Anatomy + Physiology Flashcards
Trigeminal V is a ___ type nerve. Its functions are:
Sensory AND Motor.
Facial Sensation + Jaw Mvmt (chewing and speech)
Name all 6 cranial nerves involved in speech/swallowing
Trigeminal V
Facial VII
Glossopharyngeal IX
Vagus X
Accessory (spinal) XI
Hypoglossal XII
Facial VII is a ___ type nerve. Its functions are:
Sensory AND Motor.
Taste in front 2/3 (sense); salivary glands + Facial expressions (motor)
Glossopharyngeal IX is a ___ type nerve. Its functions are:
Sensory AND Motor.
SensatN of post. 1/3 Tongue (taste/temp/position/pain),salivary glands, and pharynx sensatN (touch)
Laryngeal elevatN/pharyngeal dilation
Vagus X is a __ type nerve. Its functions are:
Sensory AND Motor.
Superior branch very important for swallow:
SensatN of base of tongue, vallecula, epiglottis, aryepiglottic folds, true and false VFs, pyriform sinuses and post. pharyngeal wall.
Motor - soft palate, pharyngeal constrictors, intrinsic laryngeal muscles, cricopharyngeus (speech/swallow, preventN of nasal regurgitation, airway closure, opening UES)
Accessory spinal XI is a ___ type nerve. Its functions are:
Motor.
Mvmt of the shoulder, arm and throat (palatopharyngeus muscle; courses along with Vagus X to elevate palate)
Hypoglossal XII is a ___ type nerve. Its functions are:
Motor.
Extrinisic + intrinsic muscles of the tongue
Extrinsic muscles of the tongue alter its position. Name the 4 muscles involved and their functions.
Genioglossus - depress + protrude
Hyoglossus - depress + retract
Styloglossus - elevate + retract
Palatoglossus - elevate post. tongue + lower velum
Intrinsic muscles of the tongue alter its shape. Name the 4 muscles involved.
Superior longitudinal
Inferior longitudinal
Transverse
Vertical
The ___ nerve innervates all muscles of the tongue except the ____ muscle.
Hypoglossal XII; palatoglossus
Why would paralysis of the Glossopharyngeal IX nerve be damaging for a swallow?
- Not sending messages to the brain that there’s food on the back of the tongue + pharynx
- Loss of motor control in half of pharynx to successfully swallow
- Absent gag reflex –> increased risk of choking
- Decreased taste –> less interest in eating?
The Recurrent Laryngeal Nerve is a branch from what cranial nerve?
Vagus X
Remember that the RLN touches all intrinsic muscles of the larynx except the cricothyroid
What cranial nerve innervates the tensor tympani?
Trigeminal V
What would happen if there were damage to the Hypoglossal XII nerve?
Tongue paralysis:
- Diminished intelligibility
- Swallowing problems (dec. oral prep, no pressure to propel bolus –> needs to reach the arches to trigger the response)
T/F: Damage to the Hypoglossal XII nerve can cause impaired taste.
False - that would be either the Glossopharyngeal IX or Facial VII
The cranial nerves are part of the
a) Central Nervous System
B) Peripheral Nervous System
C) Somatic Nervous System
D) Automatic Nervous System
Peripheral Nervous System
Both afferent and efferent:
Sensory are afferent, collecting info about the environment and bringing it to the CNS
Motor neurons are efferent, delivering messages from the CNS to muscles + glands
T/F: The CNS is made up of the brain and spinal cord.
True
The Automatic Nervous System controls ____ functions, such as:
Involuntary
Heart beat, digestion, breathing
The Somatic Nervous System is responsible for ____ functions, such as:
Voluntary
Skeletal muscle movement
The Sympathetic nervous system is part of the ____ nervous system. Its functions are:
Automatic Nervous System
Fight or flight; increases heart rate, prepares the body for stress
The Parasympathetic nervous system is part of the ____ nervous system. Its functions are:
Automatic.
Decreasing heart rate; “rest and digest”
The Brainstem controls ____. It contains 3 parts:
Vital functions
Midbrain + pons + medulla
The Midbrain is involved in controlling…
Eye movement
Arousal + Alertness
Hearing
The Thalamus’ role is the…
Main relay station btwn the cerebral cortex + brain stem
The Hypothalamus is involved in…
Regulating the body’s temperature, heart rate, hunger & thirst
The Medulla is involved in…
Breathing, heartbeat, blood pressure & flow
The Pons is involved in…
Chewing, facial movement, blinking and balance
The Cerebellum is involved in…
Balance, posture, equilibrium, muscle mvmt
Broca’s area (#__ and ___) is responsible for…
44 & 45 (Left hemisphere only)
Speech production/motor speech
Wernicke’s area (#__) is responsible for…
22 (Left hemisphere only)
Language/auditory comprehension
The ___ system is the direct motor activation pathway that is primarily responsible for facilitating voluntary muscle mvmt such as speech.
Pyramidal system
Movement on the right side of the body is generally controlled by nerve fibers that originate in the ____, and vice-versa.
Left cerebral cortex
The _____ tract is critical to speech production.
Corticobulbar tract
Lower Motor Neurons are found in the ____ and ____ nerves. They are part of the ____ nervous system and are the final route by which neural impulses communicate with muscles.
Spinal and cranial
Peripheral nervous system
Upper motor neurons are found within the ____ nervous system. They include the pathways of the pyramidal and extrapyramidal systems.
Central nervous system
The extrapyramidal system transmits impulses that control the:
a) postural support
b) fine motor mvmts
c) both
a) postural support
Damage to the extrapyramidal system creates motor disturbances that fall under what type of disorder?
Involuntary movement disorders
The Lower motor neuron pathway comes from the _____ and _____ with a destination of the _____.
Originates in the brainstem and spinal cord
Destination in the muscles
Signs of Lower motor neuron lesion
Damage = loss of ability to innervate skeletal msucles
- Weakness (paralysis or paresis)
- Hypotonia/flaccidity
- Atrophy (wasting of tissue)
- Fasciculations
Functions of the Lower Motor Neuron pathway
- Reflexes + muscle tone
- Acts out upper motor neuron commands for voluntary mvmt and posture
Function of the Pyramidal system
Direct, voluntary, skilled movement
Function of the Extrapyramidal system
Control posture, tone, supports voluntary movement
Signs of UMN - pyramidal system lesion
- Spasticity
- Limited ROM (rigidity)
- Hypertonia
- Hyperreflexia
- Weakness (but not a primary sign)
- Positive Babinski sign
No fasiculations
Signs of extrapyramidal system lesion
- Hypokinesia from decrease in dopamine at substantia nigra (Parkinsonism - Bradykinesia, rigidity, festination, mask-like)
- Hyperkinesia from decrease in acetylcholine due to BG (slow, writhing movements - athetosis, dystonia OR fast movements - chorea, tics, myoclonia)
The Upper Motor Neuron pathway starts at the ____ and ends at the ____.
Cortex
Cranial and spinal nerves’ nuclei
Name the 5 differences btwn breathing for life and breathing for speech
- Inhalation through the nose vs. mouth
- Ratio: Life = 40in/60out Speech = 10in/90out
- Volume of air: L=10%; S=20-25%
- Expiration muscles: Vital=passive; speech=uses intercostals and diaphragm
*5. Vital - thoracic wall moves laterally? Speech - moves medially?
Muscle movement for vital inspiration
Diaphragm and external intercostals contract
Muscle movement for vital expiration
Passive! - diaphragm and external intercostals relax
Name the intrinsic muscles of the larynx. What is their overall purpose/function?
Cricothyroid
Interarytenoids x2
Posterior Cricoarytenoid (PCA)
Lateral Cricoarytenoid (LCA)
Thyroarytenoid
Function: Modifies the shape/configuration of the larynx; change change the pitch/tension
Name the infrahyoid muscles. What is their overall purpose?
Thyrohyoid
Omohyoid
Sternohyoid
Sternothyroid
Depressing hyoid bone/thyroid/larynx –> going to make voice lower
Name the suprahyoid muscles. What is their overall purpose?
Mylohyoid
Geniohyoid
Stylohyoid
Digastric x2
Elevates the hyoid bone which will elongate the vocal folds and make pitch higher
Although the Extrapyramidal system is part of the Upper Motor Neuron pathway, “UMN lesions” refers only to the Pyramidal system.
When there is a lesion to the Extrapyramidal system, we would refer specifically to damage to the…
-Cerebellum
-Basal ganglia
-Substantia nigra
Which lesion site is spasticity associated with?
a) Substantia Nigra
b) Upper Motor Neuron
c) Central Grey Nucleus
d) Lower Motor Neuron
b) Upper Motor Neuron
Which lesion site is fasiculations associated with?
a) Upper Motor Neuron
b) Substantia Nigra
c) Lower Motor Neuron
d) Central Grey Nucleus
c) Lower Motor Neuron
The symptom of hypotonia is associated with cerebellar lesions and what other probable lesion site?
a) Upper Motor Neuron
b) Lower Motor Neuron
c) Central Grey Nucleus
d) Substantia Nigra
b) Lower Motor Neuron
Le symptôme de l’atrophie est associé à quel site de lésion probable?
a) Upper Motor Neuron
b) Le cervet
c) Les NGC
d) Lower Motor Neuron
d) Lower Motor Neuron
A deviation of the tongue to the left (no fasiculations or atrophy) is associated with with what nerve?
a) Trigeminal nerve V
b) Facial nerve VII
c) Vagus nerve X
d) Hypoglossal nerve XII
d) Hypoglossal XII
The symptom of weakness on the inferior right side of the face is associated with a lesion to what nerve?
Facial nerve VII
The symptom of weakness on the inferior right side of the face is associated with a lesion to the UMN or LMN?
UMN
What is the proper name for the vocalis muscle, or the innermost part of the vocal folds?
Thyroarytenoid muscle
T/F: Esophageal cancer is part of Head&Neck cancer
False
Patients should seek medical evaluation if hoarseness extends beyond ___
2 weeks
A total laryngectomy removes __
Everything from hyoid bone to first tracheal ring
Larynx moves __ and __ to open the esophageal sphincter
Up and forward
