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Anatomy and Physiology > Midterm 2: Salivary Glands & Esophageal > Flashcards

Midterm 2: Salivary Glands & Esophageal Flashcards

1
Q

Functions to chew, moisten food

A

Oral cavity

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2
Q

Functions to transport food to stomach

A

Pharynx and esophagus

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3
Q

Functions for mechanical disruption and mixing of food with gastric secretions

A

stomach

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4
Q

functions by chemical digestion and absorption of nutrients, electrolytes and water

A

small intestine

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5
Q

functions by absorption of electrolytes and water

A

Large intestine (colon)

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6
Q

Functions by storage and elimination of undigested material

A

rectum and anus

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7
Q

What regulates the digestive system?

A

The autonomic nervous system and its local control (enteric nervous system).
Also, hormones.

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8
Q

What happens during mechanical digestion?

A

Mastication/chewing occurs. Teeth brake food into pieces and mix with saliva to form a bolus (round ball of chewed food)

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9
Q

Where does chemical digestion start? What happens during chemical digestion? Give 2 enzymes and their function

A

Chemical digestion starts with saliva.

Amylase (ptyalin) is secreted by the salivary glands and begins starch/carbohydrate digestion in the oral cavity at pH of 6.5-7.0 via hydrolysis. In the stomach (pH of 2.5), amylase activity within the bolus quickly stops.

Lingual lipase is secreted by the tongue and begins the breakdown of triglycerides into free fatty acids and glycerol + one fatty acid (monoglycerides)

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10
Q

4 saliva functions

A

1) Digestion
2) Lubrication
3) Protection
4) Bactericidal

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11
Q

What enzyme is the start of carbohydrate breakdown?

A

Amylase

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12
Q

What primarily causes the lubrication of saliva?

A

Mucus that is in saliva

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13
Q

How does saliva provide protection? (2 ways)

A

1) Neutralizes gastric juices secondary to vomiting.

2) May protect against tooth decay. Insufficient saliva production linked to increased risk for dental caries

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14
Q

2 ways saliva can be bactericidal

A

1) It contains lysozyme which binds to IgA; immunologically active against bacteria.
2) It also contains lactoferrin which chelates iron required for bacterial growth.

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15
Q

Saliva composition

A
  • Water, ions, proteins (i.e., enzymes, immunoglobulins)
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16
Q

How does the composition of saliva compare to blood plasma?

A
  • They are very similar but saliva has higher bicarbonate (HCO3-) concentration which makes its pH higher (more alkaline).
  • Blood plasma has a higher Na+ and Cl- concentration than saliva which makes it hypertonic to saliva. This makes saliva hypotonic in relation to blood.
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17
Q

How is saliva modified? What happens when secretion rates are increased?

A

When saliva passes through the ducts within the gland, sodium (Na+) and chloride (Cl−) concentrations are lowered by reabsorption in the ducts. Potassium (K+) and bicarbonate (HCO−) is increased by secretion in the ducts.

When secretion rates are increased, saliva is not fully modified as less time is available to allow for reabsorption and secretion.

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18
Q

The oropharynx and laryngopharynx connect the oral cavity to the __________.

A

esophagus

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19
Q

______ skeletal muscle pairs (pharyngeal constrictors) form the pharyngeal wall to direct chewed food into the esophagus; all innervated by the _______ nerve.

A

Three; vagus

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20
Q

Sections of esophagus from superior to inferior

A

1) Cervical
2) Upper
3) Mid-thoracic
4) Abdominal

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21
Q

The upper section of the esophagus is found in the _________ mediastinum.

A

superior

22
Q

The mid-thoracic section of the esophagus is found in the _________ mediastinum.

A

inferior / posterior

23
Q

Constrictors of the esophagus

A

Upper esophageal sphincter
Aortic arch
Left primary bronchus
Esophageal hiatus

24
Q

Describe the 2 esophageal sphincters

A

1) Superior esophageal sphincter- striated muscle (cricopharyngeus) with circular orientation. Closes during respiration. At near level with thyroid in neck.

2) Inferior esophageal sphincter- Contracted ring of smooth muscle located at the gastroesophageal junction. When it relaxes, the bolus passes into the stomach. When closed, it prevents gastric acids into the esophagus.
Also has a pinching effect on the esophagus as it passes through the crural part of the diaphragm.

25
Q

Vasculature of cervical part of esophagus

A

Inferior thyroid artery and vein

26
Q

Vasculature of upper and mid thoracic esophagus

A

Arteries: Branches of the thoracic aorta
Veins: Azygous system

27
Q

Vasculature of abdominal part of esophagus

A

Arteries: Left gastric artery (one of three branches of celiac trunk)
Veins: Branches of tributaries of the hepatic portal vein

28
Q

Innervation of the esophagus

A

Sympathetic: Thoracic plexus

Parasympathetic: Vagus nerve (CN X) trunks contribute to the esophageal plexus

29
Q

Symptoms of esophageal varies and liver disease

A
  • Vomiting blood
  • Black, tarry stool
  • Lightheadedness or loss of consciousness
  • Jaundice (from liver disease)
30
Q

Describe Gastroesophageal Reflux Disease (GERD) AKA acid reflux. (Symptoms and risk factors)

A

Poor closure of lower esophageal sphincter

Symptoms: Heartburn, chest pain, acid taste, bad breath, vomiting
Risk factors: Obesity, pregnancy, medication, smoking

31
Q

What is Barrett’s esophagus?

A
  • Mucosal damage secondary to chronic acid exposure from malfunctioning lower esophageal sphincter.
  • “Fried bacon” appearance
  • Increased risk for esophageal cancer
32
Q

2 types of esophageal cancer

A

1) Carcinoma: Most common

2) Adenocarcinoma: Associated with Barrett’s esophagus

33
Q

What are the 2 parts of swallowing (deglutition)?

A

Part 1 is voluntary called voluntary phase.

Part 2 is involuntary and contains the pharyngeal and esophageal phases.

34
Q

What happens during the voluntary part of deglutition?

A

Chewing of food into a bolus and start of pushing bolus towards the oropharynx. Controlled by the cerebral motor cortices.

35
Q

Describe the pharyngeal phase

A
  • Involuntary
  • Bolus pushed into the oropharynx while uvula and soft palate lifts to seal off nasopharynx
  • Epiglottis seals over glottis. Inhibits respiration.
  • Striated muscles contract, forcing bolus towards esophagus
  • At end of phase, upper esophageal sphincter relaxes to allow bolus to pass then closes
36
Q

The bolus is only in the pharynx for _____ prior to passage into the esophagus.

A

1 second

37
Q

Describe the esophageal phase

A
  • involuntary
  • Lower esophageal sphincter typically relaxed at the start of swallowing.
  • Bolus passes through esophagus by sequential waves of muscular contraction (peristalsis).
  • Longitudinal muscles contract to shorten distance in front of bolus.
  • Circular muscles contract after bolus has passed to allow for unidirectional movement.
  • lower sphincter closes immediately after bolus passes into stomach.
38
Q

Describe peristalsis.

A
  • Longitudinal muscles contract to shorten distance in front of bolus
  • Circular muscles contract after bolus has passed to allow for unidirectional movement
39
Q

Total travel time (oral cavity → stomach) is ___ sec. for solids; ____ sec. for fluid

A

5-8 for solids

1-2 for liquids

40
Q

Swallowing reflex afferent and efferent signals

A

Afferent signals from pressure sensors in pharynx to medulla.

Efferent signals from medulla to:
Skeletal muscle within pharynx, larynx and upper esophagus
Smooth muscle in lower esophagus and stomach

41
Q

Esophageal veins anastomose with the ________ that drain into the ____________.

A

splenic vein; hepatic portal vein

42
Q

Describe Cirrhosis

A

Cirrhosis is the presence of scar tissue within the lobules of the liver that can ultimately affect optimal blood flow through the sinusoids; in some instances, the central vein of the lobule can be obliterated due to the proliferation of scar tissue

43
Q

The _____________ directs venous blood into the liver, through branches that comprises a portion of the _________, into the sinusoids of the individual liver lobules and towards the ______________.

A

hepatic portal vein ; hepatic triad ; central vein

44
Q

_______________ are veins within its wall that are enlarged with thickened walls due to the backup of venous blood in the hepatic portal v. secondary to advanced liver disease (cirrhosis)

A

Esophageal varices

45
Q

Connects the pharynx to the stomach

A

esophagus

46
Q

Layers of the esophagus from innermost to outermost

A

1) Tunica Mucosa (innermost)
2) Submucosa
3) Muscular externa
3) Adventitia (outermost)

47
Q

Describe the tunica mucosa

A 
-Stratified Squamous Non-Keratinized transitions to columnar morphology at gastroesophageal junction (int. mucosa)
Contains Lamina propria: Small vessels; Lymphoid aggregates (middle layer of mucosa)
Muscularis mucosae (ext. mucosa; MM)
48
Q

Describe the submucosa

A
  • Loose, distensible, elastic fibers
  • Seromucous exocrine glands (G)
  • Submucosal plexus (enteric nervous system)
49
Q

Describe the muscular externa

A 
Circular muscle (inner; CM)
Myenteric plexus (enteric nervous system)
Longitudinal muscle (outer; LM)
50
Q

Describe the adventitia

A

outside peritoneal cavity, so NOT serosa

51
Q

Describe Sjögren’s syndrome

A
  • Autoimmune disease that attacks and destroys the glands that produce tears and saliva
  • Can produce dry eye symptoms and issues with swallowing
  • Affects mostly females and may be associated with lymphoma (cancer of the lymph nodes)
52
Q

Describe salivary tumors. Most common, more likely to be malignant.

A
  • Parotid gland tumors most common and most are benign
  • Submandibular and sublingual less common but more likely to be malignant
  • Complexity of nerve pathways through and near glands increase risk of complications (i.e., loss of eyelid tone leading to sag, ptosis)

Anatomy and Physiology (9 decks)

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