Dysphagia 2 - Swallow Anatomy & CNs Flashcards
Which CNs innvervate the oral structures?
CN V - Jaw
CN VII - Orofacial
CV V, XII - Tongue
Describe typical jaw movement.
Name the four muscles of the jaw.
What is a possible sign of nerve damage in the jaw?
Up/down; forward/backward; side to side (i.e. rotary movement)
Lateral pterygoid
Medial pterygoid
Masseter
Temporalis
Weak mastication
Describe the primary purpose of the lips.
T/F - A smaller bolus activates greater muscle force in the lips.
T/F - Strong contraction required to pucker & purse lips
T/F - The lips are not critical in containing bolus
Name two possible signs of weak lip strength.
Grasp & seal
False - larger bolus
True
False
Drooling & spilling of food
Identify the function of each lip/facial muscle:
Obicularis
Zygomatic
Levator anguli oris/ depressor &
Levator labii superior/depressor labii inferior
Risorius
Buccinator
Lip closure
Lip retraction & puckering
Elevates corners of lips
Dimples
Flattens cheeks
Which facial CN deals w/ motor aspect?
Which facial CN deals w/ sensory aspect?
CN VII
CN V
Describe the primary purpose of the tongue.
Identify the two types of tongue muscles.
Which way do these muscles run?
Vertical muscles on the tongue are (In/Ex-trinsic).
Hold, manipulate & transport bolus
Intrinsic & extrinsic
Interior & exterior
Intrinsic
Primary sensory receptors on the dorsum of tongue responsible for what sensory perceptions?
What body secretion activates these receptors?
Salty, Sour, Sweet & bitter
Saliva
Tongue motor control is innervated by CN (?).
Tongue sensory receptors are innervated by CN (?).
Motor = CN XII Sensory = CN VII & IX
Identify the three types of intrinsic muscles on the tongue.
Longitudinal, Transverse & Vertical
Describe the general movement of the following muscles:
Longitudinal
Transverse
Vertical
Long - Anterior to posterior movement (tongue tip elevation, protrusion, cupping)
Transverse makes tongue pointier (i.e narrow)
Vertical contract & flatten the tongue
Identify the three types of extrinsic muscles of the tongue.
Styloglossus
Hyoglossus
Genioglossus
Which two extrinsic muscles retract the tongue?
Styloglossus
Hyoglossus
Although both muscles retract the tongue, describe the difference b/w the Styloglossus & Hyoglossus muscles?
Stylo muscles are posterior to the tongue (back & Up)
Hyo muscles are posterior to the tongue (i.e. tongue retraction / Back & down)
Describe the movement of the genioglossus muscle.
What feature does this muscle give the tongue?
Genio helps move the tongue forward.
It also helps get that tongue groove/curve
T/F - Tongue covered with hundreds of taste buds
T/F - Taste receptor cells in different locations respond stronger to some tastes than others
False - Thousands
True
Taste buds most sensitive to . . .
Front?
Sides?
Back?
Sweet & Salty on front
Sour on the sides
Bitter on the back
Identify the three CNs during the pharyngeal stage responsible for sensory reception.
CN’s VII, IX, X
Identify the three CNs during the pharyngeal stage responsible for motor control.
CNs IX, X, XI, XII
Describe two signs that CN IX may be damaged.
Premature spillage
Difficulty triggering swallow reflex
What event is the onset of pharyngeal stage?
Velopharyngeal closure
Identify the two muscles associated w/ velopharyngeal closure?
Levator & Tensor Veli palatini
Describe the actions of the LVP during velopharyngeal closure.
Which two CNs are involved in this closure?
Raises or elevates velum toward pharyngeal wall
CN X & XI
Describe the actions of the TVP during velopharyngeal closure.
Which CN is involved in this closure?
Opens auditory tube
May tense anterior velum during elevation
Velum stretches during elevation
CN V
T/F - Palatoglossus is a tongue muscle
What does the palatoglossus underlie?
Describe the movement of the palatoglossus.
Which CN innervate it?
False - Not a tongue muscle
Faucial arches
Lowers velum to contact the back of oral tongue; elevates posterior tongue
CN X & XI
Palatopharyngeus creates (?) phrayngeal wall movement.
PP constricts (?) to channel (?).
Lateral movement
Oropharynx / bolus
BOT tactile/taste sensation is innervated by CN (?).
BOT motor innervation is by CN (?).
T/F - The oral and pharyngeal tongue share the same sensory innervation.
CN IX & CN X
CN XII
False - Innervation is different
During hyolaryngeal elevation, which direction do the hyoid and laryngeal cartilages move?
How long are these cartilages displaced?
How long are the muscles elevated?
Anteriorly/Upward
1/2 sec max.
1/4 sec.
Describe the movement of the mylohyoid muscle during hyolaryngeal elevation.
Describe the movement of the Geniohyoid muscle during hyolaryngeal elevation.
Which direction does the digastric muscle move during this elevation?
Mylohyoid (draw hyoid up and forward)
Geniohyoid (draws hyoid up and forward)
Digastric raises the hyoid
Which CN innvervate . . .
Mylohyoid
Geniohyoid
Digastric
MY - CN V ; CN VII
GEN - CN V ; CN XII
DI - CN V
Identify the two types of VF movements.
Adduction & Abduction
True VF adduction is carried out by what three areas in the larynx?
All these areas are innervated by (???) of CN (?)
Lat. Cricoarytenoid
Interarytenoids
Vocalis (thyroarytenoid)
Recurrent laryngeal nerve of CN X
True VF abduction is carried out by which area in the larynx?
Posterior cricoarytenoid moves VFs apart
Describe the relationship b/w the larynx, trachea, & nerve function.
The larynx (and trachea) convey information to the brain via SLN and RLN branches of the Vagus (i.e., relays info re: entry of material in airway).
The recurrent laryngeal nerve is responsible for (??).
glottic closure
Describe the results of SLN damage.
Loss of SLN function results in absence of cough with secretions in trachea (i.e. silent aspiration)
What are the three primary actions of the swallowing center?
Sensory feedback
Initiates/coordinates
Elicits reflex
Identify the three areas in the brainstem w/ neurologic control of the swallow.
Nucleus tractus solitarius (S)
Nucleus Ambiguus (M)
Reticular formation
