EX1; Swallowing, Emesis, Bruxism, and TMD

Question 1

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

Answer 1

unconscious

Question 2

How many times do we swallow a dat

Answer 2

1,000

1/min except when eating/sleeping

Question 3

What are the four components of swallowing

Answer 3

large area of brain stem
six cranial nerves
receptors
muscles

Question 4

What are the four phases of swallowing

Answer 4

preparatory
oral
pharyngeal
esophageal

Question 5

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

Answer 5

preparatory phase

Question 6

What are the four parts of the preparatory phase of swallowing

Answer 6

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

Question 7

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

Answer 7

Oral

Question 8

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

Answer 8

formation of oral seal

Question 9

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

Answer 9

pushes the bolus toward the pharaynx

Question 10

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

Answer 10

expands hypopharynx and opens a chute to pharynx

Question 11

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

Answer 11

opens the glossopalatal sphincter

Question 12

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

Answer 12

this prevents the bolus from entering the nasal cavity

Question 13

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

Answer 13

mandibular; masseter, medial pterygoid, temporalis

facial; labial and buccinator

Question 14

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

Answer 14

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

Question 15

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

Answer 15

labial and buccinator

Question 16

True or False

The epiglottis is absolutely requires to prevent the aspiration of food

Answer 16

False; it is not required

Question 17

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

Answer 17

pharyngeal phase

Question 18

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

Answer 18

propels the bolus through the oropharynx and into the hypopharynx

Question 19

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

Answer 19

this moves the bolus through the pharynx

Question 20

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

Answer 20

allows bolus to enter the esophagus

Question 21

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

Answer 21

closes the opening to the larynx

Question 22

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

Answer 22

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

Question 23

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

Answer 23

esophageal

Question 24

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

Answer 24

peristaltic

Question 25

Muscles of esophageal sphincters are what

Answer 25

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

Question 26

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

Answer 26

upper esophageal sphincter

Question 27

The upper esophageal sphincter contracts when

Answer 27

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

Question 28

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

Answer 28

lower esophageal sphincter

Question 29

These four mechanisms prevent aspiration of food during the pharyngeal phase

Answer 29

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

Question 30

Which phases of swallowing are voluntary, subconscious or involuntary

Answer 30

preparatory and oral; voluntary, normally subconscious | pharyngeal and esophageal; involuntary

Question 31

What are the three components of the brainstem swallowing center

Answer 31

sensory nuclei motor nuclei interneuronal network

Question 32

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

Answer 32

nucleus tract solitarious (NTS) | trigeminal sensory nucleus

Question 33

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

Answer 33

nucleus ambiguous | facial, trigeminal, and hyopglossal nuclei

Question 34

This mediates interactions between motor and sensory nuclei

Answer 34

interneuronal network

Question 35

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

Answer 35

dorsal interneurons

Question 36

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

Answer 36

ventral interneurons

Question 37

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

Answer 37

dorsal interneurons

Question 38

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

Answer 38

cervical

Question 39

Afferent information during swallowing originates where

Answer 39

in the pharynx, larynx, and esophagus

Question 40

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

Answer 40

the info is sent to the NTS | results in modulation of swallow, depending on food consistency

Question 41

The activation of afferent fibers can also lead to this

Answer 41

the inhibition of some motoneurons

Question 42

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

Answer 42

the cortex

Question 43

Infantile swallowing involves the programming of these muscles when,

Answer 43

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

Question 44

Infantile swallowing is driven by this before tooth eruption

Answer 44

obicularis oris and buccinator; tongue thrust

Question 45

True or False | jaw closer muscles do not have a prominent role in swallowing before eruption

Answer 45

True

Question 46

When are jaw closer muscles involved in infantile swallowing

Answer 46

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

Question 47

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

Answer 47

malocclusion; specifically an anterior open bite

Question 48

True or False | infants can swallow without disruption of respiration

Answer 48

False

Question 49

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

Answer 49

infant suckling

Question 50

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

Answer 50

adult sucking

Question 51

True or False | respiration is maintained during suckling episodes

Answer 51

True

Question 52

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

Answer 52

Emesis (vomiting)

Question 53

What are the two stimuli for vomiting

Answer 53

physiological | disease-related

Question 54

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

Answer 54

physiological

Question 55

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

Answer 55

diseases-related

Question 56

What are the three stages of vomiting

Answer 56

pre-ejection ejection post-ejetion

Question 57

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

Answer 57

pre-ejection

Question 58

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

Answer 58

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

Question 59

What are two ejection phases of vomiting

Answer 59

retching | expulsion

Question 60

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

Answer 60

decrease in intra-thoracic pressure | increase in intra-abdomical pressure

Question 61

True or False | Retches can occur repetitively; 1-2 seconds between each

Answer 61

True

Question 62

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

Answer 62

upper esophageal sphincter

Question 63

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

Answer 63

antrum of stomach and upper esophageal sphincter relax | rectus abdominus and externam oblique contract

Question 64

What becomes of the pressure differences during the expulsion stage

Answer 64

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

Question 65

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

Answer 65

in the medulla; medullary control

Question 66

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

Answer 66

solitary nucleus (NTS)

Question 67

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

Answer 67

bruxism

Question 68

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

Answer 68

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

Question 69

Bruxism is associated with what

Answer 69

certain sleep phases; may have a CNS origin | appears to correlate with stress levels

Question 70

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

Answer 70

hypothalamus

Question 71

What are some consequences of bruxism

Answer 71

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

Question 72

What are some treatment options for bruxism

Answer 72

attempt to reduce stress | bite appliance therapy

Question 73

What are the two major issues of TMD

Answer 73

pain | impaired chewing efficiency

Question 74

TMDs are more common in which type of people

Answer 74

women | decreases with age

Question 75

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

Answer 75

fibromyalgia