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Dysphagia > Anatomy of Swallowing PPT 2 > Flashcards

Anatomy of Swallowing PPT 2 Flashcards

1
Q

Name the oral structures

A 
Lips
Teeth (24 deciduous, 32 permanent)
Maxilla (hard palate)
Velum (soft palate)-shared with oropharynx
Uvula
Mandible (also pharyngeal structure)
Floor of mouth
Tongue (all but base; base=pharyngeal structure)
Faucial arches - anterior & posterior
Palatine tonsils
Sulci - anterior & lateral
Salivary glands - parotid, submandibular, sublingual
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2
Q

Name the INTRINSIC tongue muscles (Oral muscles)

A

Superior longitudinal
Inferior longitudinal
Transverse
Vertical (alter shape)

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3
Q

Name the EXTRINSIC tongue muscles (Oral muscles)

A

Genioglossus
Hyoglossus
Styloglossus
Palatoglossus (protrude/retract, elevate/depress)

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4
Q

Name the TWO muscles of the roof of the mouth (Oral muscles)

A

Palatoglossus

Palatopharyngeus

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5
Q

Where is the palatoglossus located and what is its function?

A

In anterior faucial arch; pulls velum down & forward against back of tongue

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6
Q

Where is the palatopharyngeus located and what is its function?

A

In posterior faucial arch; helps elevate and retract velum (VP closure)

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7
Q

Name the pharyngeal structures.

A 
Pterygoid plates on sphenoid bone (nasopharynx)
Velum (oropharynx)
Base of tongue
Mandible (also oral)
Hyoid Bone
Pharynx! (pharyngeal walls)
Thyroid cartilage
Cricoid cartilage
Pyriform sinuses
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8
Q

T/F All laryngeal structures play a role in swallowing.

A

FALSE; not all laryngeal structures play a role in swallowing

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9
Q

Name the SUPRAHYOIDS/SUBMENTALS (pharyngeal/laryngeal muscles)

A

Mylohyoids
Geniohyoids
Digastrics (Anterior belly)

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10
Q

Name the INFRAHYOIDS (pharyngeal/laryngeal muscles)

A

Thyrohyoid

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11
Q

Name the CONSTRICTORS (pharyngeal/laryngeal muscles)

A

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor

(posterior and lateral walls)

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12
Q

What is the cricopharyngeus (CP)?

A

inferior constrictor fibers attached to cricoid lamina, prevents air from entering esophagus (secondary), reduces backflow, makes the UES

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13
Q

T/F the cricopharyngeus is tonic at rest (when awake)

A

TRUE

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14
Q

T/F the cricopharyngeus divides the oral cavity from the pharyngeal cavity.

A

FALSE; divides pharynx and esophagus

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15
Q

CP’s main jobs are (extra notes):

A

Open and allow bolus to go through
Close to not let air go through (gas)
Reduces backflow of stomach acid

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16
Q

Name the laryngeal structures involved in swallowing.

A 
Hyoid bone
Epiglottis
Valleculae
Laryngeal vestibule
Aryepiglottic folds (lateral vestibule walls)
Thyroid cartilage
Arytenoid cartilages
False vocal folds
True vocal folds
Ventricles-lateral
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17
Q

Name the laryngeal muscles involved in swallowing.

A 
PCA
LCA
Interarytenoid
TA (thyroarytenoid)
Laryngeal strap muscles (Thyrohyoid, Sternothyroid, Sternohyoid)
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18
Q

What is the PCA’s function?

A

PCA=posterior cricoarytenoid: Attaches cricoid lamina to arytenoid; abducts arytenoids/vocal folds for respiration at end of swallow

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19
Q

What is the LCA’s function

A

LCA=lateral cricoarytenoid: Attaches cricoid cartilage to arytenoid; adducts arytenoids/vocal folds

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20
Q

What are the interarytenoid’s function?

A

Attaches 2 arytenoids; adducts arytenoids/vocal folds

21
Q

What is TA’s function?

A

TA=thyroarytenoid: Attached thyroid cartilage to arytenoid; tilts arytenoids anteriorly during swallow to assist with airway closure

22
Q

What is the thyrohyoid’s function?

A

Attaches thyroid cartilage to hyoid bone; elevates & lowers larynx

23
Q

What is the sternothyroid’s function?

A

Attaches sternum to thyroid cartilage; suspends larynx & trachea in neck

24
Q

What is the sternohyoid’s function?

A

Attaches sternum to hyoid; lowers & stabilizes hyoid

25
Q

What muscle makes up the vocal fold?

A

TA (thyroarytenoid) along with vocalis m.

26
Q

List the esophageal structures.

A

UES (upper esophageal sphincter) aka=CP/PE segment
Esophagus
LES (lower esophageal sphincter)

27
Q

Approximately how long is an esophagus?

A

~25cm long

28
Q

Name the esophageal muscles and their function. (2)

A

UES=Keeps air out of esophagus, keeps contents swallowed from coming back up
LES=Keeps contents in stomach

29
Q

How many layers of muscle are located in the esophagus and what are they?

A

2 layers of muscle in esophagus

Inner-circular
Outer-longitudinal

Both striated and smooth muscle

30
Q

List swallowing A&P variations in Young (normal) (4)

A
  1. Higher hyoid & larynx (better protection), less elevation
  2. Lower velum, shorter pharynx
  3. Uvula in epiglottis, pocketing valleculae
  4. Pharyngeal swallow is triggered at anterior faucial arch (bolus flow uninterrupted, no pause)
31
Q

List swallowing A&P variations in Older (normal)

A
  1. Ossification of cartilage & hyoid bone
  2. Pharyngeal swallow triggered when bolus head reaches middle of tongue base
  3. 70+ larynx lower
  4. Arthritis in C vertebrae impinge on pharyngeal wall
  5. “Dippers”
  6. Delay, residue, penetration
  7. Reduced hyolaryngeal excursion, plateaus at CP opening
  8. Reduced CP opening flexibility
32
Q

Swallowing A&P variations (Neurologic)

A

Pharyngeal swallow triggered when bolus head reaches middle of tongue base or when falls into pyriforms

33
Q

List the Sensory (afferent nerves of swallowing)

A

V (Trigeminal), VII (Facial), IX (Glossopharyngeal), X (Vagus), XII (Hypoglossal) (5, 7, 9, 10, 12)

34
Q

Trigeminal V (afferent)

A

Sensation anterior 2/3 of tongue

35
Q

Facial VII (afferent)

A

Taste anterior 2/3 of tongue

36
Q

Hypoglossal XII (afferent)

A

Sensation, mucous membranes of pharynx, palate, posterior tongue and tonsils

37
Q

Vagus X (afferent)

A

Mucous membrane of pharynx, larynx, bronchi, lungs, esophagus, stomach

38
Q

Glossopharyngeal IX (afferent)

A

Taste and sensation posterior 1/3 of tongue

39
Q

List the Motor (efferent nerves of swallowing)

A

V (Trigeminal), VII (Facial), IX (Glossopharyngeal), X (Vagus), XI (Accessory), XII (Hypoglossal) (5, 7, 9, 10, 11, 12)

40
Q

Trigeminal V (efferent)

A

Mastication

41
Q

Facial VII (efferent)

A

Lips, face, salivary glands

42
Q

Hypoglossal XII (efferent)

A

Tongue

43
Q

Glossopharyngeal IX (efferent)

A

Pharynx, gag reflex

44
Q

Vagus X (efferent)

A

Trachea, larynx, pharynx, cough reflex

45
Q

Accessory XI (efferent)

A

Uvula, palate, pharyngeal constrictors

46
Q

When does the apneic period occur?

A

During pharyngeal stage

47
Q

The apneic period increases as _______ increases

A

The apneic period increases as VOLUME increases

48
Q

When does the apneic peiod MOSTLY occur and why?

A

During exhalation (at end or near end);
Safer than during inhalation
Dysphagia occurs during inhalation

Dysphagia (3 decks)

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