Week 2 - Salivation and Swallowing and development Flashcards
1
Q
What is the end result of mastication and salivation?
A
-Formation of a food bolus for swallowing
2
Q
How much saliva is produced per day?
A
-1.5L
3
Q
What is the function of saliva?
A
- Lubricate and wet food
- Start digestion of carbohydrates
- Protection of oral environment
4
Q
In what ways is the oral environment protected by saliva?
A
- Maintains teeth integrity by neutralising acid produced by bacteria
- Keeps mucosa moist to prevent ulceration
- Contains antibodies and WBCs to protect against bacteria
5
Q
What is zerostomia? What are the consequences of this condition?
A
- Absence of saliva production
- Oral environment degrades at a very quick rate due to acid produced by bacteria
- Halitosis and poor dentition
6
Q
What is saliva?
A
-Hypotonic watery secretion with mucus which is produced by glands in the mouth
7
Q
What triggers saliva production above baseline?
A
-Senses of food including thought as a response from the brainstem
8
Q
What are the three major salivary glands and their secretions?
A
- Parotid -> serous rich in enzymes (25%)
- Submandibular -> mixed (70%)
- Sublingual -> mainly mucus with no enzymes (5%)
9
Q
What are the constituents of saliva?
A
- Water (hypotonic )
- Electrolytes -> Na, Cl at lower conc than plasma, Ca, I and K at higher conc than plasma
- Alkali -> HCO3 at higher conc than plasma
- Mucus
10
Q
Why does saliva need to be hypotonic?
A
-Prevent water being drawn out of mucosa and being absorbed instead
11
Q
Why is there a high concentration of calcium in saliva?
A
-Prevent teeth erosion
12
Q
Why is iodide present in saliva?
A
-Bacteriocide
13
Q
Why is mucus present in saliva?
A
-To coat food bolus for easy swallowing
14
Q
What enzymes are most prominent in saliva?
A
- Salivary amylase
- Salivary lipase
15
Q
What type of glands are the salivary glands?
A
-Ducted, exocrine glands
16
Q
Describe the glandular structure of salivary glands and the fuctions of specific parts
A
- Terminal tubulo-acinar structures
- Acinar cells are secretory
- Ductal cells are modificatory
17
Q
What is stensons duct?
A
-Duct of parotid glands
18
Q
What is whartons duct?
A
-Duct of submandibular gland
19
Q
Describe the secretion from acinar cells
A
- Secretion is isotonic with ECF with a higher conc of I (via active transport)
- Secretion contains enzymes manufactured by acinar cells
20
Q
Describe ductal modification
A
- There is little change in volume
- It is the solutes which are removed rather than solvent added to make a hypotonic fluid -> impermeable to water
- NaKATPase on basolat sets us gradient
- Na ions are removed from the secretion down gradient and Cl follows
- K Diffuses out into saliva down conc garient
- HCO3 added
21
Q
Describe the differences in saliva during rest and stimulation. What accounts for these differences?
A
- During rest HCO3 is added to produce a neutral pH saliva and there is a low flow rate meaning there is sufficient time to remove Na. There are few enzymes secrted
- During stimulation excessive HCO3- added to produce an alkaline saliva and there is less Na removed due to the high flow rate and the limited removal rate of ions. Excessive enzyme secretion
22
Q
Describe the control of secretion of saliva
A
- Parasympathetic stimulates acinar cells (via ach) to produce primary secretion and ductal modification
- sympathetic input to the glands reduced blood flow and thus limits salivary flow
- Ductal recovery of Na is influenced by aldosterone
23
Q
What are the three phases of swallowing?
A
- Voluntary
- Pharyngeal
- Oesophageal
24
Q
Describe voluntary phase of swallowing
A
-Food blus moved to pharynx under voluntary control
25
Describe pharyngeal phase of swallowing
-Afferent information from pharyngeal receptors reaches swallowing centre in brain stem which causes:
Closure of glottis
Inhibition of breathing
opening of oesophagus
26
Describe oesophageal phase of swallowing
- Upper 1/3 is striated muscle under voluntary control
| - Lower 1/3 is smooth muscle under parasymp control and peristalsis propels bolus into stomach
27
What is the result of lateral embryonic folding in relation to GI tract?
- Ventral body wall formation
| - Primitive gut tube formation
28
What is the result of craniocaudal folding in relation to the GI tract?
-Creates blind pockets of forgut and hindgut
29
What is different about the midgut to foregut an hindgut in the beginning of development?
- foregut and hind gut are blind diverticula
| - Midgut has an opening at first and is continuous with yolk sac
30
When does development of primitive gut tube begin?
-Week 3
31
What is the stomatoduem?
-Future mouth
32
What is the proctoduem?
-Future anus
33
Describe the length of the primitive gut tube
-Rubs from stomatoduem (blind foregut) to proctoduem (blind hindgut) with an opening at umbilicus (midgut)
34
Where is the intermal lining of the gut tube derived from?
-endoderm
35
Where is the future musculature and visceral peritoneum of the gut tube derived from?
-Splachnic mesoderm (of lateral plate mesoderm)
36
In which cavity is the primitive gut tube?
-Suspened in intraembryonic coelom
37
How is the primitive gut tube suspended in the furture peritoneal cavity?
-By a double layer of splanchnic mesoderm
38
Name the derivatives of the foregut
-Oesophagus to 1st portion of duodenum including pancreas, liver and gall bladder
39
Name the derivatives of the midgut
-From second part of duodenum where bileduct joins to proximal two thirds of transverse colon
40
Name the derivatives of the hind gut
- Distal 3rd transverse colon to pectinate line of anus
| - Inclides intermal lining of bladder and urethra
41
From where does the foregut receive its blood supply?
-Celiac trunk
42
From where does the midgut receive its blood supply?
-Superior mesenteric artery
43
From where does the hind gut receive its blood supply?
-inferior mesenteric artery
44
Name the branches of the celiac trunk
- Splenic artery -> giving left gastroepiploic artery
- Common hepatic artery -> giving right gastric, gastroduodenal (which gives right gastroepiploic and superior pancreaticoduodenal), proper hepatic artery (which gives left and right hepatic and cystic)
- Left gastric artery
45
What is specific about the blood supply to the duodenum?
- Supplied by gastroduodenal and superior pancreaticoduodenal proximal to bile duct entry (CT)
- Supplied by inferior pancreaticoduodenal distal to bile duct entry (SMA)
46
What is specific about the blood supply to the pancreas?
- Receives sup. panc.duo art from CT
| - Receives inf. panc.duo art from SMA
47
Describe the branches of the superior mesenteric artery
-gives ileocolic, right colic and middle colic
48
Describe the branches of IMA
- Left colic
- Sigmoid arteries
- Superior rectal
49
What forms the future peritoneal cavity?
-Intraembryonic ceolom
50
What happens to the intraembryonic ceolom to divide it into the thoracic and abdominal cavities?
-Subdivided by the diaphragm
51
What is the peritoneal cavity?
-Potential space between the parietal and visceral peritoneum which should contain only a minute amount of fluid
52
What are mesenteries?
-Double layer of peritoneum which contain vessels and nerves and suspends the gut from the abdominal wall
53
From where do mesenteries form?
-From the splanchnic mesoderm which holds the primitive gut tube in the intraembryonic ceolom
54
Describe dorsal and ventral mesenteries
- Dorsal mesentery suspends entire gut ube from dorsal body wall
- Ventral mesentery only in the region of the foregut
55
What are the left and right sacs?
-The cavities created in the foregut due to dorsal and ventral mesentary
56
To which sacs do the left and right sacs contribute?
- Left sac contibutes to greater sac
| - right sac contributes to lesser sac
57
Where is the lesser sac?
-Directly behind the stomach
58
Where is the greater sac?
-The sac you enter as soon as you open the peritoneum
59
What are omenta?
-Specialised regions of peritoneum
60
From where is the greater omentum formed?
-Dorsal mesentery
61
From where is the lesser omentum formed?
-Ventral mesentery
62
What structure is related to the free edge of the ventral mesentery?
-Portal triad
63
Describe the rotation of the stomach and its role in the formation of the sacs and omenta
- Stomach first rotates clockwise upon its longitudinal axis and it pulls the mesenteries with it so that a double fold of dorsal mesentery lies on the left and a double fold of ventral lies on the right
- The stomach then rotates upon its anterioposterior axis (dont forget in the fetus this is superioinferior axis) so that the cardia and pylorus move horizontally and the lesser sac moves inferiorly. This produces the final greater and lesser omenta.
64
What happens to the liver and right sac as the stomach is rotating?
- Begins to develop in the ventral mesentrey and is pushed to the right as the stomach rotates
- This forces the right sac behind the stomach which is now the lesser sac
65
What effect does rotation of the somach have on the vagus nerve?
-The vagus nerves become anterior and posterior to the stomach instead of left and right
66
What is a peritoneal reflection?
-A change in direction from parietal peritoneum to mesentry to visceral peritoneum and vice versa
67
What happens to organs when there is no mesentery?
-They are considered retroperitoneal eg kidneys
68
What is secondary retroperitoneal? Give an example
-Organs which began development in the peritoneum and had a mesentery but with successive growth and evelopment the mesentery is lost through fusion with the posterior abdominal wall
eg pancreas
69
Why does the foregut originally include the lung bud? What happens to separate these two structures?
- Respiratory diverticulum appears in ventral wall of foregut
- Resp diverticulum thickens and tracheoesophageal septum grows separating respiratory tract anterior to GI tract
70
What are the consequences of abnormal tracheoesophageal septum positioning?
- Fistulae
| - Blind-end oesophagus
71
Why is the greater curvature present?
-Dorsal border of primordia of stomach grows faster
72
Apart from the liver, what other foregut structures develop in the ventral mesentery?
- Biliary system
| - Part of pancreas
73
Where does the pancreas develop?
-Ventral and dorsal mesentery
74
Describe the attachments of the liver to the anterior and posterior body walls and the diaphragm
- Liver attached to anterior bodywall as develops in the mesentery (by falciform ligament)
- Livver attached to posterior body wall by lesser omentum
- When diaphragm develops, the region of liver attached to the diaphragm is known as the bare area as not cobered by visceral peritoneum
75
Describe the development of the duodenum
- Develops from distal foregut and proximal midgut.
- Loops into right and into C shape when stomach rotates as well as being pressed against posterior abdominal wall causing fusion of the mesentery -> secondary retroperitoneal
- The lumen is obliterated due to speed of growth and then recanalised by the end of the embryonic period
76
What is mastication?
-Preliminary disruption of food (chewing)
77
Name 3 common causes of dysphagia
- Osophageal carcinoma
- Benign stricture
- Achalasia
78
What is achalasia?
-A condition where the muscles of the lower oesophagus fail to relax and prevent passage of bolus
79
Why might someone have dysphagia following a cerebrovascular accident?
-Poorly coordinated peristalsis
80
What is odynophagia?
-Painful swallowing
81
What is transverse mesocolon?
-Mesentery attached to transverse colon
