Rao 4 - Salivary Secretions Flashcards

1
Q

What are the 3 primary functions of salivary secretions?

A
  1. Lubrication
  2. Protects
  3. Digestion
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2
Q

What are the protective functions of Saliva?

A
  1. HCO3- neutralizes any acid washed up by the stomach
  2. Washes out pepsin and acid
  3. Antibiotic action with Lysozyme, Lactoferrin, and IgA
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3
Q

What role does saliva play in digestion?

A

1. alpha-Amylase degrades 70% of starch before it is inactivated

2. Salivary Lipase is also present with hydrolysis beginning in the stomach and remains active throughout the entire GI tract
**
Not affected by Bile Salts, Fatty Acids, or Lecithin**

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4
Q

How much saliva is secreted by the salivary glands each day?

A

1 L per day is excreted, this is the highest secretion per unit weight in the entire GI tract

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5
Q

What are the 3 primary Salivary Glands?
• How much does each gland contribute to the total amount of secretions?

A

25% of secretions:
Parotid

75% of secretions:
Submandibular
Sublingual

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6
Q

What type of secretions come from the parotid gland?
• What is contained in these secretions?

A

Parotid = SEROUS GLAND

Serous Secretions = H2O, ion, and Enzymes
Enzymes = Amylase, Lipase, Lactoferrin, Lysozyme

**Note: High Protein production means lots of ER and Protein containing granules in the cytoplasm

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7
Q

How do mucinous cells appear?
• what is secreted from them?

A

Mucinous cells appear like goblet cells
• Fluid Secreted contains Mucin and Glycoproteins

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8
Q

What are the 3 parts to the Salivary Gland?

A

Acinus, Intercalated Duct, and Striated Duct
• These are surrounded by myoepithelial cells

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9
Q

How does the initial solution secreted by Acinar Cells change as it moves from acinus to striated duct?
• How are Na, Cl, HCO3, and K affected?

A

As fluid moves from the acinus to the striated duct the fluid goes from **ISOosmolar to HYPOosmolar

there is a net ABSORPTION of Na/Cl back into the ducts and net SECRETION of HCO3-, K+ also increases**

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10
Q

What is the effect of Sympathetic, Parasympathetic, and Hormonal Stimuli on salivary gland excretion?

A

BOTH Sympathetic (minor) and Parasympathetic (major) increase secretions from the salivary glands

Hormones have NO effect on salivary gland secretions

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11
Q

What are the products of alpha amylase working on startch?

A

Maltose
Maltriose
Limit Dextrans

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12
Q

Describe the blood flow across the salivary gland.

A

Blood is supplied from vessels branching off of the external carotid that flow in the OPPOSITE direction as saliva.

1st: Capillary Bed surrounding the Striated and Intercalated Ducts is hit
2nd: Blood travels through PORTAL vessels to…
3rd: A second capillary bed surrounding the Acinus is supplied

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13
Q

What is the primary ion in Acinar Transport?
• Ductal Transport?
• Are these ions absorbed or excreted?

A

Acinar transport centers around the SECRETION of Cl- by NKATPase (Ouabain) dependent mechanisms

Ductal transport centers around ABSORPTION of Na+ by NKATPase (Ouabain) dependent mechanisms

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14
Q

What channels and transporters are located on the basal side of Acinar Cells?
• Which are most important to assuring that Cl- get exported from the cell?

A
  1. Na/K/2Cl cotransporter - increases intracellular Cl- to push it through to the lumen
    **Inhibition of this channel leads to a 65% reduction in salivary excretions
  2. Na/H Exchanger - allows for H+ efflux so that Carbonic Anhydrase can continue to produce H+ and HCO3 to operate the HCO3/Cl exchanger and increase Cl- concetration in the cell
    **Inhibition of this channel leads to a 35% reduction in salivary excretions
  3. HCO3/Cl Exchanger - imports Cl- to increas intracellular Cl-
  4. Na/K ATPase - this is what makes the entire process of Cl- transport ACTIVE, because Na+ gradient is required for steps 1. and 2.
  5. K+ channel allows K+ OUT of the cell (down its gradient) so that Na/K ATPase can continue to run
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15
Q

What channels and transporters are located on the Apical side of Acinar Cells?
• Which are most important to assuring that Cl- get exported from the cell?

A
  1. Cl and HCO3- channels allow passive diffusion out of the cell into gland lumen
  2. Cl- Channel - allows Cl- to flow by itself down electrochemical gradient
  3. AQP5 - allows for equilibration of H2O between cell and lumen (what leads to the acinar secretions being isotonic)
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16
Q

What molecules are allowed to move paracellularly in the acinar cells?

A

H20

Na+ via Cldn2

17
Q

What channels and transporters are located on the Basal side of Ductal Cells?
• Which are most important to assuring that Na+ get imported into the cell and into the blood?

A
  1. N/K ATPase exports Na+ from the cell into the blood - makes the process Ouabain dependent
  2. Na/HCO3 Exchanger imports HCO3- by letting Na+ flow into the cell down its gradient
  3. Cl- channel allows Cl- to re-enter the blood
18
Q

What channels and transporters are located on the Apical side of Ductal Cells?
• Which are most important to assuring that Na+ get imported into the cell and into the blood?

A
  1. CFTR - cAMP activated HCO3 exporter puts HCO3 into the lumen of the striated duct
  2. HCO3/Cl exhanger - pulls Cl- back into the cell and pushes HCO3- into the salivary secretions
  3. Cl Channel - allows Cl- to flow back into the ductal cell and into the blood down its concentration gradient

4/5. K+ and Na+ channels are ALDOSTERONE regulated and allow for K+ and Na+ to flow back down their gradients (so that K+ EXITS the cell into saliva and Na is absorbed into the cell and blood)

19
Q

What molecule can travel paracellularly between Ductal Cells?

20
Q

How does the composition of Saliva change with flow rate?
• What are the primary components?
• Explain this change.

A

Low Flow Rate:
• K+ is High, Na and Cl are Low, and HCO3- is relatively same
**This occurs because K+ has more time to leak out of aldosterone dependent K channels; Cl- is absorbed into Ductal Cells in Exchange for HCO3-; Na+ has more time to flow DOWN its gradient and leak INTO cells via aldosterone dependent Na channels

High Flow Rate:
• K+ is slightly lower, Na+ and Cl- are high, and HCO3- is relatively the same
***This occurs because there is little contact with the ductal cells that are responsible for changing the electrolyte composition as shown above

21
Q

What are the two broad functions of sympathetic and parasympathetic stimulation that lead to increased salivary secretions?

A
  • *1. Myoepithelial Contraction
    2. Regulating Blood Flow**
22
Q

What stimuli increase and decrease the parasympathetic stimulation of salivation?

A

Increase Parasympathetic Response:
• Conditioned Responses: Food, Nausea, Smell

Decreased Parasympathetic Response:
• Dehydration, Fear, Sleep

23
Q

What preganglionic nerves carry efferent information from central stimuli?

A

CN VII - Facial n.
CN IX - Glossopharyngeal

24
Q

How does parasympathetic stimulation lead to vasodilation to increase salivary output?

A

Ach acts to increase vasodilation (don’t know how? maybe M3 stimulated cGMP creation)

Increased Cellular metabolism as a result of Ach stimulation leads to Kallikrien release that cleaves Kininogen to Bradykin which acts as a vasodilator

25
Note: Remeber that the sympathetic and parasympathetic fibers must 1st synapse before they use POSTganglionic fibers to carry out actions
26
What cascade is set off by Ach acting on M receptors? • what are the downstream effects?
* *M receptor stimulation leads to Gq (IP3/Ca2+) cascade that leads to:** 1. Increased Myoepithelial Cell Contraction 2. Increased Blood Flow 3. Increased Metabolism 4. Increased Kallikrein 5. Salivary Gland Growth
27
Where do the parasympathetic pre-ganglionics that trigger salivation located?
**T1-T3 =\> Superior Cervical Ganglia**
28
What receptors are stimulated by the Sympathetic Nervous system? • What is the effect on salivation?
**Beta Receptors** are stimuated leading to **cAMP increase** via Gs cascade that causes **myoepithelial cell contraction** (via phoshorylation of MLCK etc) and Excretion of Saliva **Alpha-Receptors** are stimulated leading to Gq cascade via alpha 1 receptors that Reduce Blood flow via **vasocontriction**
29
Explain the Biphasic increase in salivation with sympathetic stimulation. • How does this change with alpha blockers?
This is caused by vasoconstriction (alpha agonism) followed by myoepithelial contraction (beta agonism) via NE Blocking alpha receptors leads to the effect seen in the solid line
30