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GI System > Saliva And Swallowing > Flashcards

Saliva And Swallowing Flashcards

1
Q

What are 3 functions of saliva?

A
  • Lubrication
  • Protection
  • Digestion
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2
Q

How does saliva act as lubricant?

A

Due to mucus content, makes swallowing easier as well as speech (prevents a dry mouth)

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3
Q

How does saliva protect us?

A
  • Has a cooling effect (drinking hot coffee)
  • Warning sign of vomiting
  • Buffers acid
  • Washes away debris stuck in teeth
  • Bacteria fighting substances (Lysosomes, lactoferrin- reduces iron availability to bacteria)
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4
Q

How does saliva aid digestion?

A
  • Contains amylase to break down carbs (salivary glands)

- Lingual lipase breaks down fats, works in stomach and proximal small intestine (lingual glands)

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5
Q

Name the 3 salivary glands

A
  • Parotid (most serous)
  • Submandibular
  • Sublingual (most mucous)
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7
Q

What proportion of saliva is made by parotid gland?

Describe its secretions

A

25%

Serous saliva with lots of enzymes

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8
Q

Where are the Sublingual glands?

Describe their secretion

What proportion of salvia is made here

A
  • Underneath tongue
  • Mucus- like saliva with less enzymes than Parotid Gland
  • 5%
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9
Q

Are the salivary glands endocrine or exocrine

A

Exocrine, as they open into mouth through ducts

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10
Q

Describe the structure of the salivary glands

A
  • Group of Acinar cells, lining Acinus

- Acinus connected to Ductus system, lined with Ductal cells (relatively impermeability to water)

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11
Q

Describe the process by which Saliva is made?

A
  • Initial saliva is made in Acinus and is Isotonic
  • Moved into ductal system by Myoepithelial cells of Acinus
  • Ductal cells remove Na+ and Cl- from solution, whilst secreting K+ and HCO3- into solution (Ductal Modififcation)
  • Overall, saliva is a Hypotonic at the end of the process
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12
Q

How does flow rate of saliva through the ductal system affect the amount of ductal modification that takes place?

What is the exception?

A
  • At rest/ low flow rates, more modification occurs so saliva is most hypotonic (more contact time)
  • When eating/ at high flow rates, less modification occurs so saliva is least hypotonic

E: Most HCO3- is secreted into saliva when eating/ at high flow rates

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13
Q

Describe the nervous control of the salivary glands

A
  • Mainly parasympathetic (increases production)

- Sympathetic secretes smaller amounts of less watery saliva (more mucus)

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14
Q

List the innervations of the salivary glands

A
  • Parotid: Glossopharyngeal nerve
  • Submandibular: Branches of facial nerve
  • Sublingual: Branches of facial nerve
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15
Q

What is Xerostomia?

What are the causes?

A
  • A condition where not enough saliva is made

- Anything that causes glands to stop working properly (Medications/ autoimmune/ dementia/ dehydration/ radiation)

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16
Q

Lack of saliva can lead to infections- bacterial or viral.

State 1 possible viral infection

A

Mumps

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17
Q

What is Sjogrens Syndrome?

What can you get if it infects the salivary glands?

A

An autoimmune condition affecting many organs

  • Dry mouth
  • Swollen/ painful salivary glands
18
Q

What are Sialoliths?

In which Gland are they most common?
Name the duct that connects this gland to the mouth

A
  • Calcified stones within salivary glands, or more likely within the ducts
  • Submandibular gland
  • Wharton’s duct
19
Q

How does a Sialolith present?

A
  • Swelling and pain when eating/ thinking about eating
20
Q

Name the 3 phases of swallowing

A
  • Oral
  • Pharyngeal
  • Oesophageal
21
Q

Describe the Oral phase of Swallowing

A
  • Voluntary, uses a lot of tongue movements
  • Involves preparing Bolus and moving it to Oropharynx
  • Oral phase ends when bolus touches pharyngeal wall
22
Q

Describe the Pharyngeal phase of Swallowing

A
  • Involuntary, takes place in less than a second
  • Soft palate seals off Nasopharynx
  • Pharyngeal constrictor muscles push bolus downwards
  • Larynx elevates, closing epiglottis
  • Vocal cords adduct and breathing temporarily stops
  • Upper Oesophageal Sphincter opens
23
Q

Describe the Oesophageal phase of Swallowing

A
  • Involuntary
  • Upper oesophageal sphincter closes
  • Peristaltic wave caries bolus downwards into esophagus
24
Q

What is Dysphagia?

A

Difficulty swallowing

25
Q

What are 3 things that could happen if we have problems coordinating swallowing?

A
  • Ineffective swallow-> Dribbling out of mouth

- Material entering respiratory tract-> Choking + Coughing

26
Q

Compare Dysphagia caused by neurological problems and physical obstructions

A

Neurological causes;

  • Fluids are harder to swallow, as more difficult to coordinate movement down oesophagus as a single unit
  • Can enter respiratory tract more easily than solids

Physical obstructions;
- Solids are harder to swallow, as they can’t get past the obstruction

27
Q

Suggest 3 causes of Neurological Problems leading to Dysphagia

A
  • Stroke
  • Parkinson’s
  • MS
28
Q

Suggest 3 causes of Physical Obstructions leading to Dysphagia

A
  • Fibrous rings within oesophagus (possibly due to scarring such as from repeated reflux)
  • Oesophageal cancer
  • Achalasia (Rare, failure of Lower OS to relax)
29
Q

Describe how Dysphagia presents in someone with Oesophageal cancer

A

Progressive Dysphagia, as tumour is growing (lumen gets more obstructed)

For example,

  • Initial Dysphagia to large blouses
  • Progression to small blouses
  • Progression to fluids
30
Q

What presentation of patient would warrant investigating the possibility of oesophageal cancer

A
  • Dysphagia above the age of 55, especially with other cancerous signs or progressive Dysphagia
31
Q

Describe the secretion of the Submandibular glands

What proportion of saliva is made here?

A
  • Mixed saliva with both Serous and Mucous components

- 70%

GI System (26 decks)

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