17 components of swallowing per MBSImP Flashcards
Lip closure
Oral domain
Component one
Main muscles of lip closure
Group: Lips
Name: Orbicularis Oris
Innervation: Via CN VII (Facial)
Actions: To seal the lips and anterior oral containment
Tongue control during bolus hold
Oral domain
Component two
Main muscles of tongue control during bolus hold
- Group: Intrinsic muscles of the tongue
Names: Superior and inferior longitudinal, vertical, and transverse
Innervation: Via CN XII (Hypoglossal)
Action: Shapes the tongue to hold and control the bolus
2.
Group: Soft palate muscle
Name: Tensor veli palatini
Innervation: Via CN V (Trigeminal)
Actions: Stiffens the soft palate and facilitates posterior oral containment
3.
Group: Extrinsic muscles of the tongue
Name: Palatoglossus
Innervation: Via CN X (Vagus)
Actions: Closes entry to the oropharynx via raising the back of the tongue and drawing down the palate to form the glossopalatal seal and facilitates posterior oral containment
Bolus preparation/mastication
Oral domain
Component three
Main muscles for bolus preparation/mastication
1.
Group: Muscles of mastication
Names: Massester (elevates the mandible to close the mouth), pterygoids(Medial= elevates mandible to close the mouth, Lateral=Side to side or rotary, movement of the mandible), and temporalis(elevates mandible to close mouth)
Innervation: Via CN V
Actions (above, next to each muscle)
2.
Group: Intrinsic muscles of the tongue (muscles above, same innervation)
Action: Moves the bolus to the surface of the teeth for chewing and assists in bolus formation
Bolus transport/lingual motion
Oral domain
Component four
Main muscles of bolus transport/lingual motion
Group: Intrinsic muscles of the tongue (muscles and innervation the same)
Actions: Presses the tongue against the palate to move bolus posteriorly and maintains cohesive shape of bolus b/w tongue and palate
Oral residue
Oral domain
Component five
NOT a physiologic action
Main muscles of oral residue
Group: Intrinsic muscles of the tongue (muscles and innervation the same as they have been)
Action: Collects and shapes the bolus, and then transports bolus posteriorly
Initiation of pharyngeal swallow
Oral domain
Component six
Sensory, not motor
Main sensory receptive fields
- Sensory receptive fields: Glossopharyngeal (faucil) arches, back of tongue
Innervation: Via CN IX (Glossopharyngeal)
Branch: Pharyngeal branch
Action: Initiation of pharyngeal swallow
2.
Sensory receptive fields: Base of tongue, valleculae, epiglottis, pharyngeal wall, aryepiglottic folds, ventricular folds, arytenoids, true vocal folds, and pyriform sinuses
Innervation: Via CN X (Vagus)
Branch: Superior laryngeal nerve, internal branch
Action: (same as above)
Soft palate elevation (retraction)
Pharyngeal domain
Component seven
Main muscles of soft palate elevation
Group: Muscles of the soft palate
Name: Levator veli palatini
Innervation: Via CN X (Vagus)
Action: Elevates, tenses, and retracts the soft palate against the posterior pharyngeal wall
Laryngeal elevation
Pharyngeal domain
Component eight
Main muscles of laryngeal elevation
1.
Group: Long pharyngeal muscles
Names: Stylopharyngeus (innervated by CN IX, shortens and widens the pharynx), salpingopharyngeus, palatopharyngeus (innervated by CN X, elevates the larynx)
2.
Group: Infrahyoid muscles
Name: Thyrohyoid
Innervation: Via C1 (Cervical spinal nerve 1)
Action: Elevates the thyroid cartilage to the hyoid
Anterior hyoid excursion
Pharyngeal domain
Component nine
Main muscle in the anterior hyoid excursion
Group: Suprahyoid muscles
Name: Geniohyoid
Innervation: Via C1 (Cervical spinal nerve 1)
Action: Anterior movement of the hyoid
Epiglottic movement (inversion)
Pharyngeal domain
Component ten
Main muscles in epiglottic movement
Group: Suprahyoid muscles
Names:
Geniohyoid (innervation via C1)
Mylohyoid (innervation via CN V)
Digastricus (innervation via anterior belly: CN V)
Action: Elevates and moves the hyoid anteriorly contributing to superior-anterior movement trajectory
Laryngeal vestibular closure (height of the swallow)
Pharyngeal domain
Component eleven
Main muscles of laryngeal vestibular closure (height of the swallow)
- Group: Intrinsic muscles of the larynx
Names: Thyroarytenoid, lateral cricoarytenoid (down, inward, and forward rotation and approximation of the arytenoid cartilages to meet bulging epiglottic petiole associated with laryngeal elevation), and interarytenoid (adducts the true vocal folds and approximation of ventricular folds)
Innervation: Via CN X
2.
Group: Muscles of the base of the tongue
Names: Styloglossus (innervated via CN XII) and Palatoglossus (innervated via CN X)
Action: Retracts the base of the tongue and assists in shielding the laryngeal inlet
Pharyngeal stripping wave
Pharyngeal domain
Component twelve
Main muscles in pharyngeal stripping wave
Group: Pharyngeal constrictor muscles
Names: Superior, middle, and inferior constrictor
Innervation: Via CN X
Action: Applies positive pressure generation to the bolus tail through sequential contractions (superiorly to inferiorly)
Pharyngeal contraction
Pharyngeal domain
Component thirteen
Seen in A/P view
Main muscles in pharyngeal contraction
1.
Group: Pharyngeal constrictor muscles (same as above, same innervation, and same action)
2.
Group: Long pharyngeal muscles
Names: Stylopharyngeus (innervated by CN IX, shortens and widens the pharynx) salpingopharyngeus, and palatopharyngeus (innervated by CN X and elevates the larynx)
Pharyngoesophageal segment opening (PES)
Pharyngeal domain
Component fourteen
Main muscle in pharyngoesophageal segment opening
Group: Pharyngoesophageal segment
Name: Cricopharyngeus
Innervation: Via CN X
Action: Tonically contracted at rest, but relaxes during swallowing to facilitate bolus passage
Tongue base retraction
Pharyngeal domain
Component fifteen
Main muscles in tongue base retraction
Group: Extrinsic muscles of the tongue
Names: Styloglossus (innervated via CN XII) and palatoglossus (innervated via CN X)
Action: Retracts the base of the tongue
Pharyngeal residue
Pharyngeal domain
Component sixteen
Main muscles in pharyngeal residue
1.
Group: Pharyngoesophageal segment
Name: Cricopharyngeus
Innervation: Via CN X
Action: Tonically contracted at rest, but relaxes during swallowing to facilitate bolus passage
2.
Group: Pharyngeal constrictor muscles
Names: Superior, middle, and inferior constrictor
Innervation: Via CN X
Action: Applies positive pressure generation to the bolus tail through sequential contractions (superiorly to inferiorly)
3.
Group: Muscles of the base of the tongue
Names: Hyoglossus and styloglossus (innervated by CN XII) and palatoglossus (innervated CN X)
Action: Retracts the base of the tongue
Esophageal clearance (upright position)
Esophageal domain
Component seventeen
Main muscles of esophageal clearance
Name: Longitudinal and circular muscles of the esophagus
Innervation: Via CN X and myenteric plexus
Action: Primary and secondary peristaltic contraction
