Mouth and Esophagus

Question 1

Name five functions of saliva.

Answer 1

1. Moisten food
2. Buffers oral contents
3. Protects oral cavity from microorganisms
4. Suplies Ca2+ and phosphate for remineralization of enamel
5. Neutralizes acid in the upper GI tract

Question 2

Dental caries is a process that causes _______.

Answer 2

cavities

Question 3

What is the most important factor in the process of dental caries?

Answer 3

Time of exposure to sugars

Question 4

Where in the oral cavity are most oral cancers found?

Answer 4

Lateral, ventral tongue and floor of the mouth

Question 5

Compare the actions of both the upper and lower esophageal sphincters during swallowing.

Answer 5

The UES opens for a brief moment after swallowing; the LES opens when you swallow and stays open until the food makes its way all the way down and into the stomach.

Question 6

Explain why cancers of the esophagus can spread so easily.

Answer 6

There is no serosa

Question 7

What is the difference between primary and secondary peristalsis?

Answer 7

Primary peristalsis happens when you swallow - swallowing triggers a peristaltic wave.

Secondary peristalsis happens if there is reflux back into the esophagus - this triggers a peristaltic contraction to get the stuff back into the stomach.

Question 8

Describe the various protective mechanisms that we have against GERD.

Answer 8

1. Salivary bicarb (very important!)
2. Peristalsis
3. Muscles of the diaphragm aid in keeping the LES closed
4. LES
5. Gravity

Question 9

What is the “most important factor” in the pathogenesis of GERD?

Answer 9

People that have GERD get more reflux of stomach acid during transient LES relaxations (tLESRs); the tLESRs do not happen more often than in people w/o GERD.

Question 10

Describe the relationship between hiatal hernias and GERD.

Answer 10

Hiatal hernias put people at a higher risk of developing GERD because the diaphragm no longer aligns with the LES to help out. Also, there is decreased intrathoracic pressure as compared to the abdomen, so stuff in the stomach pocket above the diaphragm is more likely to move upwards.

Question 11

What is the most likely cause of dysphagia of solid foods? What about liquids?

Answer 11

Dysphagia of solid foods = obstruction

Dysphagia of liquids = motility problem (neurologic)

Question 12

What most often causes odynophagia?

Answer 12

Esophageal ulceration - can be due to infection (herpes, CMV, candida, H. pylori) or pill esophagitis (swallow pill w/o drinking liquids, pill dissolves and ulcerates the mucosa)

Question 13

Name some risk factors for GERD.

Answer 13

Obesity
Pregnancy
Hiatal hernias
Conditions that decrease saliva production