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SF4 Exam I > Salivation and Esophagus > Flashcards

Salivation and Esophagus Flashcards

1
Q

achalasia (what is it)

A

neuromuscular disorder of lower 2/3 of esophagus

failure of the lower esophageal sphincter to relax, resulting in difficulty swallowing

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2
Q

acinus (what is it)

A

saclike dilation in the salivary gland where the initial saliva is formed (acinar cells)

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3
Q

intercalated duct (what is it)

A

part of salivary gland that connects to striated duct to the acinus

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4
Q

metaplasia (what is it)

A

change in type of cell tissue from normal to abnormal

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5
Q

primary peristaltic contraction (what is it)

A

first contraction of esophagus initiated by swallowing

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6
Q

secondary peristaltic contraction (what is it)

A

subsequent contractions of esophagus

initiated by presence of food

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7
Q

striated duct (what is it)

A

part of the salivary gland that opens into the mouth

this is where the ionic composition of the saliva is modified

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8
Q

xerostomia (what is it)

A

dry mouth due to lack of saliva

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9
Q

What are the functions of salivary secretions

A

digestion- starts digestion of starches and fats
lubrication- facilitates swallowing
protection- has antibacterial properties
sense of taste depends on adequate salivation

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10
Q

myoepithelial cells (where are they found and what do they do)

A

specialized contractile cells
in acinus and intercalated duct
contact when saliva production is stimulated and eject saliva into mouth

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11
Q

what are the three major salivary glands

A

parotid
submaxillary/submandibular
sublingual

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12
Q

rank the major salivary glands in order from greatest to least contributor to salivaton

A

submaxillary>parotid>sublingual

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13
Q

Salivation its controlled by what?

A

total autonomic system control

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14
Q

Sympathetics and parasympathetics have what effect on saliva production

A

both increase it (unique)

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15
Q

parasympathetic nerve stimulation effects salivation how (mechanisms)

A

increases transport processes of acinar and ductal cells

stimulates vasodilation of blood vessels

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16
Q

sympathetic nerve stimulation does what to salivation (mechanisms)

A

transiently increases production of saliva and growth of salivary glands
causes contraction of myoepithelial cells
causes constrictor of blood vessels

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17
Q

effect of removing parasympathetic or sympathetic innervation on salivary glands

A

removing parasympathetics- leads to atrophy of gland

removing sympathetics- little effect

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18
Q

Saliva production is increased by what?

A

food in mouth
smells (but not food)
conditioned reflexes
nausea

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19
Q

Saliva production is decreased by what?

A 
sleep
fatigue
dehydration
fear
anticholinergic drugs
20
Q

saliva is a mainly a mixture of what

A

water
electrolytes
some organic compounds

21
Q

what proteins are found in salvia and what do they do

A

alpha-amylase (ptyalin)- digests starches
lingual lipase- digests fats
mucin- lubricates food and protects oral mucosa
epidermal and nerve growth factors

22
Q

what is the composition of saliva (in general)

A

mixture of water, electrolytes and some organic compounds
proteins
bacteriocidal substances

23
Q

saliva ultra filtrate of plasma is what compared to plasma (hypotonic, isotonic, hypertonic)

A

hypotonic

24
Q

the initial fluid produced by the acinus is what compared to plasma (hypotonic, isotonic, hypertonic)

A

isotonic

25
Q

how does the started duct modify ionic composition of saliva (what is reabsorbed and what is secreted)

A

Na+ and Cl- are reabsorbed
K+ and HCO3- are secreted
relatively insoluble to water so more solute than water reabsorbed making saliva hypotonic

26
Q

what is the mechanism for reabsorption and secretion by the started duct (i.e. what is exchanged for what)

A

Cl- exchanged for HCO3-
Na+ exchanged for H+
H+ exchanged for K+

27
Q

how does flow rate affect concentration of ions in saliva

A

at higher rates the less time for reabsorption to occur so saliva is more isotonic
HCO3- increases with increases flow rate because its secretion stimulated when salivation stimulated

28
Q

As flow rate increases what happens to Na+, Cl-, K+, and HCO3- concentrations in the saliva

A

Na+: increases
Cl-: increases
K+: decreases then plateaus
HCO3-: increases then plateaus

29
Q

What are the phases of swallowing

A

oral phase

pharyngeal phase

30
Q

oral (voluntary) phase of swallowing (whats going on here)

A

swallowing is ignited by voluntary action of collecting bolus of food and forcing it into oropharynx by pushing up and back against the hard palate

31
Q

what is inhibited during pharyngeal phase of swallowing

A

breathing

32
Q

pharyngeal (involuntary) phase of swallowing (whats going on here)

A

nasopharynx closed off by soft palate (stops regurgitation)
laryngeal contract to close glottis and elevate larynx
peristalsis begins in pharynx to propel food toward esophagus
upper esophageal sphincter relaxes, allowing contraction of constrictor muscles in pharynx to move material into esophagus

33
Q

Swallowing can be controlled who?

A

reflex response coordinated in swallowing center in medulla

initiated voluntarily- requires something to trigger swallowing reflex

34
Q

lesions to swallowing center result in what?

A

loss of pharyngeal phase of swallowing

may result in aspiration

35
Q

dysphagia (what is it and how is it caused)

A

difficulty swallowing

usually neurological disorders cause it but can be due to inflammation or cancer of mouth, throat, or esophagus

36
Q

Upper Esophageal Sphincter (UES)

what is it formed from and what does it separate, what does it prevent

A

formed by circopharyngeal muscle
separates esophagus from oral cavity
prevents entry of air

37
Q

Lower Esophageal Sphincter (LES)

what does it separate, what does it prevent

A

separates esophagus from stomach
prevents entry of gastric acid
not a distinct muscle

38
Q

compared to rest of esophagus what is different about lower esophageal sphincter

A

at a higher pressure than the rest of the esophagus

39
Q

what initiates primary peristaltic contraction

A

swallowing

40
Q

during quiescent state what is the state of the muscles of the esophagus (contracted or relaxed)

A

LES tonically contracted

rest of smooth muscle flaccid

41
Q

what initiates secondary peristaltic contraction

A

presence of food in the esophagus (stretching mechanical receptors)

42
Q

secondary peristaltic contraction is mediated by what

A

enteric nervous system

vagovagal reflexes

43
Q

Gastroesophageal Reflux Disease (GERD)

cause, symptoms

A

caused by decreased tone of LES (reflux of stomach acid)
leads to heartburn and esophagitis
other symptoms: asthma, chronic cough, chest pain, laryngitis

44
Q

Hiatal Hernia

A

esophagus passes through opening in diaphragm called hiatus
LES and part of stomach moved up (instead of aligned with hiatus)
acid reflux carrier weakened

45
Q

Barretts Esophagus (what causes it and what is it)

A

caused by long term exposure to acid
constant injury to esophagus causes continuous cell growth (metaplasia)
can lead to esophageal cancer if left untreated

46
Q

Belching (Eructation)

what is it, what is happening

A

air swallowed during eating or drinking (aerophagia), or gas from heavy mea or carbonated beverage forms bubble in stomach; when LES relaxes during swallowing process, air/gas enters esophagus and is regurgitated

SF4 Exam I (16 decks)

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