Chapter 2 book

Question 1

When does the Oral Stage Start?

Answer 1

When the tung does posterior movement of bolus

Question 2

HOw much times does it take to complete Oral Stage?

Answer 2

1-1.5 secs (the higher the viscosity = longer time

Question 3

How does the tung move the bolus during the oral stage

Answer 3

In a “stripping action” - Tung presses bolus against the hard palate and creates a central groove (tung must be anchored against maxillariy alvelar ridge)!!
*The more viscosity = more tung strenght needed

Question 4

For the Oral stage to work successfully what needs to work?

Answer 4

4 things!!

1. Labial musculature (good closure)
2. Lingual movement (move the bolus back)
3. Buccal musculature (keep bolus in corect placement_
4. Palatal muscles need to stay open (breathing)

Question 5

T/F: VP closure is necessary for swallowing

Answer 5

Falso: Only if tung base and pharyngeal wall movement and contact is normal, then it can happen (Page 32)

Question 6

What elevates the hyoid and why?

Answer 6

The pull of the floor of the mouth (anterior belly of digastrucus/mylohyoid and geniohyoid)
**This contributes to airway closure and esophageal opening

Question 7

HOw is the pharyngeal swallow activated?

• 1. where are the sensors… and where do they send info to?
     
     2. at what point should the bolus activate the pharyngeal phase?

Answer 7

1. Senosry receptors on tung/faucial pillars/eppiglottis and larynx and oropharynx send info to cortex and brainstem (nucleus tractus solitarus decodes the message and sends info to nuclus ambiguous)
2. The pharyngeal phase starts when the bolus hits where the tung base crosses the lower rim of manible for all people (if not, then its considered delayed)
   Young people= usually anterior faucial pillar
   60+ = middle of tung base
   Others= pyriform sinuses

Question 8

Oral Prep phase normal hold positions are called…

Answer 8

Tippers and dippers
Tippers = b/t the midline of tung and hard palate the tip is elevated to alvealar ridge
Dippers hold food on the floor of mouth infront of tung

**when you hold food between tung and teeth (anteriorly) you may be a tung thruster!! This indicates cerebal palsy or frontal lobe damage

Question 9

How many and what are the phases of swallow

Answer 9

4
1 oral prep
2 oral phase
3 pharyngeal phase
esophageal phae

Question 10

Timing of swallowing phases depends on what?

Answer 10

Type/volume of food and voluntary control over it

Question 11

what is the average deglutition frequency?

Answer 11

580 swallows a day during sleep you can go over 20 mins without swallowing

Question 12

what are the compoents of all swallows?

Answer 12

4!!!! (only difference may be timing)
1. Oral propulsion of bolus to pharynx
2. Airway closure
3. UES opens
4 Tung base and pharyngeal wall propulsion

Question 13

T/F: No volitional control without Oral phase of swallow

Answer 13

Falso!

Question 14

Neuro function for phyraneal trigger

Answer 14

Motor portion = IX and X
Sensory is V, VII and XII
Cortical is there but not understood
Cerebellar is possible

Question 15

What happens when the cricopharyngus contracts? how long does it last? What occurs during this action?

Answer 15

• muscle relaxes (opening) it lasts .1 sec and bolus is pressed through

Question 16

How many and List what occurs during Phygeal swallow

Answer 16

6!!

1. Elevation and retraction of velum - complete closure
2. Elevation and forward movement of hyoid and larynx
3. Closure of larynx @ TVF/FVF anterior tilt of aryntenoids and thickening of the base of the eppiglottis
4. Open cricopharyngeal sphincter
5. ramping of the base of tung then tung base retraction to contact the pposterior pharyngeal wall
6. top to bottom contraction of phaygeal constructers

Question 17

How much (volumes) can be swallowed based on viscosity?

Answer 17

Thin liquids= 1 ml (saliva) - 20 ml+ (cup)
Pudding = 5-7cc
Mashed potates 3-5cc
Meat = 2cc

Question 18

Where does laryngeal closure occur during a swallow?

Answer 18

At the laryngeal vestibule all the way to the VFs

Question 19

How long does the closure of the airway occur during a single swallow?

Answer 19

1-2 thirds of a sec

Question 20

How long does the closure of the airway occur during sequential cup drinking?

Answer 20

5+ secs

Question 21

How much elevation of the larynx is needed before airway closure occurs?

Answer 21

50% of max elevation of larynx is needed

Question 22

How does the body prevent food from falling into lateral sulus ??

Answer 22

Tension in the buccal ms

Question 23

When is spillage not normal?

Answer 23

Spillage is not normal during the hold phase!

Question 24

What does the tung base and pharyngeal wall do together during phyaryngeal phase?
What is the purpose of this action?

Answer 24

the Pharyngealwall and tung base must make complete contact to propel and move bolus down!

Question 25

When does the tung and pharyngeal walls work together?

Answer 25

when the tail of the bolus reaches the tung base!

Question 26

How long does the tung and pharyngeal wall work together for during a single swallow?

Answer 26

1 sec or LESS!