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Dysphagia > Dysphagia Chapter 1 & 2 > Flashcards

Dysphagia Chapter 1 & 2 Flashcards

1
Q

The Normal Swallow: 4 stages

A

oral - prep
oral
pharyngeal
esophageal

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2
Q

Pharynx:
what is nasopharynx
what is oropharynx
what is hypopharynx

A

soft palate up

base of vallecula is oropharynx

oropharynx down to UES upper esophageal sphincter

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3
Q 
Oral Prep Phrase:
swallow phase is where ?
prior to ?
tongue moves 
...,... movements of jaw ?
chewing continues ? but may be ?
bolus? and? by the tongue against the ?
A

food/liquid is prepared for further phases of swallowing

  • oral phase of swallow
  • bolus laterally to the molars
  • crushing, repetitive movements of jaw reduce bolus size
  • reflexively once initiated/volitionally altered
  • centralized and compressed by the tongue against the hard palate for transfer in later phase
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4
Q

5 paired muscles of mastication:
4 for
1 fo

A

mastication

help forming bolus in center of the mouth

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5
Q

Name them and where they are

A

temporalis: think of temples
masseter: in cheeks
pterygoid (lateral and medial): deep inside

buccinator: muscle of cheeks

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6
Q

Temporalis function:

A

elevates or closes mandible, retracts mandible

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7
Q

masseter function:

A

elevates or closes mandible

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8
Q

Medial Pterygoid:

A

elevates or closes mandible

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9
Q

Lateral Pterygoid:

A

depressor or opener of mandible; protrudes mandible, permits side to side movement of mandible

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10
Q

buccinator function: forms ?

can’t ? if you can’t?

A

pressure in mouth to help form bolus in center of the tongue and elevate against hard palate

increase or decrease pressure in oral cavity if you can’t move muscles in cheek

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11
Q

Innervation of Mastication:
which CN nerve ?
three branches:

A

V (5) trigeminal: tell muscles to move and send sensory info back to brain (sensory and motor)

opthalmic (V1)
Maxillary branch (V2) sensory is primary function
Mandibular branch: only one in control of making muscles move (motor movement and therefore chewing)

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12
Q 
Salivary Glands: 
produce both ? 
saliva is very important in  ?
over ? in human saliva 
reduction may lead to 
three major sets of salivary glands:

Innervated by? n

A

serous and mucous components to aid in formation of lubrication of the bolus

  • digestion, oral health, taste facilitation
  • 1000 proteins
  • xerostomia (dry mouth)

submandibular, parotid, sublingual

CN VII and IX (facial and glossopharyngeal)

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13
Q 
Oral Cavity: 
... receptors on?
-
-
-
-

sensory information from these is transmitted via ?

thermoreceptors: via
chemoreceptors: are mediated by ?

A

mechanical (touch/pressure)

  • tongue
  • teeth
  • gums
  • palate

CN V to the brainstem which coordinates swallow efforts

temperature sensors: sensory branch of CN V

  • taste receptors - mediated by CN VII (anterior 2/3 of the tongue) allows to produce saliva

CN IX (glossopharyngeal) posterior 1/3 of tongue

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14
Q 
oral phase: 
waiting bolus is ?
bolus moves cohesively from?
key structure in this movement is ?
muscles that control tongue in in A>P propulsion?

base of tongue ?

velum elevation to seal nasopharynx via:

A

propelled posteriorly

oral cavity into the oropharynx

tongue

CN XII

  • intrisnic muscles of the tongue
  • extrinsic muscles of the tongue

elevates palatoglossus (CN IX, X)

palatopharyngeus (CN IX and X)
levator muscle of the velum palatini (CN X and XI)

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15
Q 
intrinsic muscles of the tongue: 
- superior longitudinal muscle 
-transverse muscle
-vertical muscle 
-inferior longitudinal muscle:
-
-
A

shorten superior aspect (raise tip) and create concave depression

elongate and narrow

flattens

shorten tongue/depress tip

epiglottis
hyoid bone

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16
Q

extrinsic muscles of the tongue:

A

palatoglossus
styloglossus
genioglossus
hyoglossus

17
Q

At beginning of oral phase:

ends when bolus enters?

A

roof of mouth

oropharynx

18
Q

pharyngeal phase:
generally from the ? until passage through?

a series of ?

  • … closure
  • inversion of
  • anterior/superior movement of
  • …. close
  • proressive
  • opening of ?
A

onset of swallow trigger/the UES

  • involuntary events of airway protection and bolus propulsion
  • velopharyngeal closure
  • epiglottis
  • movement of hyolaryngeal complex
  • ventricular and true vocal folds
  • pharyngeal contraction
  • UES
19
Q

once swallow trigger - it is

peristalsis does not happen in

A

involuntary

-pharyngeal phase of swallow

20
Q 
Sequence: 
pharyngeal 
-.... excursion/elevation
-.. protection 
-pharyngeal ?
opening of

All take place in duration of?

A 
swallow trigger
hyolaryngeal 
-laryngeal protection
-pharyngeal constriction/contraction
-UES

approx. 1 second and overlap

21
Q 
Pharyngeal swallow trigger: 
-sensory input, which is ?, stimulates sensors to ? responsible for motor instruction to muscles of the ?
-
-
-
-
innervated by ?
A

bolus-dependent/activate the cranial nerves (CNs VII, IX, X)

  • velum
  • pharynx
  • larynx
  • UES

CN IX, X, XI

22
Q

trigger continued:
-CNs ..,..,.. sensory fibers carry info to the ? in the brainstem

NTS signals the ? to fire motor responses of ?

  • this motor output is known as the ?
  • NTS can be thought of as
A

VII, IX, and X / nucleus tractus solitarius (NTS)

  • nucleus ambiguus/ CNs IX, X, XI
  • pharyngeal swallow trigger (response)

catcher of info

23
Q

Where’s the sensation?

  • many areas of the aerodigestive tract can ?
  • most research has been focused on the ?
  • common point of trigger for?
  • newer studies state lower regions of the ? to be normal in older adults

-most of all normal swallows trigger when bolus reaches?

A
  • trigger pharyngeal swallow
  • anterior faucial arches via strong connections with CN IX
  • pharynx

-the base of the tongue at the level of the lower edge of the mandible

24
Q

Hyolaryngeal elevation:

  • as tongue moves posteriorly elevation of the ?
  • newer evidence suggests that the … is the most important muscle in pulling?
  • this retraction elevates the ? and is maintianed throughout ?

the tongue has muscular connection to the ? which has muscular connection to the ?

A

posteriorly (digastric, geniohyoid, mylohyoid muscles) / complex begins
-mylohyoid/ hyoid superiorly

  • hyoid bone in superior and anterior plane/ a large portion of the swallow
  • hyoid/ thyroid and cricoid cartilages of the larynx

Dysphagia (17 decks)

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