Anatomy/Physiology Flashcards
Framework of Respiration
inhalation, chest and lungs expand, diaphragm lowers, air flows in through nose and mouth, air goes down the pharynx and between vocal folds, air continues downward through trachea and bronchial tubes, air reaches the lungs
Spinal Column (how many vertebrae and how many of each)
7 cervical vertebrae
12 Thoracic
5 lumbar
Sacrum
Coccyx
Total: 32-33 Vertebrae
Thick dome shaped muscle that separates the abdomen from the thorax. Considered the primary muscle of inspiration
Diaphragm
What are the muscles between the ribs
Intercostal Muscles
11 Paired and pull the ribs downward
Internal Intercostals
11 paired and raise the ribs up and out to increase diameter of thoracic cavity for inhalation.
External Intercostals
adduct
vocal cords move to midline
abduct
vocal folds open
What u shaped bone is the larynx suspended from
Hyoid bone
What is the largest laryngeal cartilage and forms the anterior and lateral walls of the larynx. It protects the larynx.
Thyroid Cartilage
Cartilage that completely surrounds the trachea and is larger in the back than in the front
Cricoid cartilage
Arytenoid Cartilage
small, pyramid shaped cartilages connected to the superior posterior cricoid. Permits sliding and circular movements.
Intrinsic Laryngeal muscles: responsibility and names
responsible for sound production and movements of the laryngeal cartilages and folds themselves: (PLOT CT)
posterior cricothyroid
lateral cricoarytenoid
oblique arytenoid
thyroarytenoid (Internal thyroarytenoid (vocalis muscle or vocal folds)
cricothyroid
transverse arytenoid
Extrinsic Laryngeal Muscles (purpose)
support the larynx and fix its position
Extrinsic laryngeal muscles (elevators and innervation)
Suprahyoid muscles all attach above the hyoid bone. They “elevate” the larynx.
“good dogs make girls so happy”
Digastric (V, VII)
Mylohyoid (V)
Geniohyoid (XII, C1)
Genioglossus (XII)
Stylohyoid (VII)
Hyoglossus (XII)
Extrinsinc Laryngeal Muscles (Depressors and Innervation)
TOSS
Thyrohyoid (XII, C1)
Omohyoid (C1-C3)
Sternothyroid (C1-C3)
Sternohyoid (C1-C3)
Infrahyoid muscles attach below they hyoid bone and depress the larynx
Composition of the vocal cords
epithelium: outer covering
lamina propria: middle layer
vocalis: body which provides stability and mass to the vocal cords
Aryepiglottic folds
ring of connective tissue and muscle extending fromt he tips of arytenoids to the epiglottis. They separate the laryngeal vestibule from the pharynx and help preferve the airway
Ventricular or false folds
They compress during activities such as coughing and heavy lifing
Cerebellum
Regulates motor movement
Cranial Nerve X
Vagus nerve.
Superior laryngeal nerve: internal and external branches. The interal: sensory info from the larynx
Recurrent laryngeal nerve: supplies all motor innervation to interarytenoid, posterior cricoarytenoid, thyroarytenoid, and lateral cricoarytenoid muscles. Receives all sensory info from BELOW the vocal folds
Source filter theory
energy from vibrating vocal folds is modified by the resonance characteristics of the vocal tract (the filter)
Innervation of pharyngeal muscles
X, XI
Primary muscle of the lips
obicularis oris
Innervation of the facial muscles
VII (facial nerve)
Neurons (definition and its parts)
Central building blocks of the nervous system. most important type of nerve cell. receive information from other neurons, process the information, and then transmit the info to other neurons
Consists of a cell body, dendrites and an axon
Dendrites
short fibers that extend from the cell body. They receive and transmit neural impulses
Nervous System
an organization of nerves
synapses
Junctions which neurons communicate with one another
3 basic types of neurons
motor, sensory, and interneurons
Peripheral Nervous System
collection of nerves outside of the skull and spinal column. They carry sensory impulses to the brain and motor impulses from the brain to the glands and muscles of the body
Contains three types of nerves: Cranial, spinal, and autonomic. There are 12 cranial nerves and 31 pairs of spinal
Broken into somatic (cranial nerves and spinal nerves) and autonomic (sympathetic and parasympathetic)
Cranial Nerves and function
on old olympus towering top a finn and german viewed some hops
I Olfactory: smell
II optic: vision
III Oculomotor: eye movement
IV Trochlear Eye movement
V Trigeminal Face (sensory) and Jaw (motor)
VI Abducents Eye movement
VII Facial Tongue (sensory) and Face (motor)
VIII Acoustic Hearing and Balance (sensory)
IX Glossopharyngeal: Tongue and pharynx (sensory); pharynx (motor)
X Vagus: Larynx, respiratory, cardiac, and gastro
XI Spinal accessory: shoulder, arm, and throat movement
XII Hypoglossal: Mostly tongue movement (motor)
**emerge from the brainstem and are attached to the base of the brain
CN X Vagus Nerve Branches
Recurrent Laryngeal Nerve: Regulates intrinsic muscles of the larynx. May be damaged in thyroid surgery resulting in partial or total paralysis of the vocal cords. The left RLN courses under the heart and back up. It can be damaged during cardiac surgery resulting in paresis or paralysis of the left vocal cord.
Pharyngeal Branch: supplies the pharyngeal constrictors and sensory info from the base of the tongue and pharynx, soft palate muscles (except one)
Superior Laryngeal Nerve: Divided in to internal (sensory) and external (motor) branches. Has an extensive course and can cause many deficits in swallowing, velum paralysis, voice problems. Supraglottic region.
**Vagus also supplies the esophagus and cricopharyngeal muscle, allowing it to relax. Also assists with esophageal peristalsis.
**Also plays a role with cough reflex and airway protection with swallowing
**voicing and resonance also
With lesion, palate and uvula will deviate towards INTACT side. If not elevating at ALL, that means unilateral damage.
Autonomic Nervous System
Controls and regulates the internal environment of our bodies.
Sympathetic branch: mobilizes the body for flight or fight.
Parasympathetic: brings body back to relaxation
Enteric
Central Nervous System
consists of the brain and spinal cord.
Brainstem
connects the brain and spinal cord. Serves as a bridge between the cerebellum and all other CNS structures. Contains the midbrain, pons, and medulla. All cranial nerved EXCEPT I and II begin in the structures of the brainstem.
Midbrain
Help connect the brainstem to the cerebellum. Control many motor and sensory functions. CN III and IV exit the midbrain.
Pons
Bulging structure that bridges the two halves of the cerebellum. The pons and midbrain together serve as a connection point between the cerebellum and various cerebral structures. CN V-VII exit the pons
Medulla
inferior to the midbrain and pons. Controls autonomic bodily functions such as breathing, digestion, heart rate, and blood pressure. Also facilitates reflexes like sneezing and coughing. CN IX-XII exit the medulla. CN VIII lies in between the pons and medulla.
Important for mastication and swallowing
Basal Ganglia
structures deep within the brain. A highly complex system of neural pathways that have connections with many subcortical and cortical areas. Receive input from the frontal lobe and relay information back to the higher centers of the brain via the thalamus. Lesions can result in unusual body postures, dysarthria, changes in body tone, and involuntary and uncontrolled movements.
Cerebellum
called the little brain. Error control and fine tunes movements. Regulates equilibrium, body posture, and coordinated fine motor movements. Very important to speech productions. Damage results in ataxia (abnormal gate, disturbed balance, and speech disorder called ataxic dysarthria)
Cerebrum or cerebral cortex
biggest and most important CNS structure for language, speech, and hearing. A gyrus is a ridge on the cortex and a sulcus is a valley. Fissures are deeper. The longitudinal fissure courses along the middle of the brain from front to back and divides it into left and right hemispheres. The fissure of Rolando runs lateral and divides the anterior and posterior of the brain.
Consists of four lobes: frontal, parietal, occipital, and temporal.
Frontal Lobe
Critical to deliberate formation of plans and intentions. A person with damage has difficulty carrying out consciously organized activity. contains primary motor cortex and Broca’s area. All muscles of the body are connected to the primary motor cortex.
Brocas area is located in the left hemisphere is the motor speech area. It controls motor movements in solved in speech production.
Parietal Lobe
Located on the upper sides of the cerebrum behind the frontal lobe and integrates contralateral somatic sensations (pain, pressure, touch). Also integrates information with other areas, predominantly with vision.
Supramarginal gyrus: damage can cause conduction aphasia and agraphia
Angular gyrus: damage can cause writing, reading, and naming difficulties and, in some cases transcortical sensory aphasia
Occipital Lobe
Primary concerned with receiving and processing visual information
Temporal Lobe
In the dominant hemisphere (left for most people), the auditory association area generally analyzes speech sounds so that people recognize words and sentences. In the non-dominant hemisphere (normally right), it analyzes nonverbal sound stimuli such as environmental noises, music, and prosody.
wernickes area is in the temporal lobe (left side). It is critical to the comprehension of spoken and written language. Lesions cause wernickes aphasia in which patient produces fluent but meaningless speech and experiences significant language comprehension deficits.
Hippocampus is also located in the temporal lobe. It is responsible for recalling information and long term memories. Lesions can result in anterograde amnesia (inability to create new memories) or retrograde amnesia (inability to remember prior to lesion).
aorta
main artery in the heart
Motor neurons innervating our head and neck (types and innervations)
Upper motor neurons (UMN): In the central nervous system. Originate in the cortex and carry info down to the LMN.
Lower Motor neurons (LMN: Part of the peripheral nervous system. Originate in the brainstem (cranial nerves) or spinal cord (spinal nerves). Receive info from UMN and carry it to the muscles on the same side. May receive info from the UMN on the opposite side or from both sides.
Motor neuron diseases destroy the neurons which then negatively impact the activities they control
signs of UMN lesions
spasticity
hypertonia
weakness
hyperreflexia
pathological reflexes
atrophy
normal nerve condution velocity
No denervation potentials on EMG
Contralateral damage
signs of LMN lesions
flaccidity
hypotonis
MORE weakness
Hyporeflexia
Fasciculations
MORE atrophy
abnormal nerve conduction velocity
Denervation potentials on EMG
Ipsilateral damage
only disease you will have both umn (positive babinski) and lmn signs (fasciculations)
ALS
Damage to UMN lesion vs LMN
Typically UMN lesion will affect muscles on contralateral side while LMN lesion will affect the same side (ipsilateral)
Corticobulbar Tracts: Typical
What happens during damage
Bilateral UMN innervation. If one hemisphere is damaged, the intact hemisphere is still sending information. Muscle will be weaker because it lost 50% but will still be receiving signals from the intact side.
Corticobulbar Tracts: Atypical
What happens with damage
Receiving only contralateral UMN innervation. If one hemisphere is damaged, it is 100% lost. Will be very weak as compared to opposite side of the body.
CN V Trigeminal
3 Branches. Largest CN.
1. V1 (sensory): scalp, forehead, eyes, nose
2. V2 (sensory): cheek, upper lip, upper teeth/gums, palate
3. V3 (sensory and motor)
sensory: ear, lower lip, tongue, lower teeth/gums, jaw
motor: tensor veli palatini, tensor tympani, mylohoid, angerior belly of digastricus (muscles of mastication
facial sensation and chewing*
Lesion in CN V Trigeminal Impact on swallowing
Impaired bolus mastication/prep
pain during chewing
impaired pharyngeal swallow onset
Impaired hyoid movement
CN VII Facial
5 branches:
temporal (eyebrow and forehead)
zygomatic (eyelid)
Buccal (cheek, lip)
Mandibular (chin)
Cervical (platysma)-neck muscles
**Ten zombies bothered my colleague
sensory: external ear and taste for ANTERIOR 2/3 of the tongue
motor: muscles of facial expression, salivary glands
Upper face vs Lower face innervation and lesion
Upper face received bilateral innervation EXCEPT for VII facial nerve.
Lower face only receives contralateral innervation
L UMN lesion: Left upper face still getting innervation from the right side so it is fine (lost 50% but still functional and will look normal). Left lower face is still getting innervation from right side so also ok. Contralateral lower face is affected. Upper face on right side has lost 1/2 of its innervation. Called a R central facial weakness with R facial droop.
LMN lesion: impairs both upper and lower face on ipsilateral (same side) e.g., bells palsy
CN IX Glossopharyngeal
plays critical role in onset of pharyngeal swallow. provides sensory info to brainstem that you need to swallow
sensory: sensation to oropharynx including tonsils and sensation and taste to posterior 1/3 of tongue
Motor: stylopharyngeus and parotid gland
CN IX Glossopharyngeal Lesion
sensory: pain, impaired gag reflex, impaired taste
Motor: Reduced laryngeal elevation, reduced pharyngeal shortening, impaired salivation
CN X Vagus Nerve
Longest CN. Travels from head to abdomen.
sensory: sensation to pharynx and larynx, taste sensation to epiglottis
Motor: pharyngeal constrictors, esophagus, palatal muscles
CN X Vagus impact on speech
resonance: hypernasality, weak pressure consonants, nasal air emissions
phonation :limited pitch range and loudness, breathiness/hoarseness, strained-strangled quality (bilateral UMN), diplophonia, aphonia, inspiratory stridor (RLN bilateral damage)
CN XII Hypoglossal
innervates most tongue muscles. Purely motor.
Tongue overview: Sensation
Anterior 2/3= General (V) and Taste (VII)
Posterior 1/3= General and taste (XI
Tongue overview: Movement
Intrinsics: XII
Extrinsics: XII except palatoglossus which is X
CN XII Hypoglossal Impact on speech based on damage location
Unilateral: likely mild distortions
Bilateral: May significantly impair articulation and impaired resonance
efferent vs afferent nerves
efferent: motor. brain sends signals down to nerve to innervate a muscle
*efferent exits
afferent: sensory. signal comes from organ via nerve to brain. afferent arrives
