L2 Normal Swallow Anatomy Flashcards
List the bones and hard structures that are important structures and landmarks in swallowing
- maxillary palatal arch
- mandible
- ramus of mandible
- cervical vertebra (1-7)
- hyoid
- dentition
Describe the maxillary palatal arch
- forms the roof of the mouth and opposes the tongue
- has 3 sections, palatine rugae, hard palate and soft palate
Why is the rams of the mandible an important landmark?
On VFS when the bolus reaches the ramus that is when the pharyngeal swallow commences
The mandible is _______ during chewing and ___________ during swallowing
hinged
fixed
What structure is typically located at the level of C5-6
upper esophageal sphincter
Why do we need to consider the cervical vertebrae in relation to swallowing?
- they serve as certain landmarks for swallowing
- cervical bony growth may impede swallowing
the __________ is unique in cervical vertebrae
transverse foramen
What is C1 called?
atlas
What is C2 called?
axis
What is the Atlanto-occipital joint?
articulation between the atlas and occipital bone
What movements are permitted at the atlanto-occipital joint?
flexion
extension
lateroflexion
The hyoid bone is anchored by ligaments to the _______ of the ______ bones of the skull
styloid process
temporal
Movement of the hyoid allows the _________ to passively relax and close the airway
epiglottis
What are the 4 categories of teeth
- incisors
- canines
- premolars
- molars
What process occurs if someone loses their teeth?
bone resorption and so the alveolar ridge diminishes
Sensation from chewing force, speed, and duration and how your jaw makes the excursion come from which cranial nerve
V - trigeminal
Children have _____ teeth and adults have _____ teeth (including wisdom)
20
32
What are the four quadrants of the teeth
upper left
upper right
lower left
lower right
What is the function of premolars?
crushing and grinding
What is a functional pair in relation to teeth?
A functional pair consists of a bottom tooth and the top tooth that meets it
Fewer than 8 functional pairs of teeth can have a negative effect on _________
chewing effectively
What is a Class I occlusion
normal
What is a class II malocclusion
over bite
What is a class III malocclusion
under bite
List the cartilages that are important structures and landmarks in swallowing
thyroid cricoid cricoid lamina epiglottis arytenoids
What are the 3 types of cartilage?
hyaline, elastic and fibrocartilage
Describe the epiglottis
- it has a cartilaginous base and soft tissue tip that rests behind the tongue base
- composed to elastic cartilage
- main layer of protection against choking
Describe the attachment of the epiglottis
it attaches anteriorly to the thyroid cartilage just above the VFs via the thyroepiglottic ligament
What is the function of the arytenoids?
move and control the tension within the VFs
Describe the movement of arytenoids during swallowing
they move forward to touch the base of the epiglottis during swallowing
Describe the 3 layers of protection for the larynx during swallowing
1) epiglottis closes opening
2) VFs close
3) arytenoids move forward
List the soft tissues/muscle groups that are important structures and landmarks in swallowing
lips face tongue (tip, blade, root) soft palate faucial pillars strap muscles posterior pharyngeal wall UES esophagus
What muscle surrounds the upper and lower lips
orbicularis oris
what are the three types of papillae that have taste buds
foliate papillae
fungiform papillae
(circum)vallate papillae
Describe filiform papillae
- cone shaped
- don’t contain taste buds
- for mechanical purposes
Describe circumvallate papillae
-aligned in v-shape at back of tongue just in front of the sulcus terminalis
Describe fungiform papillae
- shaped like small mushrooms
- mainly on dorsal surface and slightly on sides
Describe foliate papillae
ridges and grooves in the side of the tongue
The ________ of the tongue consists of the anterior two thirds and the __________ consists of the posterior one third
oral part
pharyngeal part
Once the bolus reaches the _________ this starts the pharyngeal swallow
anterior faucial pillar
____________ start at the level of the soft palate and continue to the level of the UES
pharyngeal constrictor muscles
What are the points of insertion of the superior pharyngeal constrictor?
sphenoid, soft palate, base of tongue and mandible
What are the points of insertion of the middle pharyngeal constrictor
hyoid
What are the points of insertion of the inferior pharyngeal constrictor
thyroid and cricoid cartilages
The ____________ muscle forms part of the USE
cricopharyngeus
At rest, the cricopharyngeus muscle is __________
contracted
The UES is comprised of 3 sets of muscles, what are they?
- lower fibers of inferior pharyngeal constrictor
- cricopharngeus muscle
- upper fibers of esophagus
Describe the esophagus
24cm long tube that connects mouth to stomach
-it is empty and collapsed at rest
What are the three layers of the esophagus
- inner mucosal
- inner circular
- outer longitudinal
List the oral and pharyngeal spaces that are important structures and landmarks in swallowing
- anterior and lateral sulci
- nasopharynx, oropharynx, and hypopharynx
- valleculae and pyriform sinuses
- laryngeal vestibule
- laryngeal ventricle
What are the boundaries of the nasopharynx
-extends from base of skull to the top of the soft palate
What are the boundaries of the oropharynx
- extends from upper surface of uvula to the tip of the epiglottis
- ant border is posterior aspect of tongue
- lateral and post borders are the middle and part of inferior pharyngeal constrictor
What are the boundaries of the laryngopharynx/hypopharynx
-extends from the tip of the epiglottis to the UES
Describe the valleculae
-natural space formed between the base of tongue and the epiglottis (one on each side)
Describe the pyriform sinuses
2 pockets formed bilaterally that are present during rest but also more prominent during swallowing
-medial border is aryepiglottic folds
List the salivary gland the are important in swallowing
parotid
sublingual
submandibular
All the saliva glands together produce saliva at a rate of ________ during rest and _______ during active secretion
0.1mL/min
4mL/min
Total saliva secretion per day =
0.75 - 1.5 Ls
The parotid gland produces ____% of saliva
25%
The sublingual gland produces ______% of saliva
5%
The submandibular gland produces _____% of saliva
up to 70%
Describe the parotid glands
- produce serous fluid only
- largest set of glands
- located in posterior and inferior cheeks, over ramus of mandible
Describe the sublingual glands
- produce mainly mucous + a little serous
- considered a ‘mixed gland’
- located immediately beneath the mucosal surface of floor of mouth, along internal surface of jaw
Describe the submandibular glands
- responsible for most of oral secretions
- produce both serous and mucous
- a mixed gland
- located under mandible
Salivary flow is controlled directly by _________ stimulation and indirectly by ___________ stimulation
sympathetic
parasympathetic
Saliva is ____% liquid
99
What are the components in saliva
- liquid
- enzyme that breaks down starch
- serous
what are the three function of saliva
1) antibacterial and antacid properties prevent tooth decay and infections
2) incorporating saliva into food makes bolus more manageable
3) saliva keeps oral mucosa moist which reduces friction along the path of the bolus and aids in swallow process
What is the difference between penetration and residue?
anything within the aryepiglottic folds is considered penetration, and anything outside is considered residue
