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MA-SLP BootCamp Exam > Day 3 > Flashcards

Day 3 Flashcards

1
Q

3 anatomical planes of reference

A

coronal, horizontal/transverse, saggital

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2
Q

Transverse plane

A

divides top (head) and bottom (toes)

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3
Q

Coronal plane

A

Divides front (stomach) from back (back)

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4
Q

Saggital plane

A

Divides left from right

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5
Q

Superior

A

above, over

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6
Q

Inferior

A

below, under

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7
Q

Lateral

A

side/outer part of body

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8
Q

Medial

A

near middle/midline

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9
Q

Anterior

A

in front of, front

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10
Q

Posterior

A

behind, near back/rear

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11
Q

Supine

A

laying face up

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12
Q

Prone

A

laying face down

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13
Q

Define: pathophysiology

A

the study of the changes of normal mechanical, physiological, and biomechanical functions, either caused by a disease, or resulting from an abnormal syndrome.

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14
Q

Define: kinematics

A

the branch of mechanics that studies the motion of a body or a system of bodies without consideration of the forces acting upon it

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15
Q

Define: biomechanics

A

the study of the action of external and internal forces on the living body, especially the skeletal system

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16
Q

Define: rheology

A

the branch of physics that deals with the deformation and flow of matter

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17
Q

Efferent/motor nerve function

A

flow of info from brain INTO muscle

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18
Q

Afferent/sensory nerve function

A

flow of info AWAY from sensory receptor in the muscle to the brain

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19
Q

Definition and purpose of muscle

A

The principal mediator of all of our movements

•Responsible for voluntary and involuntary movements

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20
Q

3 types of muscle

A

striated (skeletal), smooth (visceral), cardiac (heart)

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21
Q

Explain striated/skeletal muscle, how many? Paired? Innervated by?

A
  • Innervated by the peripheral nervous system (PNS)

* ~329 skeletal muscles, most are paired

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22
Q

Names of 2 attachments of striated muscle that develop during embryonic development

A

origin and insertion

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23
Q

Muscle name is usually a composite of its ______ and _________

A

origin and insertion points

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24
Q

Muscle contraction _______ the distance between origin and insertion, so we can predict what a particular muscle contraction will do.

A

shortens

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25
Q

What is the purpose of striated/skeletal muscle?

A

Move the skeleton

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26
Q

Define: muscle hydrostat

A

biological structure found in animals used to manipulate items (food)
muscles with no skeletal support interdigitated muscle orientation
deforms, many trajectories

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27
Q

3 examples of muscle hydrostats

A

tongue, trunk, tentacles

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28
Q

Action in a living body is _____ a laboratory model of muscle activity

A

NOT

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29
Q

Muscles act in _______ groups, so the lab model often ((does/doesn’t) account for opposing or complementary muscles in the group.

A

functional, doesn’t

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30
Q

5 special senses

A

vision, hearing, balance, smell, taste

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31
Q

Touch is a _______ sensation

A

general

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32
Q

What defines a special sense?

A

Does not have a specialized organ devoted to it

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33
Q

More info about touch

A

Touch includes mechanoreception (pressure, vibration and proprioception), pain (nociception) and heat (thermoception), and such information is carried in general somatic afferents and general visceral afferents.[1]

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34
Q

Sensation carried to brain by (various/similar) forms of (sensory/motor) receptors

A

various, sensory

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35
Q

Thermoreceptors

A

respond to heat energy

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36
Q

Chemoreceptors

A

respond to chemical energy (smell, taste)

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37
Q

Photoreceptors

A

respond to light energy (rods, cones)

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38
Q

Mechanoreceptors

A

respond to mechanical energy (pressure, distortion)

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39
Q

Nocioceptor

A

specialized chemoreceptor that detects pain via chemicals released from injured tissue

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40
Q

Proprioreceptors

A

specialized mechanoreceptors, particularly in joints, that detect body position

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41
Q

Golgi tendon

A

specialized mechanoreceptor (i.e. proprioreceptor) that detects shape change in tendon (i.e. knee jerk reflex)

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42
Q

Muscle spindles

A

specialized mechanoreceptors (i.e. proprioreceptor) that detect stretch in muscles

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43
Q

Hair cells

A

specialized mechanoreceptors that detect hearing and equilibrium in middle ear

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44
Q

3 common items used to test receptors

A

cold laryngeal mirror, flavored tongue depressor, needle

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45
Q

Intrinsic lingual (tongue) muscles

A

Intrinsic lingual muscles are within the body of the tongue (all cranial nerve XII)

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46
Q

Extrinsic lingual (tongue) muscles

A

Extrinsic lingual muscles connect the body of the tongue with surrounding structures (all cranial nerve XII, except palatoglossus X)

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47
Q

Purpose of tongue

A

rich, diverse sensory perception

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48
Q

3 receptors of general sensation in tongue

A

Mechanoreceptors – pressure/touch Thermoreceptors - temperature Nociceptors - pain

49
Q

3 nerves that innervate tongue, their proportion/location

A

Cranial nerve V- anterior 2/3 general sensory, cranial nerve IX- posterior 1/3 general and special sensory, cranial nerve VII- anterior 2/3 special sensory

50
Q

1 receptor of special sensation in tongue

A

Chemoreceptors- taste

51
Q

CN-V innervates

A

anterior 2/3 of tongue, palate

52
Q

CN-IX innervates

A

posterior 1/3 tongue, palatal arches, upper pharynx, valleculae

53
Q

5 main points: normal posterior lingual propulsion

A
  1. Primary driving force of the bolus
  2. Active bolus containment
  3. Lingual compression due to intrinsic and extrinsic muscles
  4. Propulsion very brief (168msec)
  5. Healthy elders may adjust lingual propulsion pressures alter residue
54
Q

Define: mucosa

A

an epithelial tissue that secretes mucus and that lines many body cavities and tubular organs including the gut and respiratory passages

55
Q

Mucosa function

A

lines structures of the oral cavity

56
Q

Cranial nerves that innervate the oral cavity, their function

A

CN V- general sensation, CN-IX- taste

57
Q

The richest, most diverse sensory region is the _______

A

oral cavity

58
Q

Define: two point discrimination

A

is the ability to discern that two nearby objects touching the skin are truly two distinct points, not one. It is often tested with two sharp points during a neurological exam.

59
Q

The primary goals of the oral cavity for oropharynegal swallowing are

A
  1. Processing food for safe swallowing

2. Posteriorly propelling the food into the pharynx to be swallowed (tongue).

60
Q

What happens when there is reduced oral sensation?

A

Absent, late, reduced pharyngeal response

61
Q

What happens when there is increased oral sensation?

A

Early, robust pharyngeal response

62
Q

Airway protection movements are modified when _________, likely due to _________.

A

bolus sizes vary, oral sensory information that helps to plan swallowing movements

63
Q

Are there swallowing kinematic differences between oropharyngeal swallows and isolated pharyngeal swallows?

A

NO- both 5 mL

64
Q

Are there swallowing kinematic differences by bolus volume between oropharyngeal swallows and isolated pharyngeal swallows?

A

YES for OP swallows, NO for IP swallows

65
Q

Oral sensation (is/is not) required to induce adequate swallowing kinematics

A

is not

66
Q

Oral sensation (can/can’t) optimize swallowing kinematics

A

can

67
Q

Purpose of oral movements

A

Oral movements break food down for safe swallowing

68
Q

Purpose of oral sensation

A

Oral sensation allows planning for swallowing kinematics that best accommodate the approaching bolus

69
Q

A swallow is triggered by (sensory/motor) stimulation to the _______ region

A

sensory, oropharyngeal

70
Q

Once triggered, _______ should follow.

A

a cascade of sequential swallowing events

71
Q

Define stage transition duration

A

Time between bolus at ramus of mandible and time of hyoid burst of swallow-related activity.

72
Q

2 steps in processing the signal of triggering a swallow. Where does trigger go?

A 
To brainstem
Oral horizontal  (time to process the bolus)
Pharynx, larynx vertical (gravity=danger)
73
Q

Explain the critical area in a swallow trigger

A

Critical area – sensory region to trigger patterned, automatic neuromuscular events

74
Q

Transition between oral and pharyngeal (difficult/seamless) in normals, but (sometimes/always) in patients

A

seamless, sometimes

75
Q

When transition between oral and pharyngeal not seamless, it causes a _______

A

delayed swallow onset

76
Q

Swallow normal range (decimal #)

A

-0.22 –> 0.54 seconds

77
Q

Sensory innervation from oropharynx

A

CNV – anterior 2/3 tongue, palate
CNIX – posterior 1/3 tongue, palatal arches, upper pharynx, valleculae
CNX – lower pharynx, upper esophagus, intrinsic larynx, valleculae

78
Q

Sensory nerves for triggering the swallow provide input to what 2 brainstem regions:

A

Nucleus Tractus Solitarius (NTS) •Trigeminal Nucleus

79
Q

4 main points: normal swallow trigger

A
  1. Bolus position at swallow onset varies in healthy adults
  2. Bolus position at swallow onset varies in healthy adults
  3. Bolus position at swallow onset varied is sequen-tial swallowing
  4. Healthy elders have longer swallow onset delays
80
Q

Theme of sliding door analogy

A

timing is critical!

81
Q

4 swallowing structures

A

velum, pharynx, larynx, UES

82
Q

Define velar elevation

A

Posteriorly directed elevation of the velum (soft palate) that contacts the pharyngeal wall. Contact should be COMPLETE

83
Q

Motor nerve innervation to palatal muscles

A

CNV (mandibular branch, pharyngeal plexus)- tensor veli palatini
CNX (pharyngeal branch)- levator veli palatini, palatoglossus, palatopharyngeus, muscularis uvulae

84
Q

Sensory innervation to palatal muscles

A

CNV (maxillary division, lesser palatine n)- general sensory

CN-IX- general sensory (palatal arch); special sensory (taste)

85
Q

Main point about velopharyngeal closure

A

More power in swallowing than speech, blowing

86
Q

Pharyngeal swallowing process

A

Horizontally aligned muscle fibers in the superior, middle and inferior constrictors sequentially contract to help move the bolus downward through the pharynx.

87
Q

pharyngeal stripping wave is (typically, not typically) seen on fluoro in normal adults

A

typically

88
Q

Longitudinal pharyngeal muscles are connected to (higher, lower) structures (i.e. palate, styloid process) and to the hyo-larynx to (elevate, lower) both the _____ and the _______.

A

higher, elevate, pharynx and larynx.

89
Q

3 primary muscles of the pharynx

A

Superior, Middle, and Inferior pharyngeal constrictors

90
Q

Pharynx is innervated by

A

Pharyngeal plexus: CN IX and X

91
Q

2 primary functions of the pharynx

A

Elevate and constrict, facilitate downward bolus movement

92
Q

3 longitudinal pharyngeal muscles, innervation, function

A

Salpingopharyngeus (CNX) Pharyngeal elevation
Stylopharyngeus (CNIX) Pharyngeal & laryngeal elevation
Palatopharyngeus (CNX) Pharyngeal & laryngeal elevation

93
Q

4 primary structures of pharynx movement

A

suprahyoid muscles, thyrohyoid muscles, long pharyngeal muscle, upper esophageal sphincter

94
Q

PARTS for pharynx sensation

A

Mucosa in the nasopharynx
(cranial nerve IX)
Mucosa in the hypopharynx (cranial nerve X)

95
Q

Pharynx sensory innervation

A

CN-IX and CN-X (pharyngeal plexus)- general sensory

96
Q

5 main points: normal pharyngeal constriction

A

Main Points

  1. duration: ~410msec
  2. Pharynx elevates, shortens
  3. Max constriction after UES at max open
  4. Time to max constriction longer with age
  5. Little age related pressure changes
97
Q

Hyoid bone movement and innervation

A 
Superior, anterior
CN V
mylohyoid, anterior belly dig.
CN XII
geniohyoid, hyoglossus
CN VII
stylohyoid, posterior belly dig.
Superior, posterior
Hyoid Bone Movement
Inferior
       Ansa cervicalis C1-3 
      omohyoid, sternohyoid
98
Q

Laryngeal movement and innervation

A 
C1 of Ansa Cervicalis
coursing with CNXII
Thyrohyoid muscle
Superior
CN IX
stylopharyngeus
CN X
palatopharyngeus
Inferior
       Ansa cervicalis C1-3     sternothyroid
99
Q

Intrinsic laryngeal muscles: motor innervation

A

Motor Innervation
Cranial nerve X (recurrent laryngeal): all intrinsic laryngeal muscles, except cricothyroid
Cranial nerve X (superior laryngeal): cricothyroid

100
Q

Laryngeal sensation and innervation

A

CN X superior laryngeal (SLN): Glottis and above

CN X recurrent laryngeal (RLN): Mucosa below the glottis

101
Q

Why is laryngeal vestibule closure necessary?

A

To prevent the bolus from entering the larynx

102
Q

During laryngeal vestibule closure, the ____ contacts the ______.

A

Epiglottis, arytenoids

103
Q

Which muscle is primarily involved in laryngeal vestibule closure?

A

Aryepiglottic muscle

104
Q

Measurement of laryngeal vestibule closure

A

Measured between two time points: 1st frame closed - until - 1st frame re-open

105
Q

Laryngeal Vestibule Closure Duration- Normal Range?

A

0.31-1.07 seconds

106
Q

5 main points: laryngeal vestibular closure

A
  1. LVC occurs from bottom to top
  2. LVC events preceded UES events
  3. LVC has both biomechanical and neuro- muscular parts
  4. LVC varies in sequential swal.
  5. LVC varies in sequential swal.
107
Q

Hyoid anterior movement- normal range?

A

7.6mm-18mm

108
Q

Larynx and hyoid superior movement- normal ranges?

A

Hyoid- 5.8mm-25mm

Larynx- 21mm - 34 mm

109
Q

Define UES (upper esophageal sphincter)

A

Pharyngeal esophageal segment Pharyngeal esophageal junction

110
Q

Primary muscles of UES

A

Cricopharyngeus is the primary muscle of UES

Also comprised of: •Lower Inferior Pharyngeal Constrictor •Superior cuff of Esophageal muscle

111
Q

Motor and sensory innervation of UES

A

Cranial nerve X

112
Q

UES opening and inhibition

A

Relax to open- superior view

CN-X = inhibition

113
Q

2 structures involved in opening the UES- stretch to open

A

cricoid cartilage- excursion, cricopharyngeous muscle

114
Q

Define: Cricopharyngeal bar, near (bottom, top) of cricoid

A

bottom, appearance of a prominent cricopharyngeus muscle

115
Q

Duration of UES opening

A

Measured between two time points: 1st frame open - until - 1st frame closed

116
Q

Opening the UES- normal range

A

0.21 sec - 0.67 sec

117
Q

3 main pointS: normal UES opening

A
  1. UES pressures reduce as bolus moves through
  2. UES opening associated with anterior laryngeal movement
  3. Vocal fold closure precedes UES opening
118
Q

Normal swallowing is _______, thus disorders of swallowing are often _________ (same as first).

A

multifactorial

MA-SLP BootCamp Exam (5 decks)

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