Class 2 Flashcards
Innervation of the Swallow
Normal swallowing includes an integrated, interdependent group of complex ___ ___ emerging from interacting cranial nerves of the ____ and governed by neural regulatory mechanisms in the _____, as well as in the ____ and ___ cortical system.
Normal swallowing includes an integrated, interdependent group of complex feeding behaviors emerging from interacting cranial nerves of the brainstem and governed by neural regulatory mechanisms in the medulla, as well as in the sensorimotor and limbic cortical system.
Oral Preparatory Stage
After food is introduced into the mouth:
1. Closure of \_\_\_
2. Tongue bunches up in the \_\_ with pulled down \_\_ \_\_\_
3. \_\_\_ is in charge of keeping the food in oral cavity
- sealing along the \_\_\_ \_\_\_
- compressing food against
the \_\_ \_\_\_
- moving the food onto \_\_
- pulling back of food to mix
it with \_\_
4. \_\_\_ (parotid, submandibular, sublingual)
5. \_\_ and \_\_wall contraction
After food is introduced into the mouth
Closure of mouth
Tongue bunches up in the back with pulled down soft palate
Tongue is in charge of keeping the food in oral cavity
- sealing along the alveolar
ridge
- compressing food against
the hard palate
- moving the food onto teeth
- pulling back of food to mix it
with saliva
Salivary glands (parotid, submandibular, sublingual)
Facial and buccal wall contractionOral Stage
- The bolus is ready to be ___
- Tongue ___ and pulls ___
- ___ stops
- Anterior tongue elevates to the __ ___, squeezing the bolus toward the __ ___
- Contact with the ___, soft palate, or posterior tongue triggers the ____ stage reflex
- The bolus is ready to be swallowed
- Tongue drops down and pulls posteriorly
- Mastication stops
- Anterior tongue elevates to the hard palate, squeezing the bolus toward the faucial pillars
- Contact with the fauces, soft palate, or posterior tongue triggers the pharyngeal stage reflex
Pharyngeal Stage
- Bolus reaches ___ ____
- Elevation of __ ___ (separation of oropharynx from nasopharynx)
- Cease of _____
- lip ___
- tight ___ of larynx
- constriction of __ __ __
- depression of ___
- ____ of larynx
- Bolus reaches faucial pillars
- Elevation of soft palate (separation of oropharynx from nasopharynx)
- Cease of respiration
- lip sealed
- tight adduction of larynx
- constriction of false vocal folds
- depression of epiglottis
- elevation of larynx
Pharyngeal Stage
- -Relaxed _____ (upper esophageal sphincter)
- -Sequential constriction of ________________
- -Reaching esophageal entrance through __ ___
- -Relaxed cricopharyngeus (upper esophageal sphincter)
- -Sequential constriction of superior, middle, and inferior pharyngeal constrictors
- -Reaching esophageal entrance through pyriform sinuses.
Esophageal Stage
- -Purely ____
- -Bolus reaches the orifice of the ____
- -Transported to the LES by ___ contraction and ___
- -_____ contracts again, when the bolus enters the ___
- -Depressed ___ & ____
- _____ re-begins
- -Purely reflexive
- -Bolus reaches the orifice of the esophagus
- -Transported to the LES by peristaltic contraction and gravity
- -Cricopharyngeus contracts again, when the bolus enters the UES
- -Depressed larynx and soft palate
- -Respiration re-begins
Cavities
1.
2.
3.
Nasopharynx
Oropharynx
Hypopharynx
Neurological Control:
- -“Swallowing is mediated by a distributed neural network that includes ___ & ____ structures with descending input to the brainstem.” –Daniels,(2010)
- -Theories of neural control:
- —Chain of linked ___
- —___ ___ ___ hypothesis
- –“Swallowing is mediated by a distributed neural network that includes cortical and Subcortical structures with descending input to the brainstem.” –Daniels,(2010)
- –Theories of neural control:
- Chain of linked Reflexes
- Central pattern generator hypothesis
~Efferent Motor fibers: ~Afferent sensory fibers: ~Cerebral and \_\_\_ fibers ~\_\_\_\_ swallowing centers -Dorsal Nucleus Tractus \_\_ --Nucleus \_\_\_ --Primary \_\_\_\_ Nucleus --Ventral Medial \_\_\_ \_\_\_\_
~Efferent Motor fibers: (away from organ)
~Afferent sensory fibers (toward organ)
~Cerebral and Midbrain fibers
~Brainstem swallowing centers -
-Dorsal Nucleus Tractus Solitarius
--Nucleus Ambiguous
-- Primary Trigeminal Nucleus
--Ventral Medial reticular
formation~Cerebral control
- ____ cortex
- ___ ___ cortex- face area
- Primary ____ Cortex
- Insula
- _____ White matter
~Cerebral control
- Pre-Motor cortex
- Primary motor cortex- face area
- Primary somatosensory Cortex
- Insula
- Periventricular White matter
Cortical and Sub-cortical Lesion Location:
- Anterior to the __ ___
- ___ vessels more than ___
- Specific Areas:
- Brainstem
- __ ___ cortex
- __ ___ cortex
- Primary _____ Cortex
- Insula
- _____ White matter
- Anterior to the central sulcus
- Large vessels more than small
- Specific Areas:
- Brainstem
- Pre-Motor cortex
- Primary motor cortex
- Primary somatosensory Cortex
- Insula
- Periventricular White matter
Brainstem Made up of:
1.
2.
3.
Made up of:
midbrain
pons
medulla oblongata
Cranial nerves and their nuclei arise from the ____
___ ___ ___ for life are maintained here
Cranial nerves and their nuclei arise from the brainstem
Basic bodily functions for life are maintained here
V Trigeminal Nerve
- 3 branches :
- __ to the muscles of mastication
- _____ : ___ 2/3 on tongue, floor of mouth, gums, teeth, inner lining of cheek, pinna, auditory meatus, TMJ, nasal cavity, eyelids, etc.
V Trigeminal Nerve
- 3 branches
opthalmic (GSA),
maxillary (GSA),
mandibular (GSA, SVE)
- motor supply (efferent) to the muscles of mastication
- sensory info (afferent) : anterior 2/3 on tongue, floor of mouth, gums, teeth, inner lining of cheek, pinna, auditory meatus, TMJ, nasal cavity, eyelids, etc.
VII Facial Nerve
- __ __ : bilateral innervation for the __ facial muscles, contralateral innervation for the ____ facial muscles
- ___ (lacrimal gland) and ___ (sublingual , submandibular gland)
- taste for ____ of tongue
VII Facial Nerve
- facial expression : bilateral innervation for the upper facial muscles, contralateral innervation for the lower facial muscles - tears (lacrimal gland)and salivation (sublingual , submandibular gland) - taste for anterior two-thirds of tongue
