exam 2 muscle functions Flashcards
inferior constrictor
pulls the lower part of the back wall of the pharynx forward, and draws the side walls of the lower pharynx forward and inward
middle constrictor
pulls forward on the posterior pharyngeal wall and forward and inward on the lateral pharyngeal walls. causes pharyngeal lumen to constrict regionally
stylopharyngeus
pulls upward on the pharynx and pulls the lateral walls outward (widens pharynx)
masseter outer layer
elevation of mandible and approximation of mandible and maxilla; moves mandible side to side
masseter inner layer
elevation and backwards pull on the mandible and approximates jaws
temporalis
pulls upward and backward on the mandible; moves side to side
temporalis
pulls upward and backward on the mandible; moves side to side
internal pterygoid
elevation and side to side movement of the mandible
external pterygoid
pulls condyle/mandible forward, downward and side to side
digastric (anterior belly)
pulls upward on the hyoid bone and/or downward on the mandible
mylohyoid or geniohyoid
pulls down on the mandible or upward and forward on the hyoid
GENIOHYOID IS INNERVATED BY CN XII (hypoglossal)
superior longitudinal
shortens the tongue, pulls tip upward, pulls lateral margins upward
inferior longitudinal
shortens the tongue, and pulls the tip downward
vertical
flattens the tongue
transverse
narrows and elongates the tongue
styloglossus
- body of tongue is drawn upward and backward
- side of tongue pulled up
- tongue shortened
- tongue tip pulled toward the side
palatoglossus
pulls upward, backward, and inward on the root of the tongue
hyoglossus
lowers the tongue body and draws it backwards
genioglossus lower fibers
move tongue root forward forcing tip againsat teeth or out of mouth
genioglossus middle fibers
front of tongue pulled backward
genioglossus upper fibers
centerline of tongue pulled downward to form a depression along its length
orbicularis oris
- move lips toward each other and forward (closure
- move corners of the mouth up, down, toward the side, or toward the midline
- force lips and/or corners of mouth against teeth
buccinator
- pull the mouth corner back and towards the side
- forces the lip and cheek against the teeth
risorius
draws the corner of the mouth backward and towards the side
levator labii superioris
elevates upper lip
levator labii superiors alaeque nasi
elevates the upper lip and nasal segment dilates the anterior nares
zygomatic minor
elevates upper lip and pulls the corner of the mouth upward
zygomatic major
pulls backward on the corner of the mouth, lifts it up and towards the side
depressor labii inferioris
- pulls lower lip downward and to the side
- turns lower lip outward
mentalis
- pulls chin tissue upward
- forces lower part of lower lip against the alveolar process of the mandible
- curls lower lip outward (pouting)
levator anguli oris
caninus
- draws the corner of the mouth upward and towards the side
- raises the lower lip against the upper lip
depressor anguli oris
triangularis
- pulls the corner of the motuh downward
- draws the upper lip downward towards the lower lip
incisivus labii superioris
pulls the corner of the mouth upward and toward the midline
incisivus labii inferioris
pulls the corner of the mouth downward and inward
platysma
- draws the skin of the neck towards the mandible
- pulls lower lip and corner of the mouth to the side and downward
- forces the lower lip against the lower teeth and the alveolar process of mandible
innervations of the mandible
CN V (trigeminal)
except for geniohyoid which is CN XII (hypoglossal)
innervation of the lips
CN VII (facial)
innervation of stylopharyngeus
CN IX (glossopharyngeal)
innervation of the constrictors
CN X (vagus)
innvervation of velum
pharyngeal plexus= CN IX, X, possibly XI
expcept palatal tensor which is innervated by CN V
outer nose= CN VII
innervations of the tongue
CN XII (hypoglossal)
expect palatoglossus which is CN X & XI (vagus & accessory)
nodules
structural
bilateral; anterior 1-2/3; callous-like growth; gradual onset
- causes: phonotrauma
voice Tx
polyps
structural
unilateral; fluid/blood filled blisters; contralateral lesions; not as deep as nodules; sudden onset
- causes: phonotrauma; coughing; URI; NSAIDS; menstrual cycle
voice Tx and/or surgery
LPR/GERD
structural
lesions near arytenoid cartilages
- causes: reflux; GERD becomes LPR when it comes up the esophagus and enters the larynx
reflux management; medicine; diet/lifestyle changes
granuloma
structural
sphereical growth above or below the folds; often removed surgically but they come back
- causes: reflux; intubation; phonotrauma; coughing/clearing throat; and/or chronic vomiting
lifestyle/diet changes; voice Tx; reflux manage.; cough therapy; inhaler
reinke’s edema
structural
folds are very swollen, may even overlap; lots of loose flappy fluid filled tissued
- caused by smoking
quit smoking, then surgery
carcinoma
structural
white surface legions on the folds; stiffness; varied location
- causes: smoking; HPV; causes vary
surgery; chemotherapy; radiation
papilloma
structural
irregular growths; unilateral or bilateral; can go dormant then reappear
- causes: HPV (transmitted via bodily secretion NOT blood)
surgery- it may recur but there’s no way of getting rid of it
hemmorrhage
structural
broad bruising; may appear discolored; sudden voice change
- causes: phonotrauma; coughing; URI; NSAIDS; menstrual cycle
voice rest then treat whatever is left over (nodules/polyps)
hemorrhage
structural
broad bruising; may appear discolored; sudden voice change
- causes: phonotrauma; coughing; URI; NSAIDS; menstrual cycle
voice rest then treat whatever is left over (nodules/polyps)
cyst
structural
unilateral buldge on fold; benign; cyst is deep into the tissue, so the affected fold is stiffer than the other
- cause: plugged mucous gland; cilia hair
medical management; surgery (doesn’t respond well to voice therapy)
web
structural
blunting of anterior commissure; folds cannot abduct well; noise when breathing; shortness of breath; respiratory tract looks like a U instead of a V
- cause: congenital (present at birth)
surgery- shunt is put in place so that the pieces don’t reheal together
muscle tension dysphonia
functional
rough/hoarse voice; deepening of voice; difficulty projecting; throat pain with use, especially while performing; vocal fatigue; sudden changes in pitch; sense of strained or effortful voice
- causes: pattern of muscle use that can develop during laryngitis or improper voice use; stress; can cooccur with other problems (ie. secondary problem)
voice therapy
mutational falsetto (puberphonia)
functional
abnormally high voice
- causes: habitual high voice use; tense muscles
laryngeal resposturing
paradoxical vocal fold dysfunction
functional
present at triggers (smells, certain activities); chronic cough; inhalatory stridor
- causes: variable; strong odors, smoke, exercise, work, stress
remove triggers; therapy
vocal fold paralysis
neurological
folds stuck adducted/abducted or somewhere inbetween; bilateral or unilateral
- cause: virus; surgery; congenital (if the cause is viral sometimes the nerve can heal itself with time)
surgery; collagen injection (plumps up vocal fold); voice Tx
bowing
neurological
spindle shaped glottis; bowed folds; folds cannot fully adduct
- causes: atrophy of vocal folds; presbylaryngis (aging)
voice therapy; collagen injection; surgery
vocal tremor
neurological
shaky voice; upper body, head, and vocal tremor
- cause: high hereditary (involves cerebellum, thalamus, and brainstem); thought to be associated with essential tremor
medication (esp. for blood pressure); botox; some new therapy techniques
spasmodic dysphonia
neurological
adductor is more common than abductor; focal laryngeal dystonia
- cause: involuntary muscle spasms
botox injections into TA muscle
respiratory dysphonia
neurological
present at rest; inhalatory stridor; adductor muscles involved in breathing
- causes: unknown; genetic; serious antidepressants
medical therapy – neurologist
secondary to other
neurological
voice disorder is associated with other neurological conditon
- cause: neurological condition like parkinson’s, ALS, myasthenia gravis, etc
mostly address primary condition; voice therapy
salpingopharyngeus
pulls lateral pharyngeal walls upward and inward
palatopharyngeus
pulls inward on upper pharyngeal walls and upward on lower lateral pharyngeal walls
FIXED VELUM
palatal levator
draws velum upward and backward
uvulus
only intrinsic muscle in the velum
shorten, lift, and increase bulk of velum
glossopalatine
with tongue fixed
pulls downward and forward on the velum
with tongue fixed
pharyngopalatine
with pharynx fixed
pulls downward and backward on the velum
with pharynx fixed
palatal tensor
tensor veli palatini
opens auditory tube
INNERVATED BY CN V
levator labii superioris alaeque nasi
nasal portion
draws the ala upward and enlarges the naris
the lip portion elevates the upper lip
anterior nasal dilator and posterior nasal dilator
enlarges the naris
nasalis
constricts the naris
depressor alae nasi
pulls the outer nose downward & decreases naris aperture (constricts naris)
