Anatomy: speech and swallowing

Question 1

what are the 3 phases of swallowing

Answer 1

oral phase (voluntary), pharyngeal phase (involuntary), oesophageal phase (involuntary)

Question 2

what is the role of CNV3 in the oral phase of swallowing

Answer 2

supply masticatory muscles (temporalis, masseter, pterygoid medial all close. pterygoid lateral opens).

Question 3

what is the role of CnVII in the oral phase of swallowing

Answer 3

labial seal (orbicularis oris) and tightens cheek (buccinator)

Question 4

what is the role of CNXII in the oral phase of swallowing

Answer 4

intrinsic and extrinsic tongue muscles manipulate bolus and push it against hard palate.

Question 5

what is the role of CNX in the oral phase of swallowing

Answer 5

depresses soft (lesser) palate to create oropharyngeal seal and push bolus posteriorly.

Question 6

what is the nerve supply on the hard palate

Answer 6

branches of pterygopalatine ganglion. secretomotor (CNVII), general sensation (CNV2)

Question 7

what is the course of CNXII

Answer 7

from medulla through carotid sheath supplies all muscles of the tongue except palatoglossus.

Question 8

what is the critical phase of the pharyngeal phase

Answer 8

switch from air channel to food

Question 9

what are the phases of the pharyngeal phase

Answer 9

elevation of soft palate, posterior pressure from tongue, hyolaryngeal elevation, pharyngeal constrictor contraction

Question 10

what happens in hyolaryngeal elevation

Answer 10

hyoid bone moved by suprahyoid and pharyngeal muscles. forces epiglottis to cover laryngeal aditus and protect airway

Question 11

in oesophageal phase, what relaxes the UOS to move the bolus to the oesophagus. what is innervates it?

Answer 11

cricopharyngeus, external laryngeal nerve (CNX)

Question 12

where can the retropharyngeal space spread infection to

Answer 12

mediastinum

Question 13

what forms the pharyngeal plexus and what does it innervate

Answer 13

CNIX, CNX, muscles of soft palate and pharynx (except tensor veli palantini)

Question 14

what are the pharyngeal constrictor muscles muscles

Answer 14

superior constrictor (attaches to maxilla by pterygomandibular raphe), middle constrictor (attaches to hyoid), inferior constrictor

Question 15

where is the gateway to the mouth and what does it conduct

Answer 15

inbetween sup and middle pharynx contrictors. CN IX, lingual artery, stylopharyngeus muscle

Question 16

what is the sensory (afferent) component of the gag reflex

Answer 16

post 1/3 tongue, palatine tonsil, wall of oropharynx (CNIX)

Question 17

what is the motor (efferent) component of the gag reflex

Answer 17

closes of oropharynx. constrictor muscles of pharynx (CNX), longitudinal pharynx muscles (CNIX and X). tongue (CNXII).

Question 18

what muscles open the larynx for respiration

Answer 18

posterior cricoarytenoid. widens rima glottidis

Question 19

what is the protective function of the larynx. what muscles are involved

Answer 19

closes rima glottidis during swallowing. arytenoid muscle and lateral cricoarytenoid

Question 20

how does phonation occur (briefly)

Answer 20

expiration builds sub-glottal pressure in larynx which causes vocal cords to vibrate,

Question 21

what do the intrinsic laryngeal muscles do and what innervates them

Answer 21

move vocal cords for speech, CNX

Question 22

what muscle is involved in lowering pitch and what happens

Answer 22

thyroarytenoid, relaxes vocal ligament (posterior thyroid)

Question 23

what muscle is involved in increasing pitch and what happens

Answer 23

cricothyroid, tenses vocal ligament (anterolateral cricoid cartilage)

Question 24

what is the innervation of the larynx (individual nerves)

Answer 24

mucosa above vocal fold = internal laryngeal, mucosa below vocal fold = inferior laryngeal. all intrinsic muscles (except cricothyroid) are inferior laryngeal.

Question 25

where does the left recurrent laryngeal nerve branch off of

Answer 25

under the aortic loop, CNX

Question 26

what is the path of the vagus nerve in ENT

Answer 26

exits through jugular foramen, sup laryngeal nerve branches off. descends through carotid sheath. recurrent laryngeal breaks of at aortic loop, inferior laryngeal is from recurrent.

Question 27

where to supra-glottic tumours drain to

Answer 27

superior deep cervical nodes

Question 28

where to sub-glottic tumours spread and what clinical presentation is there

Answer 28

para-tracheal, voice/ airway obs

Question 29

what nerves are involved in sound exiting mouth/ nose

Answer 29

soft palate tenses (CNV3), and elevates (CNX), tongue (CNXII) and teeth/ lips (CNVII). make sounds

Question 30

what are oral sounds and nasal sounds

Answer 30

oral most vowels and constants. nasal m, n, ing