Com Sci Dis Quiz 4 Flashcards
Population of interest for feeding and swallowing disorders
- Pediatric feeding and swallowing disorders
2. Adult dysphagia
Mastication
Chewing
Deglutition
Swallowing
Dysphagia
Difficulty of swallowing
Feeding
Early stages of swallowing
Bolus
food or liquid mixed with saliva that is to be swallowed
What is the larynx?
A tube within the tube of the throat
A primary purpose of the larynx
to protect the airway
The larynx has an overlaid function of ….
phonation
Anatomical structures necessary for efficient feeding and swallowing
- Soft palate (velum)
- Throat (pharynx)
- Larynx
- Esophagus
4 stages of swallowing
- Oral preparatory stage
- Oral stage
- Pharyngeal stage
- Esophageal stage
What happens in the oral preparatory stage?
- preparing food for transport
- lips, tongue, soft palate hold food within oral cavity
- tongue moves bolus around to be chewed
- tongue gathers bolus into central groove
What happens in the oral (transport) stage?
- Bolus is transported from oral cavity into the pharynx.
When is the swallow reflex triggered?
When the bolus touches the back of the oral cavity (faucial pillars)
What happens in the pharyngeal stage?
- Bolus is propelled into the pharynx.
- Muscles of the pharynx contract > move the bolus down > the back of the larynx
- airway closes
- larynx elevates
- upper opening of the esophagus is pulled open
What happens in the esophagus stage?
- transport of the bolus to the stomach by the esophagus through a movement called “Peristalsys”
Results of an “impaired” swallow
Penetration
Aspiration
What is penetration?
When food and liquid gets past the upper boundary of the larynx
Penetration results in
coughing
choking
respiratory distress
What is aspiration?
When food enters the larynx and passes into trachea and lungs
Aspiration results in
infection (pneumonitis)
asphyxiation
4systems of speech production
- Respiratory
- Phonatory
- Resonatory
- Articulatory
What system is involved in producing sounds and modifying word stress, intonation and other aspects of prosody
Phonatory
Vocal folds held together longer to
increase loudness
Vocal folds stretched to
manipulate frequency (pitch)
What is velopharyngeal port?
the opening between the velum & the back of the pharynx wall
When velum is raised, VP port is
closed > air goes in oral cavity
When velum is lowered, VP
open > air goes in both the oral and nasal cavity
Major structures in articulatory system include
lower jaw
Tongue
Lips
The most important articulator is
tongue
Tongue comprises intrinsic and extrinsic muscle groups divided into 4 sections:
Apex (tip)
Lamina or blade (front)
Center (middle part)
Dorsum (back)
The difference between the articulation of consonants and vowels
Consonants > a constriction in the vocal tract
Vowels > relatively little or not constriction of the vocal tract
What is motor planning?
the processes that define the sequence articulatory goals prior to their occurence
What is motor programming?
For establishing & preparing the flow of motor info across the muscle for speech production
specifying the timing and force required for the movements
What is motor execution?
activating relevant muscles during the movements used in speech production
What is schemas?
memory representations of relationships between various sources of info
Etiology of motor speech disorders (acquired)
damage to a previously intact nervous system
most often caused by CVA, degenerative diseases, brain tumors, and TBI
Etiology of motor speech disorders (developmental)
results from abnormal dev of the nervous system
< congenital diseases (CP) and a variety of genetic syndromes (fragile X, down syndrome), TBI, tumors, CVA
What causes involuntary movements
tremors
Contextual factors include
both personal and environmental factors
4 aspects to consider about motor speech disorders
- body structure
- body function
- activity/ participation
- contextual factors
Motor speech disorders
Motor programming and planning disorders and acquired apraxia of speech (AOS)
Childhood apraxia of speech (CAS)
Acquired dysarthria
Developmental dysarthria
AOS affects primarily ….
the articulatory system of speech production and prosody
Characteristics of AOS
Effortful, slow speech with increased pauses between syllables and sounds, distortion of speech sounds, impaired prosody
Types of dysarthria
Spastic Flaccid Hypokinetic Ataxic Unilateral upper motor neuron Dyskinetic
Spastic dysarthria
increased muscle tone (hypertonicity)
weakness
reduced speed and range of movement and a state of hyperreflexes
Cause of spastic dysarthria
lesions in the motor cortex and its pathway to the LMN that cause muscle contraction
Causes of hyper/Hypokinetic dysarthria
Damage to the basal ganglia
Causes of ataxic dysarthria
damage to the crebellum
Which dysarthria do they include manifestation of tremors?
hypokinetic tremor
Ataxic tremor
