Dysphagia Pharyngeal Phase continued Flashcards
Hyolaryngeal Elevation Excursion:
something we can all
connective tissue linked to base of tongue ? and muscles between hyoid bone run down to ? and when swallow happens tongue ?
locks the ? aka area above
PRIMARY REASON?
feel
comes down and is connected to hyoid bone/top of larynx/ pulls hyoid up and forward which pulls larynx up and forward
-laryngeal vestibule (area above vocal folds)
airway protection
Hyolaryngeal elevation continued:
muscles responsible for elevation:
which two groups?
suprahyoid muscles
- digastric (CN VII)
- Geniohyoid (CN XII)
- Mylohyoid (CN V )
Deep pharyngeal muscles:
Palatopharyngeus ( X, XI)
Sylopharyngeus (IX)
Upward movement is ?
much smaller than forward movement
elevate directly: ?
upward movements of hyoid have been found to be extremely? while forward movement is consistently more?
raise hyolaryngeal complex by shortening and raising pharynx
small
robust
Protecting the airway: swallow trigger leads to inversion of closure of closure of
previously believed to happen in a ?
complete closure of TVF’s by the time hyoid reaches
three tiered protection
epiglottis to cover laryngeal vestibule
fixed sequence
maximum elevation
variation in sequence of protecting airway based on?
research shows complete closure of vocal folds happens by the time?
possible to protect airway with only
bolus characteristics
hyoid reaches maximum elevation
two levels of protection
How do VF’s close?
-adduction is facilitated by the ? WHICH ARE?
All innervated by ?
intrinsic muscles of larynx
- thyroarytenoids
- lateral cricoarytenoids (sides)
- interarytenoids (between)
recurrent laryngeal branch of CN X (vagus) (everything happens in vagus)
VF closure continued:
lateral cricoarytenoid contracts causing ?
interarytenoids assist by pulling ?
ventricular folds (false folds) are ? that lies ?
-can only be adducted when?
medial movement of arytenoids for adduction of TVFs
-pulling arytenoids closer together
non-muscular mucosal tissue / superior to TVFs and attach to arytenoid
-arytenoids are moved to midline and anteriorly
Epiglottic inversion:
leaf-shaped cartilage - base attaches at bottom of tongue by way of ? the leaf like portion attaches to the hyoid bone via
as the hyolaryngeal complex moves upward and forward the epiglottis begins to ? then cover the ?
the vallecula are spaces created on each side between ?
Vallecula and pyriforms: two collection points common for ?
pyriform above
thyroepiglottic ligament
-hyoepiglottic ligament
-move from vertical to horizontal position (bolus helps to complete closure) / laryngeal vestibule
base of tongue and epiglottis
bolus to collect during swallow
UES
Pharyngeal constriction/contraction:
-progressive/sequential contraction occurs via activation of :
-
-
-
these muscles are semicircular bands that make up ?
contraction is set in motion by the ? to generate ?
superior constrictor muscles
middle constrictor muscles
inferior constrictor muscles
lateral and posterior pharyngeal walls
swallow trigger to generate forces to guide bolus to UES
Peristalsis cannot happen in constriction because it only happens with ?
circular muscles and these muscles are semicircular
The pharyngeal phase of swallow is completed with support of two forces:
mechanical: movement of anatomical features that protect airway and propel bolus through pharynx
pressure: changes in pressure of adjoining chambers assist with bolus propulsion
UES Opening:
not a true
primary makeup is of
tonic (always full of ? ) but? when swallow is triggered
elevation of hyolaryngeal process ?
base of tongue pushes against the ? creating ?
base of tongue retraction aids in ?
sphincter muscle
tone - relaxes
mechanically assists with opening of UES
wall, pressure above bolus to push it down through the pharynx - plunger effect
bolus propulsion and clearence using plunger effect
UES also known as ?
front part of UES connected to?
CP or PES pharyngoesophageal segment
bottom part of UES
