Chapter 2 book Flashcards
When does the Oral Stage Start?
When the tung does posterior movement of bolus
HOw much times does it take to complete Oral Stage?
1-1.5 secs (the higher the viscosity = longer time
How does the tung move the bolus during the oral stage
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
For the Oral stage to work successfully what needs to work?
4 things!!
- Labial musculature (good closure)
- Lingual movement (move the bolus back)
- Buccal musculature (keep bolus in corect placement_
- Palatal muscles need to stay open (breathing)
T/F: VP closure is necessary for swallowing
Falso: Only if tung base and pharyngeal wall movement and contact is normal, then it can happen (Page 32)
What elevates the hyoid and why?
The pull of the floor of the mouth (anterior belly of digastrucus/mylohyoid and geniohyoid)
**This contributes to airway closure and esophageal opening
HOw is the pharyngeal swallow activated?
- where are the sensors… and where do they send info to?
- at what point should the bolus activate the pharyngeal phase?
- where are the sensors… and where do they send info to?
- 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)
- 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
Oral Prep phase normal hold positions are called…
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
How many and what are the phases of swallow
4 1 oral prep 2 oral phase 3 pharyngeal phase esophageal phae
Timing of swallowing phases depends on what?
Type/volume of food and voluntary control over it
what is the average deglutition frequency?
580 swallows a day during sleep you can go over 20 mins without swallowing
what are the compoents of all swallows?
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
T/F: No volitional control without Oral phase of swallow
Falso!
Neuro function for phyraneal trigger
Motor portion = IX and X
Sensory is V, VII and XII
Cortical is there but not understood
Cerebellar is possible
What happens when the cricopharyngus contracts? how long does it last? What occurs during this action?
- muscle relaxes (opening) it lasts .1 sec and bolus is pressed through
How many and List what occurs during Phygeal swallow
6!!
- Elevation and retraction of velum - complete closure
- Elevation and forward movement of hyoid and larynx
- Closure of larynx @ TVF/FVF anterior tilt of aryntenoids and thickening of the base of the eppiglottis
- Open cricopharyngeal sphincter
- ramping of the base of tung then tung base retraction to contact the pposterior pharyngeal wall
- top to bottom contraction of phaygeal constructers
How much (volumes) can be swallowed based on viscosity?
Thin liquids= 1 ml (saliva) - 20 ml+ (cup)
Pudding = 5-7cc
Mashed potates 3-5cc
Meat = 2cc
Where does laryngeal closure occur during a swallow?
At the laryngeal vestibule all the way to the VFs
How long does the closure of the airway occur during a single swallow?
1-2 thirds of a sec
How long does the closure of the airway occur during sequential cup drinking?
5+ secs
How much elevation of the larynx is needed before airway closure occurs?
50% of max elevation of larynx is needed
How does the body prevent food from falling into lateral sulus ??
Tension in the buccal ms
When is spillage not normal?
Spillage is not normal during the hold phase!
What does the tung base and pharyngeal wall do together during phyaryngeal phase?
What is the purpose of this action?
the Pharyngealwall and tung base must make complete contact to propel and move bolus down!
When does the tung and pharyngeal walls work together?
when the tail of the bolus reaches the tung base!
How long does the tung and pharyngeal wall work together for during a single swallow?
1 sec or LESS!
