Clinical Introduction to GI tract
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What is the pathway that food goes through in the body?
Mouth Pharynx Oesophagus Stomach Small intestine (pancreas, liver, gall bladder) Large intestine
What is the name of the food ball formed during mastication?
Food bolus
What are the names of the three salivary glands and what do they secrete? Which are more active at rest?
Parotid (strong serous liquid) Submandibular (serous and mucous) Sublingual (mucous) Submandibular and sublingual
What are the 3 main functions of saliva?
• Digestive (chewing, bolus formation, amylase, lipase) • Protective (dilution, buffering, lubrication, remineralisation, antimicrobial, healing, cleansing • Additional (speech, excretion, trophic)
What are the three pharynx?
oro naso hypo
What is the name of the flap which stops food going down the trachea? What happens in aspiration?
Epiglottis Food goes into the trachea and can lead to suffocation or chest infections
What are the 4 layers in the oesophagus called?
• Adventitia (connective tissue - holds the oesophagus in place) • Muscle layer (voluntary and smooth) • Submucosa • Mucosa
How long is a typical oesophagus and how many sphincters (muscle for constriction) does it have?
25cm 2
What is peristalsis and what muscle is in each third of the oesophagus?
Contractions to move food down the GI tract. 1st 1/3 = voluntary 2nd 1/3 = voluntary and smooth 3rd 1/3 = smooth
What epithelium type is found in the mucosa?
Non-keratinised stratified squamous epithelium
What is the oesophagus like when no food is going down it?
Closed and compact - able to collapse and move about to get food down.
Where do each of these pass the oesophagus?
Inferior Vena Cava = T8 Oesophagus = T10 Aorta = T12
What are the 4 places that gastric secretion comes from?
Saliva (bicarbonate, amylase) Gastric (HCl) Pancreatic (bicarbonate, lipase, amylase, protease) Bile (bile salts, phospholipids, cholesterol)
What is the name of the exit of the stomach and entrance into the small intestine? What is the name of the product? Stomach - inside and outside level?
Duodenum via the pyloric sphincter Chyme Inside produces acid and outside is muscle for expansion
What is the name of ridges of muscle tissue which line the stomach?
Rugae
How long is the small intestine? Apart from digestion, what else occurs here? What is the name of the place drug absorption occurs?
6m Absorption of vitamins and minerals, breakdown of drugs Duodenum - it encourages pancreas to produce enzymes for digestion and the gall bladder to produce bile
Where does the liver, gall bladder and pancreas connect? What is the point of bile?
Common bile duct and come out into the duodenum. It is an emulsifier which allows your fats to be absorbed and digested.
What is the name role of the liver and the pancreas?
Liver = drug metabolism and coagulation factor production Pancreas = insulin production, serotonin production
Liver, gall bladder, pancreas: Structure Function
Liver S = hepatocytes, 4 lobes Liver F = metabolism of drugs, produces clotting factors, produces bile Gall bladder S = small pouch, below liver Gall bladder F = concentration of bile Pancreas S = endocrine and exocrine cells Pancreas F = regulating blood sugars, digestion
What causes gall stones in the liver?
Lots of bile salts building and congealing up Gives a right sided pain where bile cannot pass through the gall bladder
How is the way that the appendix placed affect digestion?
If it is bent, the product will build up and so will bacteria. Inflammation occurs and this leads to infection. The appendix can then burst and stomach acid can leak into surrounding tissue.
Main roles of large intestine
(Waste product flows through, absorption of water and make the product more alkali for excretion) • Absorbing water (completing the process of digestion) • Absorbing vitamins (the large intestine also helps in absorption of vitamins due to bacteria here) • Reducing acidity • Defending from infections • Producing antibodies (the appendix is a confluence of several lymphoid tissues)
What are the two forms of oral manifestation of GI disease?
• Dental - Mucosal (direct contact or indirect absorption)
Explain the direct and indirect dental defects of GI disease Give some examples of the disease
Direct (acid erosion and dietary acid) Indirect (malabsorption, medication for the GI disease, GI disease itself) Enamel defects, hypo-calcification, too much fluoride