13: The Normal Swallow Flashcards
What are the general role of the cranial nerves as a whole?
The twelve cranial nerves are part of the peripheral nervous system that send information either:
- To the brain
- From the brain to the muscles
- Both
What is the name of the cranial nerve I?
I OLFACTOY
What is the name of the cranial nerve II?
II OPTIC
What is the name of the cranial nerve III?
III OCULOMOTOR
What is the name of the cranial nerve IV?
IV TROCHLEAR
What is the name of the cranial nerve V?
V TRIGEMINAL
What is the name of the cranial nerve VI?
VI ABDUCENS
What is the name of the cranial nerve VII?
VII FACIAL
What is the name of the cranial nerve VIII?
VIII AUDITORY
What is the name of the cranial nerve IX?
IX GLOSSOPHARYNGEAL
What is the name of the cranial nerve X?
X VAGUS
What is the name of the cranial nerve XI?
XI ACCESSORY
What is the name of the cranial nerve XII?
XII HYPOGLOSSAL
What is the facial role of cranial nerve I?
OLFACTORY- SMELL
What is the facial role of the cranial nerve II?
OPTIC- VISION
What is the facial role of the cranial nerve III?
OCULOMOTOR- EYELID AND EYEBALL MOVEMENT
What is the facial role of the cranial nerve IV?
TROCHLEAR- INNERVATES SUPERIOR OBLIQUE AND TURNS EYE DOWNWARD AND LATERALLY
What is the facial role of the cranial nerve V?
TRIGEMINAL- CHEWING, FACE AND MOUTH TOUCH AND PAIN
What is the facial role of the cranial nerve VI?
ABDUCENS- TURNS EYE LATERALLY
What is the facial role of the cranial nerve VII?
FACIAL- FACIAL EXPRESSIONS, TEAR AND SALIVA SECRETION
What is the facial role of the cranial nerve VIII?
AUDITORY- HEARING, EQUILIBRIUM SENSATION
What is the facial role of the cranial nerve IX?
GLOSSOPHARYNGEAL- TASTE, SENSES, CORTICOID BLOOD PRESSURE
What is the facial role of the cranial nerve X?
VAGUS- SENSES AORTIC BLOOD PRESSURE, SLOWS HEART RATE, STIMULATES DIGESTIVE ORGANS AND TASTE
What is the facial role of the cranial nerve XI?
ACCESSORY- CONTROLS STERNOCLEIDOMASTOID SWALLOWING MOVEMENTS
What is the facial role of the cranial nerve XII?
HYPOGLOSSAL- CONTROLS TONGUE MOVEMENT
Which cranial nerves link to speech and language therapy?
The six key cranial nerves in speech and language therapy are:
- Trigeminal
- Facial
- Glossopharyngeal
- Vagus
- Spinal accessory
- Hypoglossal
How is the trigeminal nerve involved in SLT?
The trigeminal nerve contains sensory and motor fibres that innervate the face. This is important in chewing
How is the facial nerve involved in SLT?
The facial nerve contains sensory and motor fibres that are important for sensation of the oropharynx and the anterior part of the tongue. This is important in swallowing
How is the glossopharyngeal involved in SLT?
The glossopharyngeal contains sensory and motor fibres that important for the posterior tongue and functions of the pharynx. This is important in swallowing
How is the vagus involved in SLT?
The vagus is the only cranial nerve that goes below the neck. It contains sensory and motor fibres for the oropharynx and sensation and motor function to the pharynx and laryngopharynx. This initiates the cough reflex to prevent choking and protect the airways
How is the accessory nerve involved in SLT?
The accessory nerve contains motor fibres that depress and tense the velum and innervates muscles of the neck. This is important in swallowing
How is the hypoglossal involved in SLT?
The hypoglossal contains motor fibres to innervate the tongue. This is important in swallowing
What are the six stages of a normal swallow?
The six stages of a normal swallow are:
- Pre-oral
- Oral preparatory phase
- Oral phase
- Early pharyngeal phase
- Late pharyngeal phase
- Oesophageal phase
Which is the quickest type of substance to swallow?
Liquid is the quickest type of substance to swallow. It is still a bolus, so still needs saliva production to be swallowed
Describe the pre-oral stage of the normal swallow:
The pre-oral phase is the first stage of a normal swallow
In this stage, the senses are stimulated and saliva is produced in preparation for the bolus
Describe the oral preparatory phase of the normal swallow:
The oral preparatory phase is the second stage of the normal swallow
It is a voluntary stage involving stabilising the floor of the mouth, positioning the food between the teeth
The tongue collects pieces of food into a bolus and holds this towards the front centre of the palate, a seal is created within the mouth by the lips/tongue. Rotary jaw movement masticates the bolus. The posterior oral cavity is sealed off and the soft palate lowers to contact the back of the tongue and the airway is open
Describe the oral phase of the normal swallow:
The oral phase is the third stage of the normal swallow
It is mostly voluntary and involves the lips and buccal muscles contracting, posterior part of the tongue depressing and the anterior tongue elevating in a stripping action across the palate. The base of the tongue moves forwards and flattens into a chute, the tongue fleecing backwards on the hyoid bone and propelling the bolus into the oropharynx
Describe the early pharyngeal phase of the normal swallow:
The early pharyngeal phase is the fourth stage of the normal swallow
It is involuntary. Respiration is interrupted, the soft palate is elevated and contracted against the posterior pharyngeal wall, which bulges to meet the tongue base. The larynx is elevated and the pharynx widens, with pharyngeal constrictors moving upwards and forwards
Describe the late pharyngeal phase:
The late pharyngeal phase is the fifth stage of the normal swallow
It is involuntary and involves the largyngeal vestibular losing. The arytenoids cause the vocal folds to abduct. Sphincteric action takes place and the epiglottis tips backward and downward due to the laryngeal elevation and anterior movement. The bolus sees pressure from above and the retraction of the tongue base. The epiglottis covers the laryngeal opening to divert the bolus into the pryiform sinuses. Contractual pharyngeal stripping waves squeeze the bolus down
Describe the oesophageal phase of the normal swallow:
The oesophageal phase is the final stage of the normal swallow
This phase lasts for 3 seconds for liquids and 10-20 seconds for food. Peristaltic waves pass through the cricopharyngeus and oesophagus, which carries the bolus to the stomach. The cricopharyngeus then closes, and respiration resumes