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SA gastro-intestine > S4) Salivation and swallowing > Flashcards

S4) Salivation and swallowing Flashcards

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
Q

Describe the muscular changes in the oesophagus

A
  • First 1/3: skeletal muscle (voluntary control)
  • Middle 1/3: skeletal + smooth muscle
  • Last 1/3: smooth muscle (involuntary control)
26
Q

Identify 4 anatomical mechanisms which prevent gastro-oesophageal reflux

A
  • Lower oesophageal sphincter
  • Diaphragm
  • Mucosal ‘rosette’ at cardia
  • Acute angle of entry of oesophagus
27
Q

what course does the oesophagus take down

A
  • behind trachea and larynx
28
Q

what areas of the oesophagus is food most likely to get stuck

A
29
Q

what is mumps

A
  • inflammation of the parotid gland
  • can cause inflammation of the testies and the ovary
30
Q

what is parotid sialography

A
  • tube that contains dye gets inserted into the parotid gland
31
Q

stones in salivary glands presentation

A
  • pain when person salivates
  • goes own gradually
  • sometimes feel little bits of stones in the mouth passing through
32
Q

what problems can occur if swallowing goes wrong

A
  • can choke
  • food can get into nasal cavity → not sanitised and so can cause infection
33
Q

what imaging technique should you use

A

MRI

34
Q

Dsyphagia

A
  • tumour in the oesophagus
  • can’t have solids
35
Q

what is visceral pain?

what does it result from?

What does the pain feel like

A
  • pain that goes from internal organs
  • originates from:

– visceral stretching, inflammation and Ischaemia

  • poorly defined
  • nausea, vomiting
36
Q

sympathetic outflow

A
  • 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
Q

what level is the foregut and where will you consequently feel pain?

A

Greater (T5-9)N → Pain at the top of the abdomen

38
Q

what level is the foregut at and consequently where will you feel pain?

A

T10-T11 → pain here is found at umbilicus

39
Q

what level is the hindgut and consequently where will you feel pain?

A

T12 → suprapubic region very low down below belly button

40
Q

what are some conditions that can cause painful swallowing

A
  1. GORD
  2. Xerostomia: absent saliva flow, hard to chew swallow and speak
  3. Sialadenitis: inflammation of salivary gland
  4. Zenker’s diverticulum

SA gastro-intestine (19 decks)

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