chapter 2 powerpoints Flashcards
How many, and which structures are involved in the oral phase of deglutition?
- Lips
- Teeth (24 deciduous, 32 perm)
- Maxilla
- Velum (also oropharynx)
- tongue (except base)
- uvula (isnt this part of the velum?)
- manible
- floor of mouth
- Faucial Pillars (a&p)
- Palatine tonsils
- Sulci (anterior and lateral)
- Salivary glands (parotid,submandibular,sublingual)
List the tongue muscles (how many are there?
16 ms. (4 intrinsic/4 extrinsic) ins= fine motor superior longitudinal inferior longitudinal transverse vertical (alter shape) Exs= protrude,retract,elevate, depress (gross motor) genioglossus styloglossus hyoglossus palatoglossus
Anterior faucial pillar
-consists of the palatoglossus- it pulls velum down and forward against back of tongue
Posterior Facucial Pillar
Palatopharyngeus - it elevates and retracts the velum (VP closure)
Structures involved in the pharyngeal stage? How many and list
9.
- Pterygoid plates on sphenoid bone (nasopharynx)
- Madible
- Velum (oropharynx)
- Base of tongue
- Hyoid bone
- Pharyngeal walls (pharynx)
- thyroid car
- Cricoid Cartilage
- pyriform sinuses
What are the basic muscle groups in the pharyngeal stage of swallowing?
4 basic groups.
- Suprahyoids/submentals
- infrahyoid
- Constrictors
- CP
What do the suprahyoids consist of?
4:
- mylohyoid
- geniohyoids
- Digastricus (anterior)
What constrictors are involved in the pharyngeal stage of swallow?
Superior, medial, inferior
What is the CP attached to? what is its purpose? what does it divide? and what is unusual about this kind of muscle?
- attached to the Cricoid lamina
- prevents air from entering esophagus/prevents backflow from entering pharynx/oral/nasal cavity
- divides pharynx and esophagus
- tonic at rest contracted closed Open/relaxes when activated
how many, and list the structures of the laryarnx
10.
- hyoid
- Epiglottis
- Valleculae
- Laryngeal Vesitibule
- Aryepiglottic folds (lateral vesitibule walls
- Thyroid cart
- arytenoids carts
- False vocal folds
- True Vocal folds
- Ventricles (lateral
Muscles of the larynx How many and list
7.
- PCA
- LCA
- IA
- TA
- Thyrohyoid
- Sternothryroid
- Sternohyoid
PCA (name it, locate it and what does it do?)
Posterior crico-arytenoid
- attaches cricoid lamina to the arytenoid
- abducts arytenoids/VFs at the end of swallow for respiration
LCA (name it locate it what does it do?)
lateral cricoarytenoid
- attaches cricoid cart to arytenoid
- adducts arytenoids/VFS
IT (name it locate it what does it do?)
Interarytenoids
attaches 2 arytenoids adducts arytenoids/VFs
TA (name it locate it what does it do?)
Thyroarytenoid (MAKES UP THE VFS *along with vocalis)
attached thyroid cart to arytenoid
-it tilts arytenoids anteriorly during swallow to assist with airway closure
Laryngeal strap ms. (list them what are they and what do they do?)
3.
- Thyrohyoid -attaches thyroid cart to hyoid bone (elevates/lowers the larynx)
- sternothyroid -attaches ternum to thyroid cart suspends larynx and trachea in neck
- Sternohyoid - attaches sternum to hyoid - lowers and stabilzes hyoid
Structures of the esophagus include?
UES
Esophagus
LES
UES other names for it…
CP Cricopharygnous
PE Pharyngealesophageal sphincter
How long is the Esophagus
around 25cm long
List the ms of the esophagus
UES
LES
Inner circular
Outer longitudinal
What is the purpose of the LES
Keeps contents in the stomach
what is special about the muscles in the sophagus?
- there are 2 layers that are striated and smooth muscle (inner circular and the outer longitudinal)
How many things.. and what is happening during the Oral (oral prep +oral stage) -how long does it take?
4 things are happening
- mastication
- bolus formation
- Tipper/dipper to be ready to oral transit
- Bolus transport
* *TIME VARIES BASED ON CONSITANCY**
True or Falso?
More viscosity = less pressure = less volume = more ms. activity.
Falso!
More viscosity = less volume = increased pressure = increased muscle activity
T/F
There should be nose breathing occuring during oral stage
True
T/F
Buccal Ms. are invovled during oral stage
YES they are
How many, and list the things that occur during the pharyngeal stage of swallowing
6 events
- Velum elevates and retracts for VP closures Tung base retraction + pharyngeal wall constraction
- Epiglottis inverts *hyolaryngeal elevation and protraction
- Closure of larynx
- CP opening
- Transport by pharyngeal consitrtors
- CP closure/larynx relaxes
when does the pharyngeal stage become activated? what is it called when this does not happen?
- activates when bolus head passes between faucial arches and tongue base
- considered delayed pharygeal swallow if this does not occur
- how long does the esophageal stage take?
- how is the transit time measured?
- How does the bolus move in the esophagus?
- how does the bolus enter the stomach?
- 8-20 secs
- time is measured from UES to the LES
- Bolus transported by the inner circular and outer longitudinal ms of the esophagus causing periostalic contractions
- bolus enters when the LES relaxes and opens
Older vs. babies?
what is the difference in their swallow?
Young:
-larynx and hyoidis higher so less elevation is required
- the velum is lower and pharynx is shorter
- Uvula in epiglottis pocketing valleculae
- Pharygeal stage is triggered at a faucial pillar
Older
-ossified cartiages/hyoid
- pharyngeal stage triggered at middle of tongue base
- 70+ larynx is lower
- artitic in c ver. impinge on pharygeal wall
-become dippers
-delay penetration and residue
-less laryngeal exursion cp opening platues
-cp flexibilty lessens
the pharygneal trigger delay is an indicator of what?
neurological issues
V - what nerve is this
- list the afferent function
- list the efferent function
V = trigeminal
- afferent (sensory) 2/3 anterior tongue
- efferent (motor) Mastication
VII - what nerve is this
list the afferent
list the efferent
Facial
afferent- taste on anterior 2/3 of tongue
efferent- Lips, face, salivary glands
IX list afferent
List efferent
Glossopharyngeal
afferent taste and sensation on post. 1/3 of tongue
Efferent - pharynx/gag reflex
X
list afferent
Liste efferent
Vagus
afferent- mucus membrane of pharynx, larynx, bronchi, lungs, esophagus, stomach
efferent = Trachea, larynx, pharynx, cough reflex
XI
list afferent
List efferent
Accessory nerve
afferent - Uvula, palate, pharyngeal constrictors
XII
List afferent
List efferent
afferent - Sensation mucus membranes of pharynx, palate, post tongue and tonsils
efferent - motor to tongue
what in the brain controls the swallow?
They think both volitional (cortical input) and reflexive (central pattern generator in the brainstem)
what happens during the pharyngeal stage?
Apneic period (no breathing!!)
How long does the apneic period last?
around 1 sec..
is it better to swallow at the top of inhalation or at the bottom of exhalation? why?
It is best to swallow at thetop of inhalation. THis way if there is any residue then when you start breathing, you are exhaling, rather than inhaling, pushing debris out.
