Functions of the mouth and oesophagus and associated diseases

Question 1

Name functions of the mouth

Answer 1

Mastication
Protection (through taste)
Addition of saliva
Lubrication
Formation of bolus

Question 2

What is the purpose of mastication?

Answer 2

Increases surface area for digestion

Question 3

What process starts in the mouth?

Answer 3

Initial digestion of fats and carbohydrates by amylase and lipase

Question 4

What kind of glands are salivary glands?

Answer 4

Exocrine glands

Question 5

Name the three salivary glands

Answer 5

Parotid gland
Submandibular gland
Sublingual gland

Question 6

What two cell types are found in salivary glands?

Answer 6

Acinar cells

Ductal cells

Question 7

What does an acinar cell do?

Answer 7

Produce enzymes

Question 8

What does a ductal cell do?

Answer 8

Produce mucous
Secrete water
Secrete electrolytes

Question 9

How much saliva is secreted in 24 hours

Answer 9

1.5L

Question 10

Which gland produces the most saliva?

Answer 10

Submandibular

Question 11

Which gland produces watery saliva?

Answer 11

Parotid gland

Question 12

Which gland produces the most viscous saliva?

Answer 12

The sublingual gland

Question 13

Name the three roles of saliva

Answer 13

Lubrication
Hydration
Cytoprotection

Question 14

What three contents of saliva give it immune function?

Answer 14

IgA antibodies
Lactoferrin
Lysozyme

Question 15

Is saliva alkaline or acidic?

Answer 15

Alkaline

Question 16

Is saliva hypotonic or hypertonic?

Answer 16

Hypotonic

Question 17

Name two benefits of saliva being alkaline

Answer 17

It neutralises gastric acid that refluxes into the oesophagus
It protects teeth from bacterial acid

Question 18

What is Sjogren’s syndrome?

Answer 18

An autoimmune disease
Attacks salivary and tear glands
Results in dry mouth and eyes

Question 19

Which salivary gland is affected by mumps?

Answer 19

The parotid gland

Question 20

Which nervous system predominantly controls secretion of saliva?

Answer 20

The parasympathetic system

Question 21

Which nerve stimulates secretion by the parotid gland?

Answer 21

IX glossopharyngeal

Question 22

Which nerve stimulates secretion by the submandibular gland?

Answer 22

VII facial

Question 23

Which nerve stimulates secretion by the sublingual gland?

Answer 23

VII facial

Question 24

What are the four phases to swallowing?

Answer 24

Oral preparatory phase
Oral phase
Pharyngeal phase
Oesophageal phase

Question 25

Describe the oral preparatory phase

Answer 25

Food is manipulated in the mouth and masticated to a consistency which can be swallowed

Question 26

Describe the oral phase

Answer 26

The tongue propels food posteriorly until the pharyngeal swallow is triggered

Question 27

Describe the pharyngeal phase

Answer 27

Bolus is transported through the pharynx Co-ordinated closure of the glottis by the epiglottis Cessation of breathing Relaxation of upper oesophageal sphincter

Question 28

Describe the oesophageal phase

Answer 28

Oesophageal peristalsis carries the bolus through the oesophagus

Question 29

What is the oesophageal hiatus?

Answer 29

The hole in the diagram through which the oesophagus and vagus nerve pass

Question 30

Name the layers of the oesophagus

Answer 30

Mucosa Inner circular Outer longitudinal muscle

Question 31

What is gastro-oesophageal reflux disease?

Answer 31

Chronic symptoms or mucosal damage produced by the abnormal reflux in the oesophagus

Question 32

What causes GORD?

Answer 32

``` Obesity Hiatus hernia Certain drugs Pregnancy Zollinger Ellison syndrome ```

Question 33

What are the symptoms of GORD?

Answer 33

Heartburn Regurgitation Dysphagia

Question 34

What are the outcomes of GORD?

Answer 34

Oesophagitis Stricture Barrett's metaplasia Oesophageal adenocarcinoma

Question 35

How is GORD diagnosed?

Answer 35

24 hour pH monitoring Contrast swallow Endoscopy

Question 36

What are the three options for GORD treatment?

Answer 36

Conservative Medical Surgical

Question 37

What is conservative treatment of GORD?

Answer 37

Weight loss Not eating close to bedtime Reduced alcohol consumption Raise head of bed

Question 38

What is medical treatment of GORD?

Answer 38

Proton pump inhibitors H2 blockers Antacids Alignates

Question 39

What is surgical treatment of GORD?

Answer 39

Fundoplication Repair hiatus hernia Vagotomy

Question 40

What is Barrett's metaplasia?

Answer 40

A change of epithelial type in response to environmental stress

Question 41

Describe the change to cells of the oesophagus with Barrett's metaplasia

Answer 41

Stratified squamous to simple columnar

Question 42

How likely is it for Barrett's metaplasia to advance to cancer

Answer 42

1% of cases each year become cancerous

Question 43

What cancer does Barrett's metaplasia advance to?

Answer 43

Adenocarcinoma

Question 44

What is achalasia?

Answer 44

Failure to relax | Motor disorder of the oesophagus

Question 45

What causes achalasia?

Answer 45

Loss of myenteric plexus at the lower oesophageal sphincter | Cause unknown

Question 46

What are the symptoms of achalasia?

Answer 46

Dysphagia Regurgitation Chest discomfort Halitosis

Question 47

How can achalasia be treated?

Answer 47

Oesophageal dilation Surgery Botox injection