where the saliva is made more hyotonic
17
Q

describe how saliva is produced

A
  1. Acinus is where the saliva is produced
    • Isotonic with plasma
  2. Isotonic solution passes out of the acinus due to myoacinus epithelial cells which contract the acinus to move saliva into the duct
  3. Once in the ductal region , ductal cells use transporters to move Na+ and Cl- out of the solution and K+ and HCO3- into the solution
    • Producing a hypotonic solution near the end of the duct (removal of ions >secretion)
18
Q

The amount of modification (more or less hypotonic)by the ductal cells depends on how quickly the saliva is moving through the ductal system

A
  • Basal level- most hypotonic solution
  • When eating the solution moves through much quicker, less contact with ductal cells- smallest change to the tonicity of the isotonic solution (more secretion of HCO3- when active saliva production

​​

19
Q

What is secreted into the ductal lumen of the salivary gland and what is absorbed by the ductal cells

A

sodium and chloride are absorbed from the isotonic saliva produced in the acinus

K+ and HCO3- is secreted into the saliva before it leaves the duct

MORE HYPOTONIC SOLUTION

20
Q

Nerve supply to salivary glands

*

A
  • Completely autonomic
    • Parasympathetic and sympathetic control
21
Q
  • Sympathetic control of salivary glands
A

Less watery (why we get a dry mouth in the ‘fight and flight’ as opposed to ‘rest and digest’

22
Q
  • Parasympathetic control of salivary glands
A
  • Glossopharyngeal – parotid
  • Facial nerve
    • Submandibular and sublingual
23
Q

disease of the salivary gland

A

xerostomia= not enough saliva

24
Q

xerostomia= not enough saliva causes

A
  • Medications
  • Autoimmune
    • Sjogren’s syndrome (dry, swollen and painful salivary glands)
  • Dementia
  • Radiotherapy
  • Dehydration
25
Q

signs and symptoms of xerostomia

A
  • Infections
    • Viral- mumps
    • Bacterial
  • Tooth decay
  • Halitosis (bad breath)
  • Salivary stones
    • ‘Sialoliths’- calcified
    • Most common location= submandibular gland which is attached to the mouth by Wharton’s duct  can be very painful when producing saliva e.g. before you eat
26
Q

3 phases of swallowing

A

oral phase

pharyngeal phase

oesophageal phase

27
Q

outline the oral phase

A

Voluntary

  • 2 stages:
  1. Preparing the bolus
    • Chewing
  2. Move bolus to oropharynx
    • We use the tongue to move the olus up against the hard palate and then slowly move it backwards towards the oropharynx
    • As soon as the bolus touches the oropharynx a reflex sets in which moves swallowing into the pharyngeal phase
28
Q

2. Pharyngeal phase

A
  • INVOLUTNARY- reflex
  • Takes place in less than 1 second (0.2 seconds)
  • Soft palate raises up and seals off the nasopharynx
  • Pharyngeal constrictors start to push the bolus downwards
  • Larynx elevates which closes the epiglottis- stops aspiration
  • Vocal cords adduct further protection of airway
    • Breathes ceases
  • Upper oesophageal sphincter relaxes and opens
29
Q

3. Oesophageal phase

A
  • INVOLUNTARY
  • Closure of upper oesophageal sphincter to stop air in GI tract
  • Rapid peristalsis in oesophagus
30
Q

Difficulty in swallowing

A

- Dysphagia

31
Q

dysphagia can be caused by

A

If there is any problems in coordinating swallowing

Physical blockage to passe of food

32
Q
A
33
Q

If there is any problems in coordinating swallowing:

A
  • Ineffective swallow
    • Dribble
    • Material entering resp tract
      • Coughing
      • Choking
      • Pneumonia

Any disease process which may disturb the nerves supplying the upper GI tract may affect swallowing

  • Stroke
  • Parkinson’s
  • Multiple sclerosis
34
Q

Swallowing fluids is harder than solids

A

Need tighter control since can go in all directions

Use thickener

35
Q

2) Physical blockage to passe of food

A
  • Fluid easier to passes easier than food
  • Causes
    • Fibrous rings- repeated scaring from reflux
    • Oesophageal cancer
      • Progressive dysphagia as the mass grows
      • (red flag)
    • Achalasia (lower oesophageal sphincter failures to relax)

Gastrointestinal (35 decks)

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