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Dysphagia 2 - Anatomy & Physiology > Dysphagia 2 - Anatomy & Physiology > Flashcards

Dysphagia 2 - Anatomy & Physiology Flashcards

1
Q

Identify the four stages of swallowing.

A

Oral preparatory
Oral-Transit
Pharyngeal
Esophageal

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2
Q

T/F - All four swallowing stages are interdependent.

T/F - Disorders or dysfunctions in the oral cavity DO NOT spill over into other areas of swallowing.

A

True - each stage influences one another.

False

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3
Q

The Anticipatory Stage involves everything that happens before you put food in your mouth.

Name some examples of this stage.

A

True

Examples include setting the table; cutting up the food, make food appetizing (i.e. taste, smell, sight); prayer; order of meal.

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4
Q

Trachea is (Posterior/Anterior/Inferior/Superior) to the esophagus.

T/F - Both structures have a shared wall.

A

Anterior

True

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5
Q

Identify the four anatomic parts of the swallowing mechanism.

A

Oral Cavity
Pharynx
Larynx
Esophagus

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6
Q

Describe the four features of the Esophagus.

A

25 cm long
Flat/collapsed tube
It travels straight thru to stomach to Lg & Sm intestines

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7
Q

Identify the Seven structures of the Oral Cavity.

A 
Jaw
Cheeks
Lips
Teeth
Tongue
Hard Palate
Soft Palate (Uvula)
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8
Q

The Base of the Tongue is AKA (_____) tongue.

What is the difference b/w the back of the tongue & the base of the tongue?

A

Pharyngeal tongue

Back of tongue is in the oral cavity whereas the base of the tongue is inside the pharynx.

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9
Q

The oral cavity extends from the lips anteriorly/posteriorly to the nasopharynx anteriorly/posteriorly.

What two structures separate the oral cavity from the nasal cavity?

A

Anteriorly / Posteriorly

The bony palate & velum (soft palate)

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10
Q

Where is the “triggering point” of the swallow located in oral cavity?

What two structures inside the oropharyngeal stage make up the valleculae?

A

The edge of the jaw

BOT & epiglottis

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11
Q

Which two areas inside of the oral cavity do people w/ Dysphagia usually pocket food?

A

Anterior & Lateral Sulcus

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12
Q

Identify the three major divisions of the pharynx.

A

Nasopharynx
Oropharnyx
Hypopharnyx

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13
Q

The (?) is shared b/w the nasal & pharyngeal cavity.

The (?) is shared b/w the oral & pharyngeal cavity.

The (?) is located at the bottom 1/3 of the pharynx.

A

Nasopharynx

Oropharynx

Hypopharnyx

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14
Q

What structure is anterior to the Hypopharnyx?

The Hypopharnyx extends from the (?) to the (?) muscle.

A

Larynx

Epiglottis to the cricopharyngeus muscle

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15
Q

The oropharynx extends from the lower (?) to the (?).

A

Lower SP to epiglottis.

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16
Q

Identify the five structures that need to move in order to provide proper closure for airway protection.

A

Epiglottis
Aryepiglottic folds
True & False VFs
Arytenoid cartilages

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17
Q

Name the three main constrictors in the pharynx.

A

Superior, Middle & Inferior pharyngeal constrictor muscles.

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18
Q

Describe the two main purposes of the pharyngeal constrictors.

A

The PCM contract in order to move bolus thru the pharynx.

These muscles are attached to other structures that facilitate the swallow.

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19
Q

Identify the four structures that attach to the Superior Pharyngeal constrictor muscle.

A

Tensor
Levator Palatine
Pterygoid
BOT

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20
Q

Identify the two structures attached to the Middle Pharyngeal Constrictor Muscle.

A

The jaw & hyoid bone.

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21
Q

Identify the two structures attached to the Inferior Pharyngeal Constrictor Muscle.

A

Thyroid & cricoid cartilages

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22
Q

In the oropharynx, the space b/w the BOT & epiglottis is known as (?).

What two structures are located w/in the hypopharynx?

A

Valleculae

Hyoid bone & Piriform sinuses

23
Q

T/F - The UES contracts during hyolaryngeal elevation.

The cricopharyngeus muscle is a ring-like muscle located at the top of the (?).

Name the area located b/w the inferior & lower constrictor muscle.

A

False - It relaxes

Esophagus

Kilanis Dehiscence

24
Q

The attachment of which two areas form the pyriform sinus?

T/F - The pyriform sinuses is considered a structure NOT a space.

Where does the pyriform sinus end?

A

ICM & Thyroid cartilage

False - It’s a space

It ends at the bottom of the pharynx at the cricopharyngeal muscle.

25
Q

The cricopharyngeus muscles is also known as (???).

A

UES

26
Q

The epiglottis is a (?)-like structure that lies above the (?), posterior to the (???).

Identify the two main spaces in the pharynx.

A

Leaf-like, Larynx & Base of the Tongue

Piriform sinuses & valleculae

27
Q

What ligament divides the BOT & epiglottis?

A

Hyoepiglottic ligament

28
Q

T/F - The hyoepiglottic ligament divides the valleculae.

How many spaces does the Hyoepiglottic ligament separate the valleculae into?

A

True

Two: Left & right

29
Q

What structure sits on the posterior rim of the cricoid cartilage?

A

Arytenoids

30
Q

In terms of movement, the epiglottis moves (?) towards the (?) pharyngeal wall.

This movement is known as (?)

T/F - As the epiglottis moves towards the pharyngeal wall it makes contact w/ the arytenoids.

A

Back / Posterior PW

Retroversion

True

31
Q

The fold of the epiglottis & arytenoid cartilage is known as (?).

T/F - These seams close in order to avoid partial closure of the airway.

A

Aryepiglottic folds

True

32
Q

The opening of the larynx is called (??).

The entrance or (?) is the (upper/lower) most portion.

This area extends from the (?) to (superior/inferior) surface of the (??).

A

Laryngeal vestibule

Aditus / uppermost

Entrance / Superior / False Folds

33
Q

The trachea is (Superior/Anterior/Inferior) to the (True/False) VFs.

(?) is the space b/w the false & true VFs.

(?) is the space b/w the false VFs.

A

Inferior / True VFs

Ventricle

Glottis

34
Q

The (?) is described as a long, collapsed muscular tube.

The contraction to push bolus thru the esophagus is called (?).

A

Esophagus

Peristalsis

35
Q

What is Tonic Contraction?

What two structures in the esophagus are in tonic contraction?

T/F - Hyolaryngeal movement impacts relaxation of CPM.

A

It means the muscles are always contracted until a swallow is initiated.

36
Q

Where does the esophagus begin?

The esophagus separates which two areas in the swallowing mechanism?

A

Bottom of pharynx

Pharynx & esophagus

37
Q

What is the purpose of the oral-preparatory stage?

T/F - This is an involuntary stage.

How does the soft palate move during chewing?

A

Preparing food for swallowing

False - It’s voluntary

It lowers & touches the back of the tongue to avoid spillage into the pharynx.

38
Q

Identify the five major components of the oral preparatory stage.

A 
Lip closure
Facial tone
Rotary jaw motion
Rotary lateral tongue motion
Soft palate pulled anteriorly
39
Q

Identify the five areas where the primary receptors of taste are located.

What substance in the body activates these receptors? (HINT: secretion)

A

Tongue
Hard/soft palate
Pharynx,
Supralaryngeal region

Saliva

40
Q

After food is chewed & bolus forms in the oral preparatory stage, when does the oral transit stage begin?

A

When the tongue pulls bolus together & holds it at the hard palate.

41
Q

What type of movement does the tongue make as it positions a bolus into the oropharnyx?

A patient w/ damage to CN (?) may have problems cradling & pushing up bolus.

A

Anterior to posterior movement

CN XII

42
Q

Where is the trigger point of the swallow located?

What is the duration of the oral transit stage?

Oral transit time is measured at (?) & examined (?).

When does OT stage end?

A

At the edge of the jaw

1 second

Bedside / radiographically

OT ends when bolus head passes the anterior faucial arches.

43
Q

Which stage begins as the swallowing reflex is “triggered”?

T/F - It takes a single stimulus to elicit a swallow response.

A

Pharyngeal stage

False - It takes multiple stimuli

44
Q

The swallow response occurs when the head of bolus passes b/w (???) & (??).

In young adults, where the the triggering point begin?

A

Anterior faucial arches & trigger point

Anterior faucial arches

45
Q

Pharyngeal Transit Time (PTT) examines the movement of a bolus between which to areas in the pharynx?

A

Trigger point & UES

46
Q

During a swallow reflex, sensory input from bolus involves the sensory receptors on which seven structures?

A 
hard palate
posterior tongue
anterior faucial arches
tonsils
valleculae
piriform sinuses 
laryngeal vestibule
47
Q

Describe the five neuromuscular events that occur during the swallowing reflex.

These acts take place (independently/simultaneously).

A 
Closure of soft palate/VP
Ramping of tongue base
Elevation & closure of the larynx
Relaxation of the cricopharyngeus muscle
Pharyngeal contraction

Simultaneously

48
Q

Identify the four sphincters that close in the Larynx during the swallowing reflex.

Why do these four areas close during the swallow response?

A

Epiglottis, aryepiglottic folds & False/True VFs

For airway protection

49
Q

Which neuromuscular event during the swallowing reflex is one of the most important aspects?

Describe its movement during this process.

A

Ramping of BOT

It retroverts & contacts the pharyngeal wall.

50
Q

Name the the four swallowing valves active during the swallow response.

A

Lips, velum, VFs & UES

51
Q

Lip & velum closure create (+/-) pressure.

As the UES relaxes & opens up, it creates a vacuum suction w/ (+/-) pressure.

A

Positive

Negative

52
Q

What effect does a leak in any of the swallowing valves have on pressure build up?

A

A leak in the lips, VFs or velum will have a negative effect on positive pressure build up, which affects movement of bolus thru

53
Q

T/F - Bolus size DOES NOT impact movement thru the pharynx.

T/F - Bolus size influences consistency.

A

False

True

54
Q

Define apneic period (i.e. takes place during swallow).

When does the Apneic period occur?

Larger bolus ( > / < ) Apnea period

How long does the apneic period last?

A

It is the point during swallowing where we are not breathing.

Just before or at the same time the bolus moves posterior to the oropharnyx.

Larger apnea period

Fraction of a second

Dysphagia 2 - Anatomy & Physiology (6 decks)

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