Oral and Esophageal Physiology - Prunuske

Question 1

What is manometry?

Answer 1

Test to measure pressure n the GI tract

Question 2

What is xerostomia?

Answer 2

Dry mouth

Question 3

Scientific word for swallowing

Answer 3

xerostomia!

Question 4

What is the word for when your lower esophageal sphincter fails to relax.
Name a test that would clearly show this:

Answer 4

Achalasia

Manometry or barium swallow would show this pretty clearly

Question 5

Why does the ionic concentration of saliva depend on flow rate?

Answer 5

At fast flow rates saliva resembles plasma with higher HCO3.
At slow flow rates the duct cells actually have time to alter the ionic concentration. Duct cells are impermable to water but can pull more solutes out of the saliva solution.

Question 6

Walk me through how smelling a lemon in going to translate into increased salivary secretion in your parotid or submandibular gland.

Answer 6

Smell -> higher brain centers -> salivary nucleaus of the medulla -> parasympathetics -> otic ganglion parotid gland -> salivation

or

parasympathetics -> submandibular ganglion -> submandibular gland -> salivation

Question 7

What kind of saliva do parasympathetics vs sympathetics produce? What are the main mediators?

Answer 7

Parasympathetic - acts through VIP and ACh to secrete watery saliva

Sympathetic - acts though NE and Beta1/Alpha1 to secrete viscous saliva

Question 8

What exists in oral cavity secretions for digestion?

Answer 8

Lingual lipase - breaks down triglycerides

Salivary amylase - breaks down glycosidic linkages in starch (1,4)

Question 9

Causes of xerostomia?

Answer 9

xerostomia = dry mouth

• Sjogren syndrome (autoimmune disorder that destroys exocrine glands)
• Medications (muscarinic agonists, decongestants, antihistamines, etc)
• Head/Neck radiation
• Dehydration
• Sioalolithiasis (stone blockage of duct)
• Nerve damage (think diabetes)
• Post-menopausal hyposalivation

Question 10

Consequences of xerostomia?

Answer 10

• Opportunistic infections
• Halitosis
• Decreased oral pH causes tooth decay
• Decrease taste
• Speech problems
• Dysphagia -> poor nutrition

Question 11

In swallowing. What sensory info distal and proximal to the mouth that will cause primary peristalsis in the esophagus?
What are the chemical mediators that are acting?

Answer 11

Distention and changes in pH lead to contraction above and relaxation below the area where cahnges are sensed (usually where the bolus is located.

Contraction mediated by ACh
Relaxation mediated by NO/VIP

Question 12

What happens if a blous gets stick in the esophagus?

Answer 12

continued distention of acid int he esophagus from the obstruction causes a strong and powerful SECONDARY peristalsis just above the obstruction