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Physiology > Mouth and esophagus > Flashcards

Mouth and esophagus Flashcards

1
Q

What is the function of saliva relating to the oral mucosa?

A

Keeps it hydrated

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2
Q

What is the function of saliva in mastication?

A

Lubrication and swallowing

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3
Q

What is the function of saliva in the immune system?

A

Kills bacteria

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4
Q

What is the function of the saliva in protecting the teeth?

A

Neutralize gastric acid

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5
Q

What is the major enzyme found in the saliva?

A

Alpha-amylase

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6
Q

What does the mucus of saliva contain?

A

Water
Electrolytes
phospholipids
MUCIN

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7
Q

What is mucin?

A

Highly glycosylated protein with multiple functions throughout the GI system, but coats and protects the lining of the GI tract

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8
Q

What is the ion that promotes fluid secretion in the salivary glands when Ach attaches to its muscarinic factor on salivary glands?

A

Ca release

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9
Q

What is the ion that is secreted into saliva that causes water to follow?

A

Cl

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10
Q

What happens to the presaliva as it moves from the salivary duct lumen to through the duct (as far as dissolved solutes go0?

A

Goes from isotonic to hypotonic

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11
Q

What is the pH of saliva? How does it get there?

A

8–secretion of HCO3 in the duct of the salivary glands

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12
Q

What are the two ions that are reabsorbed from the salivary duct? What is secreted?

A

Na
Cl

HCO3, K are secreted

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13
Q

What is the specialization of the ductal cells that prevents water reabsorption when Na and Cl are reabsorbed?

A

tight junctions

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14
Q

What is the neurotransmitter and ion that is needed to release vesicles into the salivary ductal lumen?

A

Ach and Ca

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15
Q

What is the effect of anticholinergic drugs on salivary glands?

A

Inhibits release of saliva (dry mouth)

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16
Q

What is the function of alpha amylase in salive?

A

Starch digestion

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17
Q

What is the Ig that is released in saliva?

A

IgA

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18
Q

What is the function of lingual lipase in saliva?

A

Fat digestion

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19
Q

What is the function of mucin in the saliva?

A

Lube and protection

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20
Q

What is the function of Na, K, Cl, HCO3, H2O in saliva?

A

Alkalinization and HCO3

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21
Q

What is the function of water in saliva?

A

Taste, swallowing, and speech

22
Q

What is the type of innervation in the upper third? Lower 2/3?

A

upper 1/3 = somatic

Autonomic for the rest

23
Q

What are the three phases of esophageal motor activity (swallowing)?

A

Oral phase
Pharyngeal phase
Esophageal phase

24
Q

What happens to the soft palate during the pharyngeal phase of swallowing?

A

Pulled downward to prevent reflux into the nasopharynx

25
Q

What happens to the the larynx and vocal cords during the pharyngeal phase of swallowing?

A

move upward

26
Q

What happens to the epiglottis during the pharyngeal phase of swallowing?

A

Swings down

27
Q

What happens in the esophageal phase of swallowing?

A

The upper esophageal sphincter contracts and the primary peristaltic wave moves the bolus of food toward the stomach

28
Q

What happens if the first peristaltic wave is insufficient?

A

Second wave initiated

29
Q

What is the effect of distention/ low pH on sensory neurons in peristalsis?

A

Stimulates secondary peristalsis via recruitment of Ach upstream, and NO/VIP downstream

30
Q

What are the 5 causes of GERD?

A
  1. Delayed gastric emptying
  2. Increased frequency of transient LES relaxations
  3. Decreased pH
  4. Loss of secondary peristalsis following transient LES relaxation
  5. Decreased LES tone
31
Q

What is the vicious cycle of recurrent injury in GERD?

A

Scarring, leading to further incompetent LES

32
Q

What is the primary neurotransmitter responsible for LES relaxation?

A

NO or VIP

33
Q

What is Barrett’s esophagus?

A

transition from stratified squamous epithelium of the esophagus, to pseudostratified columnar with goblet cells in the lower esophagus

34
Q

What is the effect of benzodiazepines on GERD?

A

relaxes LES

35
Q

What is the impact of smoking on GERD (3, maybe)?

A

Increased acid secretion
Decreased LES tone
Decreased salivation

36
Q

Ninety percent of the saliva is produced from which three glands?

A

Parotid
Submandibular
Sublingual

37
Q

The initial secretion of water into the lumen of a salivary gland is mediated by what neurotransmitter? What type of receptor does this activate?

A

Ach–Muscarinic

38
Q

Although norepinephrine stimulates the secretion of fluid and enzymes, norepinephrine also does what?

A

decreases blood flow to the salivary glands (as previously discussed) which causes a net reduction in salivary secretion.

39
Q

What happens in the pharyngeal phase of swallowing?

A

The upper esophageal sphincter (UES) relaxes and the bolus of food moves deeper into the pharynx. Peristaltic contractions are initiated.

40
Q

Motor activity of the esophagus is regulated by what nerve inputs onto both smooth and striated muscle?

A

vagus

41
Q

Mechanical dysphagia can be caused by what? (3)

A

Reflux disease; alcohol and tobacco use; and viral infections caused by the human papilloma virus (HPV)

42
Q

Functional dysphagia may result from what (2)?

A

disruption of striated muscle or a neuronal disorder.

43
Q

What is achalasia?

A

Achalasia is a result of denervation of esophageal smooth muscle and impaired function of the lower esophageal sphincter

44
Q

What are sliding hiatal hernias?

A

the stomach slides into the thoracic cavity through the esophageal hiatus

45
Q

What are the symptoms of sliding hiatal hernias?

A

reflux of gastric contents into the esophagus

46
Q

What is a paraesophageal hiatal hernia?

A

the greater curvature of the stomach protrudes through an opening or tear in the diaphragm

47
Q

What happens to the salivary glands in CF patients?

A

Become clogged and fibrotic d/t malfunction of Cl transporter

48
Q

What is the pathophysiology of Sjögren syndrome?

A

Autoimmune attack against the CFTR protein in salivary glands

49
Q

What type of receptor is between the pre and postganglionic neurons that connect the vagus to the parietal cells? What is the possible effect of smoking on this?

A

Ach-nicotinic receptor. Thus smoking could potentially increase acid secretion

50
Q

What is the effect of substance P and NE on saliva production?

A

Both increase, but NE also decreases blood flow to the salivary glands, thus in the end reducing secretions

Physiology (75 decks)

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