Session 4 Flashcards
(26 cards)
What is the composition of saliva?
- Mostly water
- Hypotonic
- Rich in potassium and bicarbonate
- Mucins which help with librication
- Amylase which helps to digest carbohydrates
- Lingual lipase
- Immune proteins
How are the salivary glands regulated?
- Primarily neural
- Parasympathtic is the main driver
- Sympathetic also stimulates secretion of small amounts of saliva but also causes vasoconstriction
How does the oral preparatory phase of swallowing occur?
- Voluntary
- Pushes bonus towards the pharynx
- Once the bonus touches the pharyngeal wall, pharyngeal phase begins
How does the pharyngeal phase of swallowing occur?
- Involuntary
- Soft palate seals of the nasopharyngeal
- Pharyngeal constrictors push bonus downwards
- Larynx elevates, closing the epiglottis
- Vocal cords addict and breathing temporarily ceases
- Opening of the upper oesophageal sphincter
Outline the oesophageal phase of swallowing?
- Involuntary
- Closure of the upper oesaphagus sphincter
- Peristaltic wave carries bolus downwards into oesophagus
What is the mechanism for the neural control of swallowing and gag reflex?
Mechanoreceptors > Glossopharyngeal nerve > Medulla > Vagus nerve > Pharyngeal constrictors
How is gastro-oesophageal reflux prevented?
- Fucntional sphincter formed from smooth muscle of distal oesophagus
- Diaphragm
- Intra-abdominal oesophagus which gets compressed when intra-abdominal pressure rises
- Mucosal rosette at cardia
- Acute angle of entry of oesophagus
What is a hernia?
A protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall
What are the parts of a hernia?
The sac
Contents of the sac
Coverings of the sac
What is the sac?
A pouch of peritoneum
What are the contents of the sac?
Any structure found within the abdominal cavity
Commonly
Loops of bowel
Omentum
What are the coverings of the sac?
Consist of the layers of the abdominal wall through which the hernia has passed
What are the common causes of abdominal hernia?
Weaknesses in the abdominal wall
- Inguinal canal
- Femoral canal
- Umbilicus
- Previous incision
What is the inguinal canal?
Oblique passage through lower part of the abdominal wall
What are the boundaries of the inguinal canal?
Roof - Internal oblique/transverse abdominus
Posterior wall - Transversalis fascia and conjoint tendon medially
Floor - Inguinal ligament and lacunar ligament(medially)
Anterior wall - Aponeurosis of external oblique
What is Hesselbach triangle?
Medial border - Lateral margin of the rectum sheath
Superolateral border - Inferior epigastric vessels
Inferior border - Inguinal ligament
What is the clinical significance of hesselbach’s triangle?
Direct inguinal hernias pass through hesselsbach’s triangle
Where does an indirect inguinal hernia pass through?
- Deep inguinal ring
- The inguinal canal and the superficial inguinal ring
Where can an indirect inguinal hernia descend depending on where processus vaginalis was obliterated?
It can descend into the scrotum
What is the anatomical difference between the indirect inguinal hernia and the direct inguinal hernia?
Indirect inguinal hernia is lateral to the inferior epigastric vessels
Direct inguinal hernia is medial to the inferior epigastric vessels
Femoral hernia are more common in males. True/False
False. It is more common in female sure to the difference in pelvic anatomy. It can get easily stuck and strangulate
What is omphalocele?
A congenital umbilical hernia.
-The contents of the abdominal cavity herniate into umbilical cord and they have peritoneal covering.
What is acquired infantile umbilical hernia?
Contents of the abdominal cavity herniate through weakness in scar of umbilicus
What is an acquired adult umbilical hernia?
Goes through linea alba in region of umbilicus
More common in female than males
