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Physiology - GI > Mouth, Salivary Glands, Esophagus > Flashcards

Mouth, Salivary Glands, Esophagus Flashcards

1
Q

functions of chewing

A
  • reduces particle size of food (aids in swallowing and increases surface area for enzymes)
  • moves food in the oral cavity (stimulates taste smell receptors, promotes saliva secretion, CHO digestion starts)
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2
Q

how long should you chew soft foods v. hard foods

A

soft: 5-10x hard: 30x

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3
Q

saliva is a mixture of secretions from which glands and percentages from each

A
  • parotid (amylase - 25%)
  • sublingual (5%)
  • submandibular (mucous and serous glands - 70%)
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4
Q

what is amount of saliva we produce each day and its pH

A

1-2L/day with a pH of 7-8

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5
Q

salivation is increased by

A

sight and smell of food

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6
Q

saliva is a mixture of what secretions and what are each made up of

A
  • serous cell secretion - low glycoprotein, high amylase
  • mucous cell secretion - high mucin glycoprotein
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7
Q

enzymes in saliva

A

amylase and lipase

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8
Q

electrolytes in saliva

A

Na+, K+, Cl-, Ca2+, HCO3-, PO4-

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9
Q

other components of saliva

A
  • mucus
  • lysozyme (attack bacteria cell wall)
  • lactoferrin (chelates iron needed by bacteria for replication
  • IgA (kills bacteria)
  • epidermal factor growth (stimulates gastric mucosal growth)
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10
Q

condition of dry mouth

A

xerostomia

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11
Q

functions of saliva

A

lubricate, digest, and protect

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12
Q

how does saliva lubricate, digest, and protect

A
  • lubricate: moistens mouth, swallowing, speech, taste
  • digest: amylase – starch(75%) pH - alk, lipase-fat, ph-acid
  • protection: adverse effects of oral bacteria (lysozyme)
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13
Q

Describe the salivion schematic

A
  1. acinar cells secrete electrolytes
  2. myoepithelial cells - contract and propel saliva
  3. ductal cells - facilitate reabsorption and secretion
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14
Q

in mouth, site of secretion

A

acinus and duct

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15
Q

of the two secretion cells, which is leaky and which is tight

A

acinus is leaky and ducts are tight

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16
Q

primary secreted ion in the acinar cells

A

Cl- (main one), K+, and HCO3-

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17
Q

how does secretion work in the acinar cells

A
  • Cl is co transported with Na into the cell at the BLm
  • Electrochemical potential of Cl changes
  • Cl diffuses down the gradient
  • Channel allows HCO3 to enter
  • Na and H2O followparacellularly
  • because it is leaky and permeable to water, it is isotonic (H20 follows NaCl)
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18
Q

Describe how secretion works in the duct

A
  • active reabsorption of Na (main ion here)
  • Na/K ATPase pump on BL membrane determines ..extra K brought into the cell is actively secreted
  • anionic exchange: Cl is reabsorbed and HCO3- is secreted
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19
Q

characteristics of ductal cells

A
  • reabsorb NaCl while secreting KHCO3
  • tight so not permeable to water hence water can’t follow the NaCl
  • hence making saliva hypotonic, alkaline (HCO3-), and high K+
20
Q

how does salivary flow rate affect concentration of saliva

A
  • if slow salivary flow rate, then there is increased contact time
  • with increased contact time, there is more NaCl reabsorption and K+ secretion
  • makes saliva less concentrated so lower Na, Cl, and HCO3
  • but highest K concentration
  • so increase the flow then you increase the tonicity
21
Q

why does bicarb increase with increasing salivary rate

A

it is selectively stimulated when saliva secretion is stimulated

22
Q

what stimulates the salivary nucleus of the medulla oblangata

A

conditioned reflexes, smell, taste, tactile stimuli, nausea

23
Q

what decreases the stimulation of the salivary nucleus

A

sleep, fear, fatigue, dehydration, drugs like antihistamines

24
Q

what ANS controls salivary secretion

A

both parasympathetic and sympathetic but mainly parasympathetic

25
Q

what does activating the salivary gland cause

A

secretion, vasodilation, myoepithelial contraction

26
Q

difference in resting state salivary secretion and stimulated gland secretion

A

resting: 30ml/hr
stimulated: 400ml/hr

27
Q

difference in agonists that release calcium (parasymp) and agonists that increase cAMP (symp)

A
  • agonists that release calcium: greater effect on volume of secretion
  • agonist that elevate cAMP - increase enyzmes and mucous content
28
Q

explain the pic

A

self explanatory

29
Q

difference between the upper and lower part of the esophagus

A
  • upper part of the esophagus is UES (upper esophageal sphincter) and is made up of striated muscle and is voluntary
  • lower part of the esophagus is LES (lower esophageal sphincter) and is made up of smooth muscle and is involuntary
30
Q

describe the voluntary component of swallowing (deglutition)

A
  • there is the oral phase
  • food is shaped into a bolus then collected on the tongue and pushed into pharynx
  • tongue is raised onto the hard palate creating a pressure gradient that forces the food into the pharynx
31
Q

define the involuntary component of swallowing

A
  • pharyngeal phase (2 sec) and esophageal phase (8-10 sec)
  • stim of epithelial swallowing center in pharynx
  • swallowing reflex
  • peristalic waves
32
Q

origin of the primary vs. secondary peristaltic wave

A
  • primary: arises from the act of swallowing in absence or presence of food and is voluntary
  • secondary: occurs from distension of the esophagus and is involuntary and has low pH
33
Q

what is UES

A

thickening of the striated muscle

34
Q

what is LES

A
  • terminal 1-2cm of the esophagus
  • define more functionally than anatomically
  • smooth muscle
35
Q

what does UES and LES have to do to allow food to enter

A

they have to relax

36
Q

needed for motility

A

ENS and the vagus

37
Q

needed for contraction and relaxation

A

contraction - acetylcholine

relaxation - nitric oxide

38
Q

difficulty initiating swallowing with coughing and choking

A

oropharyngeal dysphagia

39
Q

causes of oropharyngeal dysphagia

A

anatomic, neurologic, motor, or UES abnormalities

40
Q

food stopping or sticking on swallowing

A

esophageal dysphagia

41
Q

esophageal dysphagia - solid foods are worse than liquids is what type of problem

A

mechanical obstruction

42
Q

esophageal disorder - solids and liquids are both of equal problem is what type of problem

A

motility disorder

43
Q

causes of mechanical obstruction in esophageal dysphagia

A

peptic stricture, lower esophageal ring, oesphageal cancer, GERD

44
Q

causes of motility disorder in esophageal dysphagia

A

esophageal spasm, scleroderma, achalasia (initially)

45
Q

A 17 years old female ingests malathion. what ionic change to the composition of her saliva would you see?

A

malathion is an anticholinesterase which will increase acetylcholine in cleft hence increasing parasympathetic activity which would increase salivation rate – increase in salivary rate leads to increased sodium conc, increased HCO3, increased chloride, increased osmolarity, decreased K

decreased contact time so sodium reabsorption decreases

Physiology - GI (6 decks)

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