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AU14 Physiology > EX1; Swallowing, Emesis, Bruxism, and TMD > Flashcards

EX1; Swallowing, Emesis, Bruxism, and TMD Flashcards

1
Q

Swallowing is a reflex after initial (can be voluntary) but is normally what

A

unconscious

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2
Q

How many times do we swallow a dat

A

1,000

1/min except when eating/sleeping

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3
Q

What are the four components of swallowing

A

large area of brain stem
six cranial nerves
receptors
muscles

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4
Q

What are the four phases of swallowing

A

preparatory
oral
pharyngeal
esophageal

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5
Q

In this stage of swallowing this is the forming of the bolus; same as the pre-swallowing phase at the end of mastication

A

preparatory phase

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6
Q

What are the four parts of the preparatory phase of swallowing

A
  1. bolus is formed and positioned on dorsum of tongue
  2. tip of tongue presses against maxillary incisors or anterior hard palate
  3. region of tongue where the bolus is positioned rises lateral against posterior teeth and palatal mucosa
  4. glossopalatal sphincter forms (temporarily) preventing the bolus from entering pharynx prematurely
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7
Q

This phase is the movement of the bolus from oral cavity to pharynx

A

Oral

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8
Q

This action of the oral phase; lips close, upper and lower incisors move close together has what consequence

A

formation of oral seal

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9
Q

This action of the oral phase; anterior 2/3 of tongue moves up against maxillary alveolar ridge and the anterior hard palate has this consequence

A

pushes the bolus toward the pharaynx

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10
Q

This action of the oral phase; base of tongue moves downward and forward has this consequence

A

expands hypopharynx and opens a chute to pharynx

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11
Q

This action of the oral phase; palate moves up has this consequence

A

opens the glossopalatal sphincter

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12
Q

This action of the oral phase; palate contacts posterior pharyngeal wall and the side walls of the nasopharynx are opposed has this consequence

A

this prevents the bolus from entering the nasal cavity

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13
Q

What mandibular and facial muscles are involved in preparatory and oral phases of swallowing

A

mandibular; masseter, medial pterygoid, temporalis

facial; labial and buccinator

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14
Q

The muscles involved with preparatory and oral phases of swallowing is a variable groups called the “facultative group” why is this

A

which muscles are involved at any time depends largely on the food consistency

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15
Q

contraction of these muscles contribute to the formation of the oral seal and stabilizes the mandible

A

labial and buccinator

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16
Q

True or False

The epiglottis is absolutely requires to prevent the aspiration of food

A

False; it is not required

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17
Q

This phase is the movement of the bolus from oropharynx to esophagus (~0.7 sec)

A

pharyngeal phase

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18
Q

This action of the pharyngeal phase; piston-like movement of posterior tongue has this consequence

A

propels the bolus through the oropharynx and into the hypopharynx

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19
Q

This action of the pharyngeal phase; pharyngal constrictors contract several times has this consequence

A

this moves the bolus through the pharynx

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20
Q

This action of the pharyngeal phase; upper esophageal sphincter opens has this consequence

A

allows bolus to enter the esophagus

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21
Q

This action of the pharyngeal phase; epiglottis movement cause by elevation of the hyoid bone and larynx and contraction of the thryohyoid muscle has this consequence

A

closes the opening to the larynx

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22
Q

What is the group of muscles involved with the pharyngeal phase called and why

A

“obligate group” and its because the leading complex of muscles contract fairly synchronously, followed by contractions that are more sequential

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23
Q

This phase is the movement of food along the entire esophagus (3 sec for liquids, 9 sec for solids)

A

esophageal

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24
Q

These waves of contraction (primarily smooth muscles) move the bolus through the open esophageal sphincter and into the stomach

A

peristaltic

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25
Q

Muscles of esophageal sphincters are what

A

tonically active; however basal activity stops before bolus enters the esophagus

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26
Q

This relaxes about when the tongue and upper pharynx contract and is open before the pressure wave passes through the pharynx

A

upper esophageal sphincter

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27
Q

The upper esophageal sphincter contracts when

A

after the food bolus enters the esophagus and its pressure rises well above resting level for several seconds

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28
Q

This sphincter relaxes for about 3 seconds before peristaltic wave reaches it and remains open until the last in a series of swallows in complete then the sphincter contracts for 1-2 seconds such that again the pressure developed is well above resting level

A

lower esophageal sphincter

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29
Q

These four mechanisms prevent aspiration of food during the pharyngeal phase

A

respiration is inhibited
larynx and upper esophageal sphincter elevate
intrinsic muscles of glottis move vocal cords toward each other
bolus moves through sinuses in pharynx

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30
Q

Which phases of swallowing are voluntary, subconscious or involuntary

A

preparatory and oral; voluntary, normally subconscious

pharyngeal and esophageal; involuntary

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31
Q

What are the three components of the brainstem swallowing center

A

sensory nuclei
motor nuclei
interneuronal network

32
Q

What are the two components of the sensory nuclei in the brainstem swallowing center

A

nucleus tract solitarious (NTS)

trigeminal sensory nucleus

33
Q

What are the two components of the motor nuclei in the brainstem swallowing center

A

nucleus ambiguous

facial, trigeminal, and hyopglossal nuclei

34
Q

This mediates interactions between motor and sensory nuclei

A

interneuronal network

35
Q

These interneurons are involved with initiation and programming (or timing) or swallowing

A

dorsal interneurons

36
Q

These interneurons are involved with distributing the excitation to the swallowing motor nuclei

A

ventral interneurons

37
Q

Which interneuron network can occur in the complete absence of sensory input but normally many afferent fibers send information to these interneurons through the NTS

A

dorsal interneurons

38
Q

These interneurons are also involved in the control of swallowing; cell bodes are not in the brainstem; therefore not considered part of the brainstem swallowing center

A

cervical

39
Q

Afferent information during swallowing originates where

A

in the pharynx, larynx, and esophagus

40
Q

Where does the afferent information during swallowing go, and what does it result in

A

the info is sent to the NTS

results in modulation of swallow, depending on food consistency

41
Q

The activation of afferent fibers can also lead to this

A

the inhibition of some motoneurons

42
Q

Stimulation of the this can also initiate swallowing but it is not required for smooth, efficient swallowing

A

the cortex

43
Q

Infantile swallowing involves the programming of these muscles when,

A

programming of obligate muscles beginning in utero; markedly different from the facultative muscles which have different patterns of activation before and after tooth eruption

44
Q

Infantile swallowing is driven by this before tooth eruption

A

obicularis oris and buccinator; tongue thrust

45
Q

True or False

jaw closer muscles do not have a prominent role in swallowing before eruption

A

True

46
Q

When are jaw closer muscles involved in infantile swallowing

A

after tooth eruption; decreased contribution from labial and buccinator and from tongue thrust

47
Q

What could be the result if infantile swallowing is maintained after tooth eruption

A

malocclusion; specifically an anterior open bite

48
Q

True or False

infants can swallow without disruption of respiration

A

False

49
Q

Is this infant suckling or adult sucking; infant suckling; lips seal around nipple, mandible lowered and negative pressure develops; elevation of jaw and tongue espresses the liquid; both jaw openers and closers involved

A

infant suckling

50
Q

Is this infant suckling or adult sucking; lips form a seal but jaw opening mucles and now closing muscles do not have a prominent role; it is driven by inspiration mucles

A

adult sucking

51
Q

True or False

respiration is maintained during suckling episodes

A

True

52
Q

The purpose of this is to ride the stomach of its contents which often include toxic substances

A

Emesis (vomiting)

53
Q

What are the two stimuli for vomiting

A

physiological

disease-related

54
Q

This stimulus for vomiting includes pain, vestibular imbalance, distention or injury to stomach, intestine, bladder, or uterus, irritation of gut or peritoneum; substances in the blood can directly stimulate chemoreceptors in the medulla

A

physiological

55
Q

This stimulus for vomiting includes increased intracranial pressure (often during a heart attack), stenosis of pyloric valve, radiation therapy, anesthesia, and psychological stress

A

diseases-related

56
Q

What are the three stages of vomiting

A

pre-ejection
ejection
post-ejetion

57
Q

The characteristics of this stage of vomiting include licking, salivation, tachycardia, and relaxation of the proximal part of the stomach

A

pre-ejection

58
Q

What is the duration of the pre-ejection stage of vomiting

A

as short as a few minutes or as long as several days (pregnancy)

59
Q

What are two ejection phases of vomiting

A

retching

expulsion

60
Q

In the retching stage of ejection, the glottis is closed and the inspiratory muscles contract, causing this change in pressure

A

decrease in intra-thoracic pressure

increase in intra-abdomical pressure

61
Q

True or False

Retches can occur repetitively; 1-2 seconds between each

A

True

62
Q

This relaxes during each retch, but contracts again between each one

A

upper esophageal sphincter

63
Q

During the expulsion stage of vomiting, these two things relax, and this contracts

A

antrum of stomach and upper esophageal sphincter relax

rectus abdominus and externam oblique contract

64
Q

What becomes of the pressure differences during the expulsion stage

A

intra-thoracic and intra-abdominal pressures rise do ~100mmHg, compared to the 10mmHg pressure in the resting lower esophageal sphincter

65
Q

This group of nuclei coordinates vomiting act; afferent information from the stimuli terminated in the sensory nucleus of this complex

A

in the medulla; medullary control

66
Q

Direct stimulation near this in animals causes vomiting; this area is also connected to the area postrema which contains the “chemoreceptor trigger zone” which can be stimulated directly by emetic agents in the blood

A

solitary nucleus (NTS)

67
Q

This is forceful tooth clenching and grinding during sleep; sometime rhythmic chewing and sometimes sustained contraction

A

bruxism

68
Q

Interferences in occlusion were thought to cause bruxism, but this is unlikely, why?

A

the primary effect of tooth stimulation is inhibition, not excitation of jaw closers

69
Q

Bruxism is associated with what

A

certain sleep phases; may have a CNS origin

appears to correlate with stress levels

70
Q

In animal studies, the stimulation of certain brain areas, such as this, evoke stress-like responses and the same stimulation causes excitation of jaw-closer motoneurons

A

hypothalamus

71
Q

What are some consequences of bruxism

A

pain, possible muscle damage
excessive tooth wear, fractures
inhibition of chewing
may can use TMD

72
Q

What are some treatment options for bruxism

A

attempt to reduce stress

bite appliance therapy

73
Q

What are the two major issues of TMD

A

pain

impaired chewing efficiency

74
Q

TMDs are more common in which type of people

A

women

decreases with age

75
Q

TMD may be one set of disorders which are collectively referred to as what, involving muscular pain, depression, treatments are similar

A

fibromyalgia

AU14 Physiology (24 decks)

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