A&P for Swallowing

Question 1

Places and Spaces

Answer 1

◾Is it stuck in the valleculae (spaces posterior to the tongue, anterior to epiglottis)
◾Is it stuck in the pyriform sinuses
◾Is food stuck in the anterior commissure, or the posterior commissure
◾She said to know these locations (picture is found on slide 4 swallowing.ppt), because we need to be accurate when we tell other professionals where the food is being pocketed on the patient.
◾Is food getting stuck in vestibule- aka the additus/additus laryngeaus= much more hazardous than pocketing.

Question 2

VP Port

Answer 2

Is it closing?

Or is the tongue shoving food backwards and it’s coming out the nose?

Question 3

Pharyngeal constrictors

Answer 3

Superior
Middle
Inferior

Question 4

Esophagus

Answer 4

UES- Cricopharyngeus
Perastaltic Motion
LES- lets food into stomach (swallow over)

Question 5

Suprahyoid

Answer 5

•muscles are very important for swallowing, this muscle group is comprised of the laryngeal elevators
◦Digastricus
◦Mylohyoid: forms floor of the mouth
◦Geniohyoid (deep to digastricus), superior to mylohyoid
◦Stylohyoid

Question 6

How does the Larynx protect the airway?

Answer 6

• True Vocal folds close, False Vocal Folds Close, Aryepiglottic folds close, epiglottis closes. Its a sphincter that is air and water proof.
• With the airway sealed off, the food travels to the esophagus and through the lower esophageal sphincter (LES), which lets food into the stomach

Question 7

Infrahyoids

Answer 7

◦Sternohyoid
◦Omohyoid
◦Thyrohyoid - Although it is below the larynx, it is an ELEVATOR - sneaky!
◦Sternothyroid

Question 8

Risk for Dysphasia

Answer 8

◦Lack of muscle function
◾no innervation
◦Lack of sensation
◾Swallow is triggered because of sensation of food on back of tongue
◦Lack of Cough/clear reflex

Question 9

Aspiration

Answer 9

Food has gone below level of true vocal folds (at the level of the glottis)

Question 10

Penetration

Answer 10

Food is sitting in vestibule (additus laryngeaus)

Question 11

Residue

Answer 11

pocketed in oral cavity. Could also mean food in vestibule and pyriform sinuses.

Question 12

Backflow

Answer 12

◦Specifically talking about food/liquid and the Peristaltic motion. Backflow is not vomiting, vomit has hit the stomach and then comes back up. Backflow has never hit the stomach. Its just triggered by food hitting posterior tongue, faucial pillars. TBI can cause backflow.