Anatomy of Swallowing PPT 2 Flashcards
Name the oral structures
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
Name the INTRINSIC tongue muscles (Oral muscles)
Superior longitudinal
Inferior longitudinal
Transverse
Vertical (alter shape)
Name the EXTRINSIC tongue muscles (Oral muscles)
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus (protrude/retract, elevate/depress)
Name the TWO muscles of the roof of the mouth (Oral muscles)
Palatoglossus
Palatopharyngeus
Where is the palatoglossus located and what is its function?
In anterior faucial arch; pulls velum down & forward against back of tongue
Where is the palatopharyngeus located and what is its function?
In posterior faucial arch; helps elevate and retract velum (VP closure)
Name the pharyngeal structures.
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
T/F All laryngeal structures play a role in swallowing.
FALSE; not all laryngeal structures play a role in swallowing
Name the SUPRAHYOIDS/SUBMENTALS (pharyngeal/laryngeal muscles)
Mylohyoids
Geniohyoids
Digastrics (Anterior belly)
Name the INFRAHYOIDS (pharyngeal/laryngeal muscles)
Thyrohyoid
Name the CONSTRICTORS (pharyngeal/laryngeal muscles)
Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor
(posterior and lateral walls)
What is the cricopharyngeus (CP)?
inferior constrictor fibers attached to cricoid lamina, prevents air from entering esophagus (secondary), reduces backflow, makes the UES
T/F the cricopharyngeus is tonic at rest (when awake)
TRUE
T/F the cricopharyngeus divides the oral cavity from the pharyngeal cavity.
FALSE; divides pharynx and esophagus
CP’s main jobs are (extra notes):
Open and allow bolus to go through
Close to not let air go through (gas)
Reduces backflow of stomach acid
Name the laryngeal structures involved 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
Name the laryngeal muscles involved in swallowing.
PCA LCA Interarytenoid TA (thyroarytenoid) Laryngeal strap muscles (Thyrohyoid, Sternothyroid, Sternohyoid)
What is the PCA’s function?
PCA=posterior cricoarytenoid: Attaches cricoid lamina to arytenoid; abducts arytenoids/vocal folds for respiration at end of swallow
What is the LCA’s function
LCA=lateral cricoarytenoid: Attaches cricoid cartilage to arytenoid; adducts arytenoids/vocal folds
What are the interarytenoid’s function?
Attaches 2 arytenoids; adducts arytenoids/vocal folds
What is TA’s function?
TA=thyroarytenoid: Attached thyroid cartilage to arytenoid; tilts arytenoids anteriorly during swallow to assist with airway closure
What is the thyrohyoid’s function?
Attaches thyroid cartilage to hyoid bone; elevates & lowers larynx
What is the sternothyroid’s function?
Attaches sternum to thyroid cartilage; suspends larynx & trachea in neck
What is the sternohyoid’s function?
Attaches sternum to hyoid; lowers & stabilizes hyoid
What muscle makes up the vocal fold?
TA (thyroarytenoid) along with vocalis m.
List the esophageal structures.
UES (upper esophageal sphincter) aka=CP/PE segment
Esophagus
LES (lower esophageal sphincter)
Approximately how long is an esophagus?
~25cm long
Name the esophageal muscles and their function. (2)
UES=Keeps air out of esophagus, keeps contents swallowed from coming back up
LES=Keeps contents in stomach
How many layers of muscle are located in the esophagus and what are they?
2 layers of muscle in esophagus
Inner-circular
Outer-longitudinal
Both striated and smooth muscle
List swallowing A&P variations in Young (normal) (4)
- Higher hyoid & larynx (better protection), less elevation
- Lower velum, shorter pharynx
- Uvula in epiglottis, pocketing valleculae
- Pharyngeal swallow is triggered at anterior faucial arch (bolus flow uninterrupted, no pause)
List swallowing A&P variations in Older (normal)
- Ossification of cartilage & hyoid bone
- Pharyngeal swallow triggered when bolus head reaches middle of tongue base
- 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
Swallowing A&P variations (Neurologic)
Pharyngeal swallow triggered when bolus head reaches middle of tongue base or when falls into pyriforms
List the Sensory (afferent nerves of swallowing)
V (Trigeminal), VII (Facial), IX (Glossopharyngeal), X (Vagus), XII (Hypoglossal) (5, 7, 9, 10, 12)
Trigeminal V (afferent)
Sensation anterior 2/3 of tongue
Facial VII (afferent)
Taste anterior 2/3 of tongue
Hypoglossal XII (afferent)
Sensation, mucous membranes of pharynx, palate, posterior tongue and tonsils
Vagus X (afferent)
Mucous membrane of pharynx, larynx, bronchi, lungs, esophagus, stomach
Glossopharyngeal IX (afferent)
Taste and sensation posterior 1/3 of tongue
List the Motor (efferent nerves of swallowing)
V (Trigeminal), VII (Facial), IX (Glossopharyngeal), X (Vagus), XI (Accessory), XII (Hypoglossal) (5, 7, 9, 10, 11, 12)
Trigeminal V (efferent)
Mastication
Facial VII (efferent)
Lips, face, salivary glands
Hypoglossal XII (efferent)
Tongue
Glossopharyngeal IX (efferent)
Pharynx, gag reflex
Vagus X (efferent)
Trachea, larynx, pharynx, cough reflex
Accessory XI (efferent)
Uvula, palate, pharyngeal constrictors
When does the apneic period occur?
During pharyngeal stage
The apneic period increases as _______ increases
The apneic period increases as VOLUME increases
When does the apneic peiod MOSTLY occur and why?
During exhalation (at end or near end);
Safer than during inhalation
Dysphagia occurs during inhalation
