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16 Cards in this Set
- Front
- Back
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deglutition: when do we do it how |
feeding or saliva use volume to trigger reflex: need NTS and CNS innervation
comes up in polio or head trauma or alzheimer: use medulla oblongata for correct sequence: non-vagal
inhibit inspiration to prevent aspiration |
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phases of deglutition |
buccal or oral- tactile receptors in back of mouth and pharynx. Afferents V VII IX X. Efferents V VII IX X XII
pharyngeal: stereotyped (same regardless), all or none. Soft palate goes up, palatopharyngeal folds close to prevent nasal reflux, epiglottis covers trachea, UES relaxes (PNS activation also relaxes LES). Peristaltic wave from superior constrictor muscles of pharynx as bolus moves the UES contracts
esophageal: strong peristaltic wave is conducted down esophagus |
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how does peristalsis happen in esophagus |
moving ring contractions: longitudinal muscle followed by circular
regulated both extrinsically: brainstem/vagus and intrinsically: ENS
upper eso requires CNS for peristalsis since it's striated and no autorhythmic |
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how does the food get through the LES |
relaxed near beginning of swallow due to brainstem and vagal activity (VIP/NO) and stays open until perstaltic wave passes by
when drinking it only closes after the last swallow |
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special conditions of drinking cold water |
eliminates peristalsis since diffusion worse and muscles cold but LES still relaxes |
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what if the food you swallowed didn't make it through LES/all the way down |
secondary peristalsis happens but is slower weaker and not as well-coordinated |
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so how does loss of vagus affect swallowing |
not as good of swallowing but still works since it's not the only input |
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what gives esophagitis, heart burn, gastric reflux, GERD |
LES doesn't maintain complete closure and esophageal lining is damaged.
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why do infants spit up often |
peristaltic circuitry isn't complete so don't maintain LES closure |
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how to tell difference between heart attack and heart burn |
large meals pregnancy obesity alcohol consumption
are factors in this pressure in stomach, LES efficiency, repair of esophagus (healing ability), esophagus clearance, acidity of regurgitated contents |
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factors that decrease LES pressure |
ethanol smoking fat chocolate caffeine and theophylline peppermint barbiturates progesterone for pregnancy large stomach volume and supine posture
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easy way to help heart burn |
use pillow for gravity to help |
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progressive dysphagia uncomfortable eso when eating- eat less for weight loss
night time heartburn and aspiration |
achalasia |
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what happens if LES does NOT relax |
achalasia. Food accumulates and secondary peristalsis happens which can cause pain
usually a problem of myenteric plexus |
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what can cause achalasia |
myenteric plexus issue aperistalsis incomplete LES relaxation hiatal hernia |
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what is and what causes diffuse esophageal spasm |
abnormal sequence of peristalsis prevents food from moving
simultaneouos long contraction of lower eso
spontaneous or after swallowing- esp hot or cold fluids |
