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Dysphagia > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

Muscles responsible for Mandible Elevation

A

Masseter, temporalis, medial pterygoid

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2
Q

Masseter (mandible elevation)

A

Origin: zygomatic arch (cheek)
Insertion: mandible at angle
Innervation: V (mandibular branch of trigeminal)

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3
Q

Temporalis (mandible elevation)

A

Origin: temporal bone (lateral surface)
Insertion: coronoid process of mandible
Innervation: V (mandibular branch of trigeminal)

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4
Q

Medial Pterygoid

A

Origin: sphenoid bone
Insertion: inner surface of mandible
Innervation: V (mandibular branch of trigeminal)

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5
Q

Muscles responsible for Mandible Protrusion

A

lateral pterygoid

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6
Q

Lateral pterygoid (mandible protrusion)

A

Origin: sphenoid bone
Insertion: mandible at condyle
Innervation: V (mandibular branch of trigeminal)

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7
Q

Muscles responsible for Mandible Depression

A

Geniohyoid, mylohyoid, anterior belly digastric

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8
Q

Geniohyoid (mandible depression)

A

Origin: hyoid
Insertion: mandible, inner anterior surface
Innervation: C1 root

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9
Q

Mylohyoid (mandible depression)

A

Origin: hyoid
Insertion: mandible, inner surface
Innervation: V (mandibular branch of trigeminal)

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10
Q

Anterior belly digastric (mandible depression)

A

Origin: hyoid
Insertion: mandible, inner anterior surface
Innervation: V (mandibular branch of trigeminal)

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11
Q

Muscles responsible for HLE with anterior movement

A

geniohyoid, mylohyoid, anterior belly digastric

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12
Q

Geniohyoid (HLE with anterior movement)

A

Origin: mandible, inner anterior surface
Insertion: hyoid
Innervation: C1 root

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13
Q

Mylohyoid (HLE with anterior movement)

A

Origin: inner surface of mandible
Insertion: hyoid
Innervation: V (mandibular branch of trigeminal)

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14
Q

Anterior belly digastric (HLE with anterior movement)

A

Origin: mandible, inner anterior surface
Insertion: hyoid
Innervation: V (mandibular branch of trigeminal)

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15
Q

Muscles responsible for HLE with posterior movement

A

stylohyoid, posterior belly digastric

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16
Q

Stylohyoid (HLE with posterior movement)

A

Origin: styloid process of temporal bone
Insertion: hyoid
Innervation: VII facial

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17
Q

Posterior belly digastric (HLE with posterior movement)

A

Origin: mastoid process of temporal bone
Insertion: hyoid
Innervation: VII

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18
Q

Muscle responsible for tongue protrusion

A

Genioglossus

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19
Q

Genioglossus (tongue protrusion)

A

Origin: anterior mandible near geniohyoid
Insertion: body of tongue
Innervation: XII hypoglossal

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20
Q

Muscle responsible for vertical HLE

A

Hyoglossus

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21
Q

Hyoglossus (vertical HLE)

A

Origin: tongue body
Insertion: hyoid greater horns
Innervation: XII facial

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22
Q

Muscle responsible for tongue base elevation

A

Palatoglossus

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23
Q

Palatoglossus (tongue base elevation)

A

Origin: soft palate
Insertion: tongue base laterally through anterior faucial pillars
Innervation: X

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24
Q

Muscle responsible for tongue base elevation and retraction

A

styloglossus

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25
Styloglossus (tongue base elevation/retraction)
Origin: styloid process of temporal bone Insertion: tongue base to tip Innervation: XII (hypoglossal)
26
Muscle responsible for tongue depression
hyoglossus
27
Hyoglossus (tongue depression)
Origin: hyoid Insertion: tongue Innervation: XII (hypoglossal)
28
Muscles responsible for tongue shaping
Intrinsic muscles of the tongue: vertical, transverse, and longitudinal
29
Muscle responsible for velum depression
palatoglossus
30
Palatoglossus (velum depression)
Origin: tongue base laterally through anterior faucial pillars Insertion: soft palate Innervation: X (vagus)
31
Muscle responsible for velum elevation
levator veli palatini
32
Levator veli palatini (velum elevation)
Origin: skull base Insertion: soft palate Innervation: X (vagus)
33
Muscle responsible for velum tensing
tensor veli palatini
34
Tensor veli palatini (velum tensing)
Origin: sphenoid Insertion: bilaterally to midline velum Innervation: V trigeminal
35
Muscles responsible for pharynx elevation
palatopharyngeus, stylopharyngeus, salpingopharyngeus
36
Palatopharyngeus (pharynx elevation)
Origin: hard palate Insertion: lateral walls of pharynx Innervation: X (vagus)
37
Stylopharyngeus (pharynx elevation)
Origin: styloid process of temporal bone Insertion: pharynx Innervation: IX (glossopharyngeal)
38
Salpingopharyngeus
Origin: near toris tubarius Insertion: pharynx Innervation: X (vagus)
39
Muscles responsible for pharyngeal constriction
superior, middle, and inferior constrictors (O: cricoid, arytenoidsm thyroid cartilage I: arytenoids In: X (vagus) via RLN
40
Muscles responsible for vocal fold adduction
lateral cricoarytenoids, vocalis, and thyro and interarytenoids
41
Muscles responsible for vocal fold abduction
posterior crycoarytenoid
42
Muscle responsible for UES closure
cricopharyngeus
43
Cricopharyngeus
Origin: cricoid Insertion: C-shaped pharynx Innervation: X via RLN
44
Muscles responsible for larynx depression and stabilization
sternohyoid, sternothyoid, thyrohyoid
45
Sternohyoid (larynx depression and stabilization)
Origin: sternum Insertion: hyoid Innervation: C2-C3
46
Sternothyroid (larynx depression and stabilization)
Origin: Sternum Insertion: thyroid cartilage Innervation: C2-C3
47
Thyrohyoid (larynx depression and stabilization)
Origin: thyroid cartilage of larynx Instertion: hyoid Innervation: C2-C3
48
Sternocleidomastoid (head turn)
Origin: Sternum, head of clavicle Insertion: Mastoid process of temporal bone Innervation: XI (accessory)
49
Consequences of inhaled bolus
Aspiration and pneumonia
50
The ball of food/liquid being swallowed
Bolus
51
Occurring while eating or drinking
Prandial
52
Nutrition delivered directly to the gut
Enteral
53
Nutrition delivered directly to the central large vein
Parental
54
Swallowing, ingestion
Deglutition
55
Foreign material enters larynx, remains above glottic plane
Penetration
56
Foreign material enters trachea
Aspiration
57
Oral Stages of Swallow
1. Oral preparatory 2. Oral transit 3. Stage transition
58
Pharyngeal stages of swallow
1. pharyngeal stage | 2. esophageal stage
59
Oral preparatory phase
food/liquid taken into the mouth
60
Difference between food and liquid in the mouth
Liquids: linguavelar valve closed, bolus positioned for transit Foods: – bolus positioned for mastication. Mastication including rotary mandible movement, crushing of bolus. Tongue moves bolus for mastication.
61
Oral transit stage
prepared bolus is propelled by tongue to palate progressive anterior to posterior contact. a. Liquids typically all at once b. Solids aggregate in pharynx until pharyngeal response begins
62
Pharyngeal phase onset
Pharyngeal response begins a. Linguavelar closure (liquid) ends, velopharyngeal closure begins b. Bolus head enters pharynx (passes faucial arch) 1. Young: a occurs before b 2. Aging: b occurs before a a. Prolonged stage transition c. Disordered: a begins abnormally later than it should based on age
63
Pharyngeal transit stage
``` Velopharyngeal closure completes Pharyngeal tube constriction begins UES resting tone inhibition Increases UES compliance Vocal folds adduct Hyolaryngeal excursion (anterior, superior) Traction forces on larynx UES Epiglottis inverts, vocal folds adduct Airway closes, breathing stops Bolus enters UES, clears UES Hyolaryngeal excursion ends, UES closes Structures return to rest ```
64
Esophageal transit stage
UES remains tightly closed Superior to inferior “peristalsis” (constriction) of esophageal muscles Circular muscles constrict top to bottom Longitudinal muscles shorten Net result is propulsion LES (tightly closed at rest) “relaxes” when pressure of bolus (intrabolus pressure) rises LES opens, bolus enters stomach Bolus clears LES LES closes
65
Development of embryo weeks 4-8
Now known as “pharyngeal arches” Neural and organ development Cranial nerves form
66
Development of embryo weeks 9-12
Sucking is observed (non-nutritive) Fetus begins swallowing amniotic fluid Taste buds form
67
Development of embryo weeks 13-on
Limbs start to move, skin forming Alveolar surfactant (20-25 wk.) Respiratory movements are spontaneous Fetus can survive at about 25+ weeks
68
Anatomical changes from infant-adult
Elongation/enlargement of pharynx, larynx, oral cavity Lowering of laryngeal, BOT position Loss of buccal pads-more muscle activity needed
69
Muscles that pull hyoid toward the mandible
Mylohyoid (V) Anterior digastric (V) Geniohyoid (C1)
70
Pulls hyoid toward skull base
``` Stylohyoid (VII) Posterior digastric (VII) ```
71
Pulls hyoid toward tongue
Hyoglossus (XII)
72
Pulls larynx toward hyoid
Thyrohyoid (C2)
73
HLE anterior superior movement....
Pulls airway out of bolus path Contributes to epiglottic inversion Pulls open UES
74
Pulls tongue backwards and upward
Palatoglossus (X) and styloglossus (XII)
75
Pulls tongue backwards and downwards
Hyoglossus (XII)
76
Tongue depression
Hyoglossus (XII)
77
Tongue retraction and elevation
Styloglossus (XII)
78
Tongue to soft palate contact
Palatoglossus (X)
79
3 types of salivary glands
1. Parotid 2. Buccal 3. Submandibular, sublingual
80
Parotid salivary gland
Innervated by IX, located in the lateral mandible
81
Buccal salivary gland
Innervated by VII, located in the cheek
82
Sublingual and submandibular gland
Innervated by VII, located in the floor of the mouth
83
Space between tongue base and epiglottis
Valleculae (2)
84
Space lateral to the larynx
Pyriform sinuses
85
General duties of Masseter/pterygoids
mandibular elevation-bolus containment, lingual | stabilization
86
General duties of Soft palate elevators
velopharyngeal closure
87
General duties of Suprahyoids
``` elevation and (net) anterior displacement of HLC (HLE), UES distension Mylo-, geniohyoid, digastrics, Mandibular depression ```
88
General duties of Infrahyoid
laryngeal stabilization
89
General duties of pharyngeal constrictors
pharyngeal | peristalsis (wavelike top to bottom contraction-bolus propulsion)
90
General duties of pharyngeal elevators
Bolus propulsion
91
General duty of Cricopharyngeal segment of inferior | constrictor
UES closure
92
Mandible elevators CN V
Masseter Both pterygoids Temporalis
93
Mandible protruders CN V
lateral pterygoid
94
Mandible lateralizers CN V
Pterygoids, temporalis
95
Mandible depressors + innervations
Mylohyoid CN V Anterior Belly of Digastric (ABD) CN V Geniohyoid (C1 roots)
96
Hyolaryngeal Elevators (anterior-superior)
Mylohyoid CN V Anterior Belly of Digastric (ABD) CN V Geniohyoid (C1 roots)
97
Hyolaryngeal elevators (posterior-superior)
Stylohyoid, posterior belly of digastric (VII)
98
Hyolaryngeal elevators (superior)
hyoglossus (XII)
99
Tongue posterior-superior movement
Palatoglossus (X) | Styloglossus (XII)
100
Tongue depression
Hyoglossus (XII)
101
Tongue shaping
All lingual intrinsic muscles (XII) Shortening: superior and inferior longitudinals Narrowing: transversus Flattening: verticalis
102
Tongue protrusion
Genioglossus (XII)
103
Soft palate contact with pharyngeal | walls
Levator veli palatini (X) | Assist: Tensor veli palatini (V)
104
Soft palate contact with tongue base
Palatoglossus (X)
105
Pharyngeal constriction, elevation
``` Pharyngeal constrictors (X through pharyngeal plexus) Pharyngeal elevators: Stylopharyngeus (IX) Salpingopharyngeus, palatopharyngeus (X) ```
106
UES tone maintenance
Cricopharyngeal segment of inferior constrictor | X via recurrent laryngeal nerve - RLN
107
Intrinsic laryngeal musculature
Adductors and abductors: (X via RLN) Tensors and “tighteners”: (X via RLN and SLN (CT))
108
Esophageal peristalsis
Circular, longitudinal esophageal layers | X and myenteric plexus
109
Tactile sensation - anterior to soft palate
V - Inside mouth and outside mouth | VII – outer ear
110
Tactile sensation - Palate, pharynx, tongue base
Mixed fibers of pharyngeal plexus (IX, X, XI)
111
Taste sensation
Anterior 2/3 of tongue: VII | Posterior 1/3 of tongue: IX
112
Valves of swallowing
velopharyngeal port tongue base to pharyngeal wall laryngeal (3) cricopharyngeal sphincter
113
What law of pressure is used in the swallow mechanism?
Boyles law
114
Steps of the oral preparatory stage
``` Mastication (rotary) Salivation Bolus Formation/Shaping Oral Sensation/Enjoyment Oral Containment ```
115
Steps of oral transit stage
``` Bolus Containment and Compression Bolus Release and Propulsion Development/maintenance of Intrabolus Pressure Directional propulsion Release of linguavelar seal ```
116
Steps of pharyngeal phase
Positive (propulsive) forces | Hyolaryngeal excursion
117
Steps of esophageal phase
Peristaltic top‐to‐bottom contraction LES closed at rest (before, after bolus) Pressure above LES rises
118
Factors that vary swallows in normal people
``` Bolus Volume affects biomechanics Variability in bolus position at onset of HLE Tippers and Dippers Aging Straw Drinking Breathing and Swallowing Coordination Swallowing Solids ```
119
CNS
brain and spinal cord
120
PNS
cranial and spinal nuclei
121
Major structures of CNS
``` Cerebral hemispheres (Frontal, parietal, occipital, temporal lobes, cerebellum) Brainstem (Midbrain, pons, medulla oblongata) Spinal cord ```
122
Grey matter
clusters of nuclei, unmyelinated axons
123
White matter
Tracts of axons projecting between clusters of | nuclei, Myelinated (white)
124
Cranial/Spinal motor nucleus
origin of outgoing cranial/spinal motor nerve
125
Cranial/Spinal Sensory nucleus
end of incoming cranial/spinal | sensory nerve
126
PNS
Each cranial or spinal motor nerve emanates from a cranial or spinal motor nucleus Each cranial or spinal sensory nerve terminates in a cranial or spinal sensory nucleus.
127
Upper Motor Neurons (UMN)
Axons projecting between brain and cranial/spinal nuclei Emanate from “giant” pyramidal motor cells in cortex Terminate in cranial/spinal motor nucleus
128
Brain to spinal cord tracts
corticospinal tracts
129
Brain to brainstem tracts
corticobulbar tracts

Dysphagia (1 decks)

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