A&P of swallow Flashcards
What are the oral structures used in swallowing?
lips teeth maxilla (hard palate) velum (soft palate) uvula mandible floor of mouth tongue (all but the base) faucial arches (anter & post) palatine tonsils sulci (anterior and lateral) salivary glands (parotid, submandibular, sublingual)
How many deciduous teeth/ permanent teeth do we have?
24 deciduous (baby teeth) 32 permanent
What are the muscles of the oral cavity that are important for swallowing?
tongue (extrinsic/intrinsic)
roof of mouth
what are the intrinsic muscles of the tongue?
superior longitudinal
inferior longitudinal
transverse
vertical (alter shape)
what are the extrinsic muscles of the tongue?
genioglossus hyoglossus styloglossus palatoglossus (protrude/retract, elevate/depress)
What are the muscles of the roof of the mouth?
palatoglossus-in anterior faucial arch; pulls velum down & forward against the back of the tongue
palatopharyngeus-in posterior faucial arch; helps elevate & retract velum ( VP closure)
what are the suprahyoids/submentals muscles? They elevate and depress the larynx (extrinsic muscles).
mylohyoids
geniohyoids
digastrics (anterior belly)
what are the pharyngeal constrictors?
superior
middle
inferior
posterior lateral walls
what structure divides the pharynx from esophagus
cricopharyngeus (CP)
prevents backflow
what are the laryngeal structures used in swallowing?
hyoid bone epiglottis valleculae laryngeal vestibule aryepiglottic folds > lateral vestibule walls thyroid cartilage arytenoid cartilages false vocal folds true vocal folds ventricles -lateral
what are some laryngeal muscles that are used during swallowing?
PCA (posterior cricoarytenoid): attaches cricoid lamina to arytenoid; abducts arytenoids/vocal folds for respiration at end of swallow
LCA (lateral cricoarytenoid): attaches cricoid cartilage to arytenoid; adducts arytenoids/vocal folds
IA ( interarytenoid):attaches 2 arytenoids; adducts arytenoids/vocal folds
TA ( thyroarytenoid): attached thyroid cartilage to arytenoid; tilts arytenoids anteriorly during swallow to assist with airway closure
Laryngeal strap muscles:
—thyrohyroid-attaches thyroid cartilage to hyoid bone; elevates and lowers larynx
—sternothyroid: attaches sternum to thyroid cartilage; suspends larynx & trachea in neck
–sternohyoid: attaces sternum to hyoid; lowers and stabilizes hyoid
what is the only abductor of the vocal folds?
PCA
what are the three adductors of the vocal folds?
LCA, IA, TA
which muscle of the vocal folds makes up the vocal fold with the thyrovocalis muscle
TA
how long is the esophagus?
25 cm long
What are the names for the CP (cricopharyngeus) Other names?
PE segment ( pharyngoesophageal sphincter) UES ( upper esophageal sphincter)
what are the parts of the esophagus involved in swallowing?
UES
Esophagus
LES ( lower esophageal sphincter)
What does the UES do?
keeps air out of esophagus, keeps contents swallowed from coming back up
What does the LES do?
keeps contents in stomach
what are the 2 layers of muscle in esophagus
inner circular outer longitudinal ( striated and smooth muscle)
what are the swallowing A& P variations in young and old people.
young normal:
- higher hyoid & larynx (better protection), less elevation needed bc everything is closer together
- lower velum, shorter pharynx
- uvula in epiglottis, pocketing valleculae
- pharyngeal swallow is triggered at anterior faucial arch (boplus flow uninterrupted, no pause_
Older normal:
- ossification of cartilages and hyoid bone
- pharyngeal swallow triggered when bolus head reaches middle of the tongue base (past pillars)
- 70+ larynx lower
- arthritis in C vertebrae impinge on pharyngeal wall
- dippers
- delay, residue, penetration
- reduced hyolaryngeal excursion, plateaus at CP opening
- reduced CP opening flexibility
Neurologic:
Pharyngeal swallow trigerred when bolus reaches middle of tongue base or when falls into pyriforms ( delayed /premature spillage)
What are the cranial nerves of swallowing?
trigeminal facial hypoglossal vagus glossopharyngeal
Tell me the motor and sensory of the trigeminal nerve ( V ) ?
sensory –sensation anterior 2/3 tongue
motor–mastication
Tell me the motor and sensory innervations of the facial nerve ( VII)?
sensory: taste anterior 2/3 of tongue
motor: lips, face, salivary glands
Tell me the motor and sensory innervations of the hypoglossal nerve ( XII) ?
sensation, mucous membranes of the pharynx, palate, post tongue, and tonsils
motor: tongue
tell me the motor and sensory innervations of the vagus ( X)?
sensory: mucous membrane of the pharynx, larynx, bronchi, lungs, esophagus, stomach
motor: trachea, larynx, pharynx, cough reflex
Tell me the motor and sensory innervations of the glosso pharyngeal ( IX)
sensory: taste and sensation post. 1/3 tongue
motor: uvula, palate, pharyngeal constrictors
are they sure where the control for swallowing is?
no
they think the reflexive swallowing is in the CPG: central pattern generator (in medulla)
they think that there may be some cortical damage bc when there is cortical damage it can lead to an abnormal swallow but when underdeveloped infancts are born with out a cortex they have normal swallowing
do you breathe when you swallow?
no there is an apneic period
when is the apneic period?
during the pharyngeal stage
explain the apneic period?
during pharyngeal stage
increases as volume increases
mostly during exhalation (at end or near end)
safer than inhalation
what are the two protectors for your airway during swallowing?
epiglottis and vocal folds
