Salvation and swallowing

Question 1

What is saliva made up of?

Answer 1

Water mainly potassium and bicarbonate hypotonic, can be from slightly acidic to pH 8-

mucins Amylase

lingual lipase, immune proteins

Question 2

What is the function of saliva?

Answer 2

Chemical digestion

Lubricates food and mouth to speak properly

solvent- helps to carry taste molecules to taste buds

cleans teeth and mouth

antibacterial - lysozyme

Spread diseases

Question 3

What is xerostomia?

Answer 3

Dry mouth

Due to change in composition of saliva

Question 4

What are the three phases of swallowing?

Answer 4

Oral preparatory phase Pharyngeal phase Oesophageal phase

Question 5

What occurs in the oral preparatory phase?

Answer 5

Voluntary Pushes the bolus towards the pharynx

Question 6

When does the pharyngeal phase being?

Answer 6

When the bolus touches the pharynx

Question 7

What happens in the pharyngeal phase?

Answer 7

Involuntary

Soft palate seals off the nasopharynx

Pharnygeal constrictions push bolus downwards

Larynx elevates closing the epiglottis

vocal cords adduct and breathing temporarily stops

UOS opens

Question 8

What happens in the oesophageal phase?

Answer 8

Involuntary Close UOS Peristalic was carry bolus down oesophagus

Question 9

How is salivary gland secretion controlled?

Answer 9

Primarily neural

parasympathetic as main driver to increase

sympathetic also causes small secretions and vasoconstriction

Question 10

Which drugs may have dry mouth as a side effect?

Answer 10

Inhibit mACh production

Question 11

If swallowing closes the airway and inhibits breahthing, how is this possible?

Answer 11

Baby epiglottis is projecting up into nasopharynx so can breath and drink milk at the same time?

Means cannot speak

Question 12

What is the order for swallowing and gag reflex?

Answer 12

1. Mechanoreceptor- in the throat and detects bolus
2. Glossopharyngeal nerve
3. Medulla
4. Vagus nerve
5. Pharyngeal constrictors- contracts and pushes bolus inferiorly

Question 13

Why would a stroke mean swallowing is affected?

Answer 13

Bit of the brain that supplies the face in infarcted

close to bit of brain that supplies the pharnyx so also infarcted

Must rehabilitate and give IV

Question 14

What is a parotid sialography?

Answer 14

Injecting a contrast medium

can get stones in ducts of glands so needed to see this

This is the parotid

Question 15

How is gastro-oesphageal reflux prevented?

Answer 15

Function sphincter from smooth muscle os distal oesphagus

Diaphragm

Intra-abdominal oesphagus gets compressed if ressure rises

Mucosal rosetta at cardia (folds)

Acute angle of entry of oesphagus

Question 16

What are the the submandibular and sublingual glands innervated by?

Answer 16

Parasympathetic fibres from the FACIAL nerve

Question 17

What is the innervation of the parotid gland?

Answer 17

Glossopharyngeal nerve

Question 18

What is this?

Answer 18

Mumps

Swelling over parotid gland

Also causes testicular and ovarian inflammation

Question 19

Why is mumps so painful in the parotid gland?

Answer 19

Fibrous capsule surrounds the gland so it will not stretch so will hurt

Question 20

What is the epiglottis and closing of vocal cords used for?

Answer 20

Stopping food going into the airway

Question 21

Where is the gag reflex in a baby?

Answer 21

Much more anterior

Question 22

What is this, what would happen?

Answer 22

Oesophageal tumour

Food would feel like it was sticking, liquids okay

Question 23

What are some reasons for narrowing of the oesphagus?

Answer 23

Junction with the pharynx

Arch of the aorta

Left main bronchus crosses

Pierce diaphagm at T10

Question 24

What is the muscle types in the oesphagus?

Answer 24

Top is skeletal and bottom is smooth

middle is both

Question 25

Where is the trachea in regards to the oespahgus?

Answer 25

Oesophagus is Posterior to trachea

Question 26

Why do wew want to prevent gastro oesphageal reflux?

Answer 26

Metaplasia can occur causing barretts oesphagus (cancers)