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DIG > MOUTH AND OESOPHAGUS > Flashcards

MOUTH AND OESOPHAGUS Flashcards

1
Q

How many salivary glands are there and what are they called?

A
  • Parotid gland
  • Submandibular gland
  • Sublingual gland
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2
Q

What action does the tongue do?

A

Pushes bolus of food to back of the mouth and also has sensory receptors to detect food

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3
Q

What is mastication and it’s importance?

A
  • Mastication is chewing food and breaking it down to increase it’s SA:V ratio
  • The purpose of this is so that there is more area for enzymes to work on and for absorption to take place
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4
Q

What does saliva do to the bolus of food?

A

Saliva lubricates food before swallowing

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5
Q

What type of cells are found in the salivary glands and what do they produce?

A
  • Acinar cells - produce proteins and enzymes
  • Ductal cells - secrete water and electrolytes
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6
Q

What is the volume of saliva that is produced by the salivary glands in 24 hrs

A

1.5 L

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7
Q

What type of saliva does each gland produce?

A
  • Parotid - water
  • Submandibular - viscous
  • Sublingual - viscous
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8
Q

Which type of cells produce mucous ?

A

Goblet cells

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9
Q

What 3 substances does saliva produce for its immune function?

A
  • IgA - IgA antibodies bind to pathogenic antigens
  • Lactoferrin - binds iron and is bactericidal
  • Lysozyme - attacks bacterial cell wall = cell lysis
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10
Q

How is the secretion of acinar cells modified?

A

Modified by salivary duct cells which makes saliva hypotonic and alkaline

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11
Q

Why is it important that saliva is alkaline?

A
  • It protects the teeth from bacterial acid
  • Neutralises gastric acid that refluxes into the oesophagus
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12
Q

What is sjorgren’s syndrome

A

An autoimmune attack of salivary and tear glands which results in dry mouth and eyes. It is associated with rheumatoid arthritis and commonly affects women

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13
Q

What is another name for mumps?

A
  • Parotitis
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14
Q

What is the parasympathetic innervation of the submandibular gland and what does stimulation lead to?

A
  • Facial nerve CN VII
  • Stimulation results in secretion
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15
Q

What is the parasympathetic innervation of the sublingual gland and what does stimulation lead to?

A
  • Facial nerve - CN VII
  • Stimulation results in secretion
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16
Q

What is the parasympathetic innervation of the parotid gland and what does stimulation lead to?

A
  • Glossopharyngeal nerve CNXI
  • Stimulation results in secretion
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17
Q

What is the sympathetic innervation of the salivary gland and what does stimulation lead to?

A
  • Thoracic sympathetics in the superior cervical ganglion
  • Stimulation results in vasoconstriction and thick mucous secretion
18
Q

What are the 4 phases to swallowing?

A
  • Oral preparatory phase
  • Oral phase
  • Pharyngeal phase
  • Oesophageal phase
19
Q

What happens in oral preparatory phase?

A

Food is masticated (chewed) to reduce it to a consistency that can be swallowed

20
Q

What happens in the oral phase?

A

The tongue properly food posteriorly until the pharyngeal swallow is triggered

21
Q

When does the pharyngeal swallow occur?

A

When food gets to the back of the mouth in the oral phase

22
Q

What happens in the pharyngeal phase?

A

Once the pharyngeal swallow is triggered, the bolus is transported through the pharynx

23
Q

What 3 things occur in the pharyngeal phase so that the bolus can be transported through the pharynx?

A
  • Closure of the glottis via the the movement of the epiglottis
  • Cessation of breathing
  • Relaxation of the upper oesophageal sphincter
24
Q

What happens in the oesophageal phase

A

The bolus moves via oesophageal peristalsis from the upper oesophageal sphincter through the oesophagus to the lower oesophageal sphincter

25
Q

Where does the oesophagus start and end?

A

Starts in the thorax and ends in the oesophageal hiatus which is the hole in the diagram.

26
Q

What type of muscle is found in the upper third of the oesophagus, middle third and lower third?

A
  • Upper = striated muscle
  • Middle = striated and smooth
  • Lower = smooth muscle
27
Q

What is GORD?

A

Chronic symptoms or mucosal damage produced by the abdominal reflux in the oesophagus. Acid reflux occurs multiple times a day every day

28
Q

What are 3 causes of GORD?

A

-

29
Q

What are 3 causes of GORD?

A
  • Obesity - this impacts intra abdominal pressure
  • Hiatus hernia
  • Zollinger Ellison syndrome
30
Q

What are 4 symptoms of GORD?

A
  • Heartburn
  • Regurgitation
  • Dysphagia
  • Cough
  • Hoarseness
31
Q

What are 4 outcomes of GORD

A
  • Oesophagitis
  • Stricture
  • Barett’s metaplasia
  • Oesophageal adenocarcinoma
32
Q

How to diagnose GORD?

A
  • 24 hour pH monitoring that defines reflux by seeing if there is acid
  • Contrast swallow
33
Q

What are the 3 types of treatment for GORD?

A
  • Conservative
  • Medical
  • Surgical
34
Q

What are the 3 types of treatment for GORD?

A
  • Conservative
  • Medical
  • Surgical
35
Q

What does conservative treatment include?

A
  • Weight loss
  • Avoid food and alcohol before going to bed
  • Reduce alcohol
  • Raise bed by around 30cm
36
Q

What does medical treatment include?

A

Decrease acid using:
- Proton pump inhibitors
- Antacids which increase pH
- H2 blockers
- Alginates (Gaviscon)

37
Q

What does surgical treatment include?

A

Anti reflux surgery which tightens the gastro oesophageal sphincter so you’re less likely to leak acid up into the oesophagus

38
Q

Explain what happens to cells in Barents

A

They go from normal stratified squamous epithelium to single columnar epithelium

39
Q

Give the difference between squamous cell carcinoma and Adenocarcinoma

A

Squamous cell carcinomas don’t tend to occur as the oesophageal sphincter whereas adenocarcinomas mostly occur at the oesophageal sphincter

40
Q

What is achalasia?

A

Very tight gastro oesophageal sphincter that doesn’t relax because there is a loss of the myenteric plexus at the lower oesophageal sphincter

41
Q

What are 3 possible treatments for achalasia?

A
  • Botox injection at lower oesophageal sphincter
  • Oesophageal dilation
  • Surgery - Hellers myotomy

DIG (6 decks)

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