The anatomy of salivation and swallowing Flashcards

1
Q

What is saliva composed of?

A
  • Mostly water
  • Rich in K+ and bicarbonate (keeps pH slightly alkaline so we don’t dissolve our teeth)
  • Mucins help with lubrication
  • Amylase
  • Lingual lipase
  • Immune proteins e.g. IgA, lysozyme, lactoferrin
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2
Q

What are the functions of saliva?

A
  • Lubricates mouth + contributes to phonation
  • Mastication
  • Maintenance of oral health
  • Immunity
  • Solvent for taste molecules
  • Beginning process of digestion
  • Way of transmitting
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3
Q

What is the clinical term for a dry mouth?

A
  • Xerostomia
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4
Q

What are our 3 pairs of salivary glands called?

A
  1. Parotid
  2. Sublingual
  3. Submandibular
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5
Q

How is salivary secretion regulated?

A
  • Primarily autonomic
  • Parasympathetic increases production via facial nerve (VII) and glossopharyngeal nerve (IX)
  • Sympathetic causes vasoconstriction of blood vessels feeding salivary glands
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6
Q

What is parotiditis?

A
  • Mumps
  • Very painful because parotid gland is enclosed in a tough sheath, so can’t swell
  • Causes inflammation of testes and ovaries, leading to infertility
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7
Q

What is parotid sialography used to diagnose?

A
  • Stones forming in parotid gland
  • Pain and swelling on anticipation of food
  • Or feeling gritty little stones inside the mouth
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8
Q

What are the different phases of swallowing?

A
  • Oral preparatory phase
  • Pharyngeal phase
  • Oesophageal phase
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9
Q

Outline the oral preparatory phase of swallowing

A
  • Lasts 7.4 seconds
  • Voluntary
  • Pushes bolus towards pharynx
  • Once bolus touches pharyngeal wall, pharyngeal phase begins
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10
Q

Outline the pharyngeal phase of swallowing

A
  • Lasts 0.2 seconds
  • Involuntary
  • Soft palate rises and seals of nasopharynx
  • Pharyngeal constrictors push bolus downwards
  • Larynx elevates, closing epiglottis, preventing food from entering airway
  • Vocal cords adduct (protecting airway)
  • Breathing temporarily ceases
  • Upper oesophageal sphincter opens
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11
Q

Outline the oesophageal phase of swallowing

A
  • Involuntary
  • Closure of the upper oesophageal sphincter
  • Peristaltic wave carries bolus downwards into oesophagus
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12
Q

What causes aspiration pneumonia?

A
  • When food is aspirated (inhaled into the lungs)
  • Lungs are sterile but food is not
  • Causes pneumonia
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13
Q

How can babies continue breathing while they feed?

A
  • They don’t close their vocal cords when they swallow
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14
Q

Outline the neural control of swallowing and the gag reflex

A
  • Mechanoreceptors detect something touching the back of the throat
  • Glossopharyngeal nerve
  • Medulla
  • Vagus nerve
  • Pharyngeal constrictors
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15
Q

How can a stroke affect someone’s ability to swallow?

A
  • Muscles involved in swallowing may have been affected
  • Pt needs to be assessed by a speech and language therapist
  • Nil by mouth until assessment
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16
Q

Describe the anatomical position of the oesophagus

A
  • Sat relatively far back in the chest
  • Travels behind trachea
  • Crossed over by left main bronchus - this squashes the oesophagus
17
Q

Describe the muscle composition of the oesophagus

A
  • Skeletal muscle
  • Changes to smooth muscle
18
Q

At which parts of the oesophagus is food likely to get stuck?

A
  • Junction of oesophagus with pharynx
  • Where oesophagus is crossed by arch of aorta
  • Where oesophagus is compressed by left main bronchus
  • At oesophageal hiatus
19
Q

What prevents the gastro-oesophageal reflux?

A
  • Functional sphincter formed from smooth muscle of distal oesophagus
  • Diaphragm squeezes oesophagus to prevent acid from moving up
  • Intra-abdominal oesophagus gets compressed when intra-abdominal pressure rises
  • Mucosal rosette at cardia
  • Acute angle of entry of oesophagus
20
Q

Why do we need to prevent gastro-oesophageal reflux?

A
  • Reflux disease can pre-dispose to oesophageal cancer