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56 Cards in this Set

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Salivation Function
1) Digestion 2) Lubrication 3) Protection
Salivary Function: Digestion
Starts digestion of: 1) Starches 2) Fats
Salivary Function: Lubrication
Facilitates swallowing
Salivary Function: Protection
Antibacterial properties
Major Salivary Glands
1) Parotid 2) Submaxillary/submandibular 3) Sublingual
Order of Contribution to Salivation of Major Salivary Glands
submaxillary>parotid>sublingual
Structure of Salivary Gland
1) Acinus 2) Intercalated duct 3) Striated duct 4) Myoepithelial cells
Acinus
1) Blind end of each duct 2) Lined with acinar cells that secrete initial saliva
Intercalated Duct
Connects acinus with striated duct
Striated Duct Function
Modifies inorganic composition of saliva
Myoepithelial Cells
1) In acinus and intercalated duct 2) Specialized contractile cells 3) Contracts when saliva production is stimulated 4) Ejects saliva into mouth
Salivation Control
1) Total ANS 2) Both Parasypathetic and Sympathetic nerves increase saliva production 3) Parasympathetic system provides stronger input
Salivation Control: Parasympathetic
1) Increases transport processes of: A) Acinar B) Ductal cells 2) Stimulates vasodilation of blood vessels
Salivation Control: Sympathetic
1) Transiently increases production of: A) Saliva and B) Growth of salivary glands 2) Causes contraction of myoepithelial cells 3) Causes constriction of blood vessels
Salivation Control: Effect of Severing Parasympathetic Nerves on Glands
Causes glands to atrophy
Salivation Control: Severing Sympathetic Nerves
Has little effect on glands
Salivation Control: Stimuli for Increased Production
1) Food in mouth 2) Smells 3) Conditioned reflexes 4) Nausea
Salivation Control: Stimuli for Decreased Production
1) Sleep 2) Fatigue 3) Dehydration 4) Fear 5) Anticholinergic drugs
Anticholinergic Drugs
1) Inhibit parasympathetic nerve activity by blocking acetylcholine receptors 2) Examples: A) Benadryl B) Dramamine C) Antidepressants
Saliva Composition
1) Water 2) Electrolytes 3) Organic compounds
Saliva Composition: Organic Compounds
1) Proteins 2) Bacteriocidal substances
Saliva Composition: Proteins
1) α-amylase 2) Lingual lipase 3) Mucin
α-Amylase
1) Digests starches 2) Found in saliva
Lingual Lipase
1) Digests fats 2) Found in saliva
Mucin
1) Lubricates food 2) Protects oral mucosa 3) Found in saliva
Saliva Composition: Ions
1) Initial fluid produced is isotonic to plasma 2) Striated ducts modify ionic composition of fluid 3) Flow rate affects [ions]
Saliva Composition: Osmolarity v. Plasma
1) Saliva ultrafiltrate of plasma 2) Hypotonic to plasma
Saliva Composition: Striated Ducts
1) Reabsorb Na+ and Cl- 2) Secrete K+ and HCO3- 3) Relatively impermeable to H2O 4) More solute than H2O is reabsorbed 5) Saliva becomes hypotonic
Saliva Composition: Mechanism of Ion Secretion and Reabsorption
1) Cl- exchanged for HCO3- 2) Na+ exchanged for H+ 3) H+ exchanged for K+
Saliva Composition: Flow Rate
1) At higher rates there is less time for reabsorption to occur 2) Saliva more isotonic; increased A) Na+ B) Cl- C) HCO3-
Why is HCO3- Increased in Saliva with Increase in Flow Rate?
HCO3- secretion is stimulated when salivation is stimulated
Xerostomia Symptoms
1) Dry mouth 2) Lack of salivary secretion 3) Associated with: A) Cavities B) Chronic infections of buccal mucosa C) Dysfunction of: i) speech ii) taste iii) swallowing
Sjögren's Syndrome
1) Disease that affects salivary glands 2) Causes xerostomia
Xerostomia Causes
1) Anticholinergics (e.g. antidepressants) 2) Sjögren's Syndrome 3) Radiation therapy
Xerostomia Treatments
1) Sipping water 2) Lemon-flavored lozenges 3) Artificial saliva 4) Pilocarpine mouthwashes and tablets
As Flow Rate Increases, [Na+]...
Increases
As Flow Rate Increases, [Cl-]...
Increases
As Flow Rate Increases, [K+]...
Initially decreases, then plateaus
As Flow Rate Increases, [HCO3-]...
Initially increases, then plateaus
Swallowing (Deglutition) Phases
1) Oral phase 2) Pharyngeal phase
Swallowing (Deglutition) Mechanism: Oral Phase
1) Voluntary 2) Initiated by: A) Collecting bolus of food B)
Forcing it into oropharynx by pushing up and back against the hard palate
Swallowing (Deglutition) Mechanism: Pharyngeal Phase
1) Involuntary 2) Nasopharynx closed by soft palate 3) Breathing inhibited 4) Laryngeal muscles contract to: A) Close glottis B) Elevate larynx 5) Peristalsis begins in pharynx to propel food toward esophagus 6) Upper esophageal sphincter relaxes, 7) Allows contraction of constrictor muscles in pharynx to move material into esophagus
Swallowing (Deglutition) Control
1) Coordinated in swallowing center of medulla 2) Initiated voluntarily, but requires something to trigger swallowing reflex 3) Lesions in swallowing center result in loss of pharyngeal phase
Dysphagia
1) Difficulty swallowing 2) Caused by: A) Neurological disorders B) Inflammation C) Cancer of: i) mouth ii) throat iii) esophagus
Esophagus: Structure
1) Muscle A) Upper 1/3 striated B) Lower 1/2 smooth C) Gradient of striated to smooth in between 2) Upper esophageal sphincter 3) Lower esophageal sphincter
Upper Esophageal Sphincter
1) UES 2) Formed by cricopharyngeal muscle 3) Separates esophaus from oral cavity 4) Prevents entry of air
Lower Esophageal Sphincter
1) LES 2) Separates esophagus from stomach 3) Prevents entry of gastric acid 4) Not distinct muscle; thickening of esophagus and increased pressure
Esophagus: Motility
1) UES relaxes to permit bolus entry 2) UES contracts to prevent bolus reflux 3) Primary peristaltic contraction (PPC) begins 4) PPC move down esophagus, propelling food to LES 5) LES relaxes 6) Bolus enters stomach 7) LES contracts, preventing acid reflux 8) Secondary peristaltic contraction (SPC) begins and continue until esophagus empty 9) Gravity assists faster motility in upright position
Primary Peristaltic Contraction
1) Creates zone of increased pressure behind bolus 2) Initiated by swallowing
Secondary Peristaltic Contraction
Initiated by presence of food in esophagus, which stretches mechanical receptors
Gastroesophageal Reflux Disease
1) GERD 2) Decreased tone of LES 3) Reflux of stomach acid 4) Causes A) Heartburn B) Esophagitis C) Ulceration D) Stricture due to scaring 5) Treatment: A) Lifestyle changes B) Medications C) Surgery D) Endoscopy
Hiatal Hernia
1) LES and part of stomach move up 2) Acid reflux barrier weakened
Hiatus
1) Opening through which esophagus passes through diaphragm 2) Normally aligned with LES
Barrett's Esophagus
1) Constant esophageal injury (e.g. acid exposure) causes continuous cell growth 2) If left untreated can lead to esophageal cancer
Achalasia
1) Neuromuscular disorder of lower 2/3 of esophagus 2) Absence of peristalsis and failure of LES to relax 3) Food accumulates in esophagus, taking hours to enter stomach 4) Causing dilation of esophagus 5) Patients experience: A) Dysphagia B) Regurgitation of ingested food C) Weight loss 6) Treated with: A) Drugs B) Endoscopic procedures C) Surgery to relax LES
Belching
1) Eructation 2) Caused by: A) Air swallowed (aerophagia) B) Gas from heavy meal C) Carbonated beverage, forms bubble in stomach 3) LES relaxes during swallowing process 4) Allows air/gas to enter esophagus
and be regurgitated