S4) Salivation and swallowing Flashcards

(40 cards)

1
Q

Identify 5 components of saliva

A
  • Mostly water
  • Mucins → lubrication
  • Amylase
  • Lingual lipase
  • Immune proteins e.g. IgA, lysozyme, lactoferrin
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2
Q

In terms of osmolarity, what sort of fluid is saliva?

A

Hypotonic

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3
Q

Which ions are found in high concentration in saliva?

A
  • Potassium ions
  • Bicarbonate ions
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4
Q

What is the role of mucins in saliva?

A

Mucins help with lubrication

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5
Q

Where are the following enzymes secreted from:

  • Amylase
  • Lipase
A
  • Amylase – secreted by salivary glands
  • Lipase – secreted by lingual glands
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6
Q

Identify 5 functions of saliva

A
  • Lubricates mouth (maintains moisture) to help with speech
  • Begins chemical digestion

– chewing

  • Assists swallowing
  • Allows tongue to taste food (solvent effect)
  • Protects teeth

– can transmit disease

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7
Q

What is xerostomia?

A
  • Xerostomia is the dryness of the mouth due to a change in the composition of saliva or reduced saliva in the mouth
  • It is associated with dehydration
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8
Q

What are the 3 salivary glands in the body?

A
  • Sublingual glands
  • Submandibular glands
  • Parotid glands
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9
Q

Describe the location and function of the parotid gland

A
  • Location: each parotid is wrapped around the mandibular ramus
  • Function: secretes serous saliva through the parotid duct into the mouth
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10
Q

Where are the sublingual glands located?

A

The sublingual glands lie directly under the mucous membrane covering the floor of the mouth beneath the tongue

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11
Q

Where are the submandibular glands located?

A

The submandibular glands lie near the inner side of the lower jawbone, in front of the sternocleidomastoid muscle

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12
Q

Describe the regulation of salivary secretion

A
  • Driven by parasympathetic nervous system as it increases production of saliva
  • Sympathetic nervous system also stimulates secretion of small amounts of saliva and causes vasoconstriction
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13
Q

Describe the neural control of the submandibular and sublingual glands

A

Submandibular and sublingual glands are supplied by the parasympathetic nervous system through the facial nerve (7th)

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14
Q

Describe the neural control of the parotid glands

A

Parotid glands are supplied by the parasympathetic nervous system through the glossopharyngeal nerve (9th)

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15
Q

Which drugs might have dry mouth as a side effect?

A

Drugs which target muscarinic ACh receptors

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16
Q

Identify and describe the 3 different stages in swallowing

A
  • Oral preparatory phase (voluntary)
  • Pharyngeal phase (involuntary)
  • Oesophageal phase (involuntary)
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17
Q

What occurs in the oral preparatory phase of swallowing?

A

– voluntary

  • Bolus is pushed towards pharynx
  • Once bolus touches pharyngeal wall, the next phase begins
18
Q

Describe the 5 events which occur in the pharyngeal phase of swallowing

A

→ involuntary

⇒ Soft palate seals off nasopharynx → so food doesn’t enter the nasal cavity

⇒ Pharyngeal constrictors push bolus down

⇒ Larynx elevates and moves forward, closed by epiglottis

⇒ Vocal cords adduct protecting the airways

⇒ Upper oesophageal sphincter opens

19
Q

Why do the vocal cords adduct during the pharyngeal phase?

A
  • Protect airway
  • Breathing temporarily ceases
20
Q

What occurs in the oesophageal phase of swallowing?

A

– involuntary

  • Closure of the upper oesophageal sphincter
  • Peristaltic wave carries bolus downwards into oesophagus
21
Q

If swallowing closes the airway and inhibits breathing, how are long periods of breast feeding possible?

A

Infants have a higher epiglottis which allows them to breath and swallow simultaneously

22
Q

Decscribe the neural control of the gag reflex

A

Mechanoreceptors detect food at the back of the throat→ Glossopharyngeal nerve → Medulla → Vagus nerve → Pharyngeal constrictors

23
Q

How does the gag reflex vary with age?

A

Infants have a more anterior gag reflex

24
Q

Why does dysphagia occur with a stroke?

A

Damage to the nerves and muscles which cause a stroke also involve damage to the nerves and muscles which control swallowing

25
Describe the muscular changes in the oesophagus
- **First 1/3**: skeletal muscle (voluntary control) - **Middle 1/3**: skeletal + smooth muscle - **Last 1/3:** smooth muscle (involuntary control)
26
Identify 4 anatomical mechanisms which prevent gastro-oesophageal reflux
- Lower oesophageal sphincter - Diaphragm - Mucosal ‘rosette’ at cardia - Acute angle of entry of oesophagus
27
what course does the oesophagus take down
* behind trachea and larynx
28
what areas of the oesophagus is food most likely to get stuck
29
what is mumps
* inflammation of the parotid gland * can cause inflammation of the testies and the ovary
30
what is parotid sialography
* tube that contains dye gets inserted into the parotid gland
31
stones in salivary glands presentation
* pain when person salivates * goes own gradually * sometimes feel little bits of stones in the mouth passing through
32
what problems can occur if swallowing goes wrong
* can choke * food can get into nasal cavity → not sanitised and so can cause infection
33
what imaging technique should you use
MRI
34
Dsyphagia
* tumour in the oesophagus * can't have solids
35
what is visceral pain? what does it result from? What does the pain feel like
* pain that goes from internal organs * originates from: – visceral stretching, inflammation and Ischaemia * poorly defined * nausea, vomiting
36
sympathetic outflow
* T5-L2 (preganglionic) pass through sympathetic trunk without synapsing * form presynaptic splanchnic nerves * synapse with pre vertebral ganglia * extends to viscera * innervate blood vessels
37
what level is the foregut and where will you consequently feel pain?
Greater (T5-9)N → Pain at the top of the abdomen
38
what level is the foregut at and consequently where will you feel pain?
T10-T11 → pain here is found at umbilicus
39
what level is the hindgut and consequently where will you feel pain?
T12 → suprapubic region very low down below belly button
40
what are some conditions that can cause painful swallowing
1. GORD 2. Xerostomia: absent saliva flow, hard to chew swallow and speak 3. Sialadenitis: inflammation of salivary gland 4. Zenker's diverticulum