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Medical Physiology > Saliva Secretions > Flashcards

Saliva Secretions Flashcards

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USMLE® Step 1 flashcards
1
Q

what GI components produce secretions?

A

salivary glands gastric mucosa pancreatic exocrine cells liver

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2
Q

how much saliva is secreted into the mouth per day

A

1L/day

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3
Q

what are the functions of saliva

A
  1. mucus for lubrication 2. enzymes for initial digestion of lipids and starches 3. dilution and buffering of ingested foods
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4
Q

what comprises parotid gland

A

serous glands secrete water, ions, and enzymes

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5
Q

what comprises submandibular gland

A

serous and mucous glands secrete water and mucin glycoproteins

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6
Q

what comprises the sublingual gland

A

serous and mucous glands (mostly mucous) secrete water and mucin glycoproteins

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7
Q

what leads to the ejection of saliva into the mouth?

A

neural stimulation of myoepithelial cells present in acini and intercalated ducts

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8
Q

what neural stimulation stimulates ejection of saliva?

A

predominantly parasympathetic but both SNS and PSNS

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9
Q

what part of salivary gland actually makes the secretions

A

acini

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10
Q

what do the intercalated and striated ducts do

A

chemically modify the electrolyte composition in response to the need at the time (rate and amount)

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11
Q

what impact does SNS activation have on salivary gland blood flow?

A

causes vasoconstriction to shut down blood flow and decrease secretion

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12
Q

what impact does PSNS activation have on salivary gland blood flow?

A

causes vasodilation to increase blood flow and secretion

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13
Q

what occurs in high salivary demand?

A

Kallikrein is released to activate bradykinin, which causes vasodilation

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14
Q

what substance is crucial in increasing secretions?

A

bradykinin (vasodilates)

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15
Q

arterial blood supply to parotid gland

A

branches of external carotid artery

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16
Q

arterial blood supply to submandibular gland

A

branches of facial and lingual artery

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17
Q

arterial blood supply to sublingual gland

A

sublingual and submental artery

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18
Q

innervation of parotid gland

A

glossopharyngeal hitches ride to V3 to otic ganglion then to parotid

19
Q

innervation of submandibular gland

A

chorda tympani

20
Q

innervation of sublingual gland

A

chorda tympani

21
Q

describe saliva composition

A

is hypotonic thanks to luminal antiports but is NOT an ultrafiltrate of blood (is formed de novo)

22
Q

what does saliva have in it

A

more K than blood more HCO3 than blood less Na than blood less Cl than blood

23
Q

how is saliva formed

A
  1. formation of isotonic plasma like solution by acinar cells 2. modification of this solution by ductal cells
24
Q

how is solution modified by ductal cells?

A

the serosal Na/K ATPase creates a Na gradient where Na is low inside the cell. Na then follows its concentration gradient by being resorbed from luminal primary saliva. leads to less Na in the saliva.

25
Q

what luminal ductal transporters are in ductal cells?

A
  1. Na/H antiport
  2. Cl/HCO3 antiport
  3. H/K antiport
26
Q

what other substances do acinar cells secrete

A
  1. alpha amylase
  2. lingual lipase
  3. mucin glycoproteins
  4. IgA
  5. Kallikrein
27
Q

what does kallikrein secretion do

A

converts kininogen to bradykinin to produce vasodilation and increased salivary blood flow during periods fo increased saliva demand

28
Q

describe saliva composition during flow saliva flow rates (less than 1mL per min)

A

hypotonic to blood plasma

29
Q

describe saliva composition during high saliva flow rates (4mL/min)

A

is isotonic to blood plasma

more Cl and Na present

30
Q

what is saliva compositon proportional to?

A

amount of exposure time to ductal cells

more time exposed to ductal cells, more hypotonic, less time, more isotonic

31
Q

how is saliva secretion unique to the rest of GI secretions?

A

it is under sole control of ANS. no endocrine regulation.

both PSNS and SNS stimulate salivary secretion.

32
Q

how does the sympathetic nervous system stimulate salivary secretion??

A

T1-T3 (mainly T2) stimulates NE release and binding to beta adrenergic receptors. this increases cAMP release to increase saliva.

basically NE binding to beta adrenergic receptors increases cAMP to increase saliva

33
Q

what triggers the PSNS to increase saliva?

A

conditioning

food

nausea

smell

34
Q

what inhibits PSNS saliva release?

A

dehydration

fear

sleep

35
Q

how does PSNS increase saliva release?

A

facial nerve and glossopharyngeal nerves release Ach to bind muscarinic receptors. binding of Ach increases IP3 to increase Ca to increase saliva.

36
Q

what is different between PSNS and SNS innervation of salivary glands

A

parasympathetic has singular innervation, meaning the innervation comes from the same nerve root, just has a branch to blood vessel and gland.

sympathetic has dual innervation, meaning there are 2 separate innervations to the blood vessel and gland.

37
Q

what duct provides most of saliva?

A

submandibular gland at 70%

38
Q

how much saliva does the parotid gland contribute? and sublingual?

A

20%

5%

39
Q

how does PSNS innervate parotid gland

A

directly via glossopharyngeal nerve

40
Q

how does SNS innervate parotid gland

A

indirectly via superior cervical ganglion where beta adrenergic receptor NE binding increases cAMP to stimulate secretion

41
Q

how does PSNS innervate sublingual and submandibular glands

A

facial nerve via Ach and substance P secretion to increase IP3 and Ca release

42
Q

how is saliva secreted from sublingual gland?

A

mucoid saliva exits directly from 8-20 excretory Rivinus ducts

43
Q

how is saliva secreted from submandibular glands?

A

serous fluid with alpha amylase and mucus is secreted via submandibular gland to mouth

44
Q
A

Medical Physiology (21 decks)

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