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SHS 574 Voice & Swallowing > Chapter 2: Normal Swallowing in Adults > Flashcards

Chapter 2: Normal Swallowing in Adults Flashcards

1
Q

Swallowing is regulated by

A

Cranial nerves of the brainstem medulla limbic cortical systems

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2
Q

4 Stages of swallowing

A
  1. Oral Prep 2. Oral Stage 3. Pharyngeal stage 4. Esophageal stage (<– in which material moves into gastric cardia)
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3
Q

Nasopharynx

A

Above velum

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4
Q

Oropharynx

A

Posterior to the oral cavity

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5
Q

Hypopharynx

A

Most inferior section

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6
Q

Occlusive muscular constriction of the laryngeal vestibule and downward displacement of the epiglottis

A

This protects respiratory system

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7
Q

Valleculae

A

lateral recesses at the base of the tongue on each side of the epiglottis

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8
Q

Piriform sinuses

A

lateral recesses between the larynx and the anterior hypopharyngeal wall

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9
Q

This nerve innervates the principal muscles for chewing

A

Trigeminal (CN V) mandibular branch

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10
Q

Muscles of mastication

A

masseter temporalis lateral pterygoid medial pterygoid

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11
Q

Mandible elevators

A

Temporalis Masseter Medial pterygoid

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12
Q

Muscles that permit jaw grinding

A

Medial pterygoid Lateral pterygoid

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13
Q

This nerve innervates lower facial muscles attached to maxillae and mandible of the skull

A

Facial (CN VII)

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14
Q

This nerve innervates the four muscles of the tongue

A

Hypoglossal nerve (CN XII)

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15
Q

Muscle that serves as a fulcrum for the musculature needed in order to swallow

A

hyoid

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16
Q

Muscles of the palate

A

Levator veli palatini Tensor veli palatini Palatoglossus Palatopharyngeus Uvulae

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17
Q

This nerve innervates all the muscles of the palate EXCEPT the Tensor veli palatini

A

Vagus (CN X) and Accessory (CN XI). *The tensor veli palatini is innervated by the Trigeminal (CN V)*

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18
Q

Suprahyoid muscles

A

Mylohyoid (anterior belly of the digastric) DIgastric (anterior belly) Geniohyoid Stylohyoid Hyoglossus Genioglossus Styloglossus Palatoglossus

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19
Q

This nerve innervates the mylohyoid and the digastric

A

Trigeminal (CN V)

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20
Q

This nerve innervates the geniohyoid

A

Cervical (C1 & C2) through hypoglossal

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21
Q

This nerve innervates the stylohyoid

A

Facial (CN VII)

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22
Q

This nerve innervates all the ‘-glossus’ muscles EXCEPT the palatoglossus

A

Hypoglossal (CN XII)

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23
Q

This nerve innervates the muscular pharynx (superior, middle, and inferior constrictor muscles)

A

Vagus (CN X)

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24
Q

Muscle that lies at the transition between

pharynx —> esophagus. It acts as a sphincter, relaxes during passage of bolus. Innervated by Vagus (CN X)

A

Cricopharyngeal

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25
Q

Separation point between pharynx and esophagus

A

Pharyngeal esophaeal segment (PES)

26
Q

Separation point between esophagus and stomach

A

lower esophageal sphincter (LES)

27
Q

Esophageal area that is collapsed under resting conditions, creating a potential space that can be distended up to 3 cm.

A

esophageal lumen

28
Q

Muscle fibers from

proximal (1/4) end –> middle 1/3–> distal 2/3

A

striated–> smooth & striated–> smooth

29
Q

Relation of esophagus to heart

A

Runs lateral and posterior to the L ventricle of the heart (then it passes toward the diaphragmatic hiatus)

30
Q

5 valves of the swallowing mechanism

A

Lips, velum, airway closure, PES, UES

31
Q

The bolus moves from an area of ___ pressure to ____ pressure as facilitated by laryngeal elevation and tongue deflection.

A

High, low

32
Q

Stasis

A

What happens when the bolus moves from a zone of high pressure –> high pressure, halting flow and creating residue

33
Q

These 2 nerves are responsible for activation of saliva

A

Facial (CN VII) and parotid branch of glossopharyngeal (CN IX)

34
Q

Taste sensation on anterior 2/3 ____, while taste sensation on posterior 1/2 ____.

A

Chorda tympani branch of facial (CN VII), and glossopharyngeal (CN IX)

35
Q

What is involved in the Oral Preparatory stage?

A
  1. Activation of the receptors by saliva
  2. Taste sensations are sent to the laryngeal aditus
  3. Tongue and jaw manipulate & shape bolus onto oropharynx
  4. Triggers the SLN for initiation of the next stage of swallowing
36
Q

What is involved in the Oral Stage?

A
  1. Oral cavity is occluded
  2. As respiration ceases, posterior tongue delivers bolus to pharynx.
  3. VFs are adducted
  4. Palatopharyngeal muscles are pulled medially to form a slit through which the bolus passes.
  5. Velum is sealed
  6. Larynx is pulled up and forward
  7. Epiglottis closes
  8. Vallecular spaces divide bolus at the level of the tongue base, keeping it away from airway
37
Q

Point at which apnea occurs.

A

When bollus collects at the vallecula

38
Q

An extra _____ occurs after swallow.

A

exhalation

39
Q

What is involved in the pharyngeal stage?

A
  1. Hyoid moves superiorly/anteriorly, tilting larynx under retracting tongue base.
  2. S, M, and I constrictor muscles activate to narrow and shorten pharynx, creating peristalsis-like movements to propel bolus.
  3. Bolus moves (divided) into piriform sinuses
  4. Passes the region of the PES, as hyoid returns to rest and airway reopens.
40
Q

What is involved in the Esophageal Stage?

A

Coordination of:

  1. The proximal, striated muscle zone
  2. The body
  3. The distal, specialized smooth muscle zone

*The PES needed to relax and distend to accomodate bolus*

41
Q

Bolus size range

A

1-20 mL

42
Q

Bolus size doesn’t affect _____ & _____, but does affect ________________.

A

Hyoid displacement, effort of the oral-stage transit, length of time the PES stays open to the onset of relaxation

43
Q

Oral Stage and Aging (3)

A
  1. Hypertrophy of tongue and decreased tongue force
  2. Sensory decreases in smell and taste
  3. Alterations in dentition affecting mastication
44
Q

Pharygneal Stage and Aging (4)

A
  1. Inadequate anterior laryngeal movement due to decreased connective tissue, reducing opening of PES
  2. Reduced hyoid movement
  3. Slower transit time overall
  4. Lessening of the protective reflex in upper airway
45
Q

Esophagus and Aging (2)

A
  1. Esophageal contractions are less strong due to smooth muscle thickening
  2. Delay in esophageal emptying, greater nonperistltic contractions
46
Q

Sensory nerves involved in swallowing (3)

A

Facial (CN VII)

Glossopharyngeal (CN IX)

Vagus (CN X)

47
Q

3 “Swallowing center” areas

A
  1. Pons
  2. Mesencephalon
  3. Limbic and cerebral cortices
48
Q

This nerve innervates the massater and pterygoid muscles

A

Trigeminal (CN V)

49
Q

This nerve innervates the muscles of the lips and cheeks

A

Facial (CN VII)

50
Q

These nerves innervates all the extrinsic muscles of the tongue (except the palatoglossus)

A

Trigeminal (CN V) and Hypoglossal (XII)

51
Q

ONLY extrinsic tongue muscle that is not innervated by the trigeminal and the hypoglossal

A

Palatoglossus (it is innervated by the Vagus (CN X) and the Accessory (CN XI))

52
Q

This nerve innervates all the intrinsic muscles of the tongue

A

Hypoglossal (CN XII)

53
Q

This muscle innervates all the palatal muscles (except the tensor veli palatini)

A

Vagus (CN X)

54
Q

The ONLY palatal muscle that is not innervated by the Vagus

A

Tensor veli palatini (it is innervated by the Trigeminal (CN V))

55
Q

This nerve innervates the stylopharyngeus muscle

A

Glossopharyngeal (CN IX)

56
Q

This nerve innervates the palatopharyngeus

A

Vagus (CN X) and the Hypoglossal (CN XII)

57
Q

These nerves are responsible for the gag reflex and nasal regurgitation

A

Glossopharyngeal (CN IX) and Vagus (CN X)

58
Q

Damage to medula unilaterally will cause ______ muscle impairment.

A

Ipsilateral

59
Q

Leading Complex (6 muscles)

A

posterior tongue

superior constrictor

palatopharyngeous

palatoglossus

stylohyoid

geniohyoid

60
Q

Mesenteric plexus

A

A neural network that lies between the circular and longitudinal esophageal musculature

61
Q

Reflexive swallowing is mediated by ________, while voluntary swallowing is mediated by the ________.

A

Brainstem, supranuclear

*Although the act of swallowing is not purely one or the other*

62
Q

Regions of the brain active during swallowing (3)

A

Supplementary motor cortex

Orbitofrontal operculum

anterior cingulate gyrus

SHS 574 Voice & Swallowing (1 decks)

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