Salivary function 1 & 2 Flashcards
1
Q
Type II diabetes causes a _____ in Angiotensin II and a ____ in BP
A
increase, increase
2
Q
how do ACE inhibitors work?
A
Angiotensin I can’t be transformed into angiotensin II if the enzyme (ACE) is inhibited, which in turn lowers Vasoconstriction and BP
3
Q
what are some of the major functions of saliva?
A
- Washing away pathogens, lubrication, swallowing, tongue movement, speech
- Digestion
- Solvent action
- Anti-microbial/viral/fungus actions to prevent disease
- Agglutination
- Buffering action
- Remineralization
- Pellicle formation
- Temperature regulation
- Production of growth factors
4
Q
what are the two enzymes that aid in digestion in saliva?
A
α-amylase
Lingual lipase
5
Q
what does α-amylase help digest? how does it work?
A
-important for digestion of starches, can enhance salivary flow by releasing sweet tasting glucose/maltose from starches
-Breaks α-1,4,glycosidic bonds but NOT α-1,6-glycosidic bonds
6
Q
what is shown in Stephan’s curve?
A
After sucrose rinse, pH drops below 5.5 and slowly returns to normal
7
Q
what are some symptoms of Xerostoia?
A
Oral Pain
Dysphagia
Reduced taste and olfactory sensation
Burning mouth sensation
Opportunity for infections/caries
8
Q
_________ is a swallowing problem leading to diet changes and possible malnutrition
A
Dysphagia
9
Q
what are some possible causes of Xerstomia?
A
Cystic fibrosis
Sjorgens syndrome
Diabetes
Many medications
Radiation and other therapies for head and neck cancers
10
Q
what are the different types of salivary glands in the body?
A
Parotid gland
Submandibular gland
Sublingual gland
Minor salivary glands
11
Q
what is the histological type and secretion type for the parotid gland?
A
Histological type: Serous
Secretion: Watery
12
Q
what is the histological type and secretion type for the Submandibular gland?
A
Histological type: Mixed
Secretion: Moderately viscous
13
Q
what is the histological type and secretion type for the Sublingual gland?
A
Histological type: Mixed but mostly Mucous
Secretion: viscous
14
Q
which gland has the most secretion?
A
Submandibular
15
Q
what are the other names for these glands?
1. Parotid
2. Submandibular
3. Sublingual
A
- Stensen’s
- Wharton’s
- Bartholin’s and Rivinus ducts
16
Q
Mixed glands = ___% serous, ___% Mucous
A
90%, 10%
17
Q
Mucous glands = _____% mucous, _____% serous
A
66.6%, 33.3%
18
Q
there are around _______ minor salivary glands and they ______ (ARE/AREN’T) regulated by neurons
A
600-1,000, are NOT
19
Q
what do minor salivary glands secrete? (3 things)
A
70% salivary mucins
IgA
Lipase
20
Q
IgA comes from _______ while Lipase comes from ______
A
-Plasma B cells
-lingual von Ebner’s gland
21
Q
what is salivary secretion mainly controlled by?
A
oral/facial afferent/efferent reflex control
22
Q
Efferent pathways for salivary secretion are by ________ (SNS or PSNS?)
A
BOTH SNS and PSNS
23
Q
Afferents can travel with ________ (SNS or PSNS?)
A
BOTH
24
Q
Up to ______% of the fibers that travel with the PSNS are afferent, while up to ________% of the fibers that travel with the SNS are afferent
A
90%
50%
25
what is the pathway for the parasympathetic efferent innervation to the parotid gland?
Medulla (INF salivary nucleus) → Otic ganglion → Parotid gland
26
what are the nerves that are along the Parasympathetic efferent innervation for the Parotid gland?
CN IX → Auriculotemporal n.
27
which nucleus is used to start the PSNS efferent innervation pathway for the parotid gland? Where does it come from?
INFERIOR salivary nucleus, Medulla
28
for the PSNS efferent to the parotid gland, what are the neurotransmitters released from the pre and postganglionic neuron?
Pre: Ach to Nicotinic
Post: Ach to M1, M3 muscarinic
29
what is the pathway for the parasympathetic efferent innervation to the Submandibular/lingual glands?
Pons (SUPERIOR salivary nuc) → Submandibular ganglion → submandibular/lingual glands
30
what are the nerves that are along the Parasympathetic efferent innervation for the submandibular/lingual glands?
CN VII → Lingual n.
31
which nucleus is used to start the PSNS efferent innervation pathway for the submandibular/lingual glands? Where does it come from?
SUPERIOR salivary nucleus, Pons
32
for the PSNS efferent to the submandibular/lingual gland, what are the neurotransmitters released from the pre and postganglionic neuron?
Pre: Ach, nicotinic
Post: Ach, M1, M3 Muscarinic
33
what is the path that Sympathetic NS efferent neurons take to reach the Parotid/submandibular/sublingual glands?
Thoracic nerves → Superior cervical ganglion → arterial blood supply → glands
34
for the SNS efferent to the parotid/submandibular/lingual gland, what are the neurotransmitters released from the pre and postganglionic neuron?
Pre: Ach to Nicotinic
Post: NE to B1
35
What drugs can be used to try to heighten salivary secretion? which Muscarinic receptor do they effect?
Pilocarpine (M3)
Cevimeline (M1, M3)
36
what do serous cells secrete?
ions, H2O, amylase proteins, others
37
what do mucous cells secrete?
mucin
38
what does a striated duct look like histologically?
infolded mitochondria/membrane gives the appearance of striations
39
what does it mean if a striated duct has a lot of mitochondria?
they do a lot of transport!
Need many mitochondria to make ATP for active transport
40
what are the parts of a salivary serous gland? and what are these parts made of?
- Excretory duct (interlobular, simple columnar)
- Striated duct (simple columnar)
- intercalated duct (simple cuboidal)
-Acinar pyramidal shaped epi cells at the very end
41
what are the PSNS and SNS neurotransmitters to Acinar cells?
Parasympathetic: Ach → M1, M3
Sympathetic: NE → α, B1 (mainly B1
42
what are the PSNS and SNS neurotransmitters to Myoepithelial cells?
Parasympathetic: Ach → M1, M3
Sympathetic: NE → α
43
______________ cells are octopus like structure and provide structural support, force saliva out of ducts
Myoepithelial
44
what is the composition of salivary gland secretion?
Water (99%)
Electrolytes (Na+, Cl-, K+, HCO3-)
Proteins
Glycoproteins (mucins)
Other
45
T/F: whole saliva is very similar to its secreted products
FALSE!
- whole saliva is much different in composition than the secreted products bc it also contains components of gingival crevicular fluid (including some hormones, desquamated epithelial cells, nasal secretions, bacteria and its products, viruses, fungi, and other items
46
How do all the electrolytes and water get into the interstitial space ?
Hydrostatic pressure, diffusion/transport
47
How do all the electrolytes and water get across acinar cells in lumen?
Active transport, following electrical gradients, and simple diffusion including osmosis
48
what type of system surrounds the ducts and acinar cells?
portal type capillary system
49
If duct pressure > systolic BP → saliva movement is caused by _________?
Active secretion mechanism and NOT by hydrostatic BP
50
what are the two types of mucous secretions? what are the different functions they have?
1. MG1: coat hard and soft tissues
2. MG2: clump bacteria together
51
what are some examples of the proteins/glycoproteins that are secreted mainly by ACINAR cells?
Mucous
Growth Factors
Immunoglobulins
DIgestive enzymes
Kallikrein
52
what are the 2 types of growth factors?
Nerve Growth Factor (NGF)
Epidermal Growth Factor (EGF)
53
_____________ is found in salivary secretion of submandibular gland and also produced by other organs
Nerve Growth Factor
54
what is the function of NGF in saliva?
wound healing
55
what are some of the functions of EGF?
-Wound healing in oral cavity
-Aids in healing stomach ulcers
-Maintains ileal mucosa
-Role in liver regeneration
-Stomach dissolves EGF so it doesn't work in gut when ingested
56
which immunoglobulin is secreted the most at 87%?
IgA
57
where does IgA come from?
Formed by plasma B cells → enters secretory cells by endocytosis → secreted by exocytosis
58
______ complex allows for endocytosis of IgA
s-pIgR
59
______________ Causes formation of bradykinin (a peripheral vasodilator to enhance capillary flow)
Kallikrein
60
what are some other constituents of saliva?
Lysozyme
Lactoferrin
Proline-rich glycoproteins
Peroxidase
Statherin
Histidine rich proteins
Agglutinins
Fluoride
Mercury
61
_________ breaks peptidoglycan bonds (in sugar and gram positive bacteria)
Lysozyme
62
_______ binds the iron that bacteria need
Lactoferrin
63
_______________ protect enamel and binds toxic tannins
Proline-rich glycoproteins
64
__________ is an antimicrobial oxidative enzyme
Peroxidase
65
_____________ prevents CaPO4 precipitation in saliva and helps to maintain high saliva Ca+ levels
Statherin
66
_______________ function in wound healing, antimicrobial, antifungal, and is secreted by lingual serous glands (von Ebner's glands)
Histidine rich proteins
67
____________ aggregates bacteria and viruses, promotes clearance
Agglutinins
68
Major salivary glands have small _____ secretion (CNS), and most of their secretion is caused by ____________
basal
- afferent sensory input or positive/negative influence of the higher NS
69
are minor salivary glands under neural control? How do they secrete?
NOT under neural control and secrete continuously
70
what are the different taste sensations from greatest to least?
acid>salt, umami, sweet> bitter
71
Mechanical stimulation can cause increased salivation what type of feedback is this?
positive feedback
72
what are some modes of salivary stimulation?
Taste
Mastication
Olfactory
Nociception
73
Nociceptors are stimulated by _______ in the mouth
capsaicin
74
Mainly ________ signals that initiate changes in _____ ANS control of salivary secretion
afferent
effferent
75
which causes higher protein content to be secreted: PSNS or SNS?
SNS
76
how can PSNS efferent cause secretion of saliva?
Ach attaches to muscarinic receptor → they activate PLC → this converts PIP2 → IP3 and DAG → Ca+ and PKC increased → Ca can activate Calmodulin → large volume of salivary secretion, but LOW in protein
77
what can postganglionic parasympathetic fibers release to cause vasodilation? how can they cause effects?
VIP and Ach
-cause effects directly or by formation of NO
78
why is vasodilation so important?
salivary components come from interstitial fluid
79
what is the secretion like that SNS efferent causes ?
high in protein content
80
SNS efferent stimulated both Acinar α receptors and Acinar B1 receptors, what are their paths like/what do they activate??
1. Acinar α receptors activate PLC → which converts PiP2 → IP3/DAG → small secretion volume
2. Acinar B1 receptors = more numerous → activate adenylyl cyclase → increases cAMP → protein rich secretion
81
what are the osmotic pressures for:
1. inside capillaries, inside acinar cells
2. inside secretory cell
3. outside secretory cell
1. 285 mOsm
2. 285 mOsm
3. 310 mOsm
82
From capillaries → interstitial fluid = ________ pressure
hydrostatic
83
As water in ion moves down striated ducts = ___+ removed, ___+ is put back in
Na removed, K put back in
84
why is saliva always hypotonic to plasma?
-More Na removed than K is put back
-Walls of striated ducts do not allow water to follow ion movements
-Since we're removing so much Na, saliva is always hypotonic to plasma
*there is Decreased osmolality when you remove Na*
85
how do ions get in lumen?
1. Na/K pump = 3 Na+ out, 2 K+ in
2. All cells = inside is negative, more Na outside, so Na+ will go into cell down its concentration/electrical gradient
3. Cotransporter: moves Na+ from interstitial fluid → inside cell (moves 3Na, 3K, 6Cl into cell)
86
what happens to the Na, K, Cl once theyre moved into the cell by the cotransporter?
1. 3 K+ go down concentration gradient and leak out of cell
2. 3 Na+ are pumped out by ATP pump
3. Cl- leaves cell through anion channel in Lumen side by concentration gradient
4. 6 Na+ go to lumen side through junctions by attraction to (-)
87
water moves by _________
simple diffusion
88
which side has more water? 285 mOsm or 310 mOsm?
285
89
Some water moves ________ using aquaporins, but most enters lumen ________
transcellularly, paracellularly
90
Parasympathetic and sympathetic stimulation _________ (Increases or decreases?) aquaporins
increases
91
explain how bicarbonate was thought to be created in the old system. why was this incorrect?
1. Cell that is metabolically active makes CO2 and H2O
2. Carbonic anhydrase converts that into H2CO3, then H2CO3 breaks down into H+ and HCO3-
3. HCO3- leaves cell down a concentration gradient and electrical gradient into the lumen
4. H+ pumped back out into interstitial fluid
5. Glucose + 6O2 = 6CO2 + 6H2O
-Way too much bicarbonate being produced to be accounted for by this system!
92
explain how bicarbonate is thought to be moved into the cell in the new system?
1. Na goes into cell down its concentration gradient
2. Na+ pulls bicarbonate out of plasmid into cell
3. bicarbonate builds up in cell
4. bicarbonate leaves down concentration/electrical gradient into lumen
5. bicarbonate takes K+ with it out of the cell
93
Salivary pH __________ with enhanced flow rate (more HCO3-)
Salivary pH increases with enhanced flow rate (more HCO3-)
94
how does Ca+ enter the cell and move through the cell?
1. Ca+ enters cell by Ca+ channel down its electrical and concentration gradient
2. it then moves inside ER to apical membrane
3. it is then actively transported out of the cell
95
why do we need Ca+ to move quickly through the cell?
Ca+ is a second messenger for many systems so we just want to quickly move it through the cell so that nothing else is activated
96
how does Phosphate move through the cell?
1. Na+ pulls Phosphate inside cell
2. phosphate’s anion port opens
3. phosphate goes down its concentration gradient, exits the cell, and goes into interstitial fluid
97
Primary acinar secretion is modified in the _______ ducts
striated
98
_____% proteins/glycoproteins are secreted by acinar cells
85%
99
how is primary acinar secretion modified?
1. Na+ removed, K+ added (exchange occurs here)
2. also Secrete various glycoproteins and proteins (NGF, EGF, kallikrein, immunoglobulins)
100
what is the electrolyte composition for Na and K in plasma? what is the overall osmolality?
Na: 143
K: 4
Osm: 285
101
explain how ions move through striated ducts? (Na, K, Cl, Bicarbonate)
1. Na/K pumps working → Na out, K in
2. K+ leaves through its concentration gradient
3. Na+ brings Cl- with it when it comes in from lumen
4. Cl- leaves on interstitial side
5. Bicarbonate enters into cell with Na+ and leaves on lumen side by electrical and concentration gradient
102
what are some other factors involved in salivary secretion?
1. Hormones
2. Psychic conditioned reflex:
3. Fright
4. Anxiety
5. Circadian and seasonal factors
6. Nausea/vomiting
7. hot/cold substances
8. Medications
103
lack of insulin action in diabetes causes saliva secretion to be ________
reduced
104
Fright _______ secretion
Anxiety ________ secretion
decrease
increase
105
secretion is lower during sleep and _______ months
summer
106
which medication can increase salivary secretion?
Sialorrhea
107
how does the cephalic reflex work?
hearing something (like Pavlovs dog) or seeing food can causes a conditioned relflex of salivation
