L5. Biomechanics of Swallowing Flashcards
1
Q
What is the setting up, arranging, and bringing food or fluid from the container to the mouth?
A
Feeding
2
Q
__________ is the keeping or manipulating food or fluid into the mouth.
A
Eating
3
Q
Swallowing or deglutition involves what?
A
- movement of solid or liquid bolus towards the esophagus
- moving food from mouth to the stomach
4
Q
What is the ball like mixture of food and saliva formed in the mouth?
A
bolus
5
Q
What are the main anatomical structures used for swallowing?
A
oral cavity, pharynx, larynx, esophagus
6
Q
What is the function of the orbicularis oris?
A
closes the mouth
7
Q
What is the function of the labial muscles?
A
opens the mouth
8
Q
What structure prevents the pocketing of food and loss of food?
A
buccinator
9
Q
What structures close the jaw?
A
temporalis, masseter, medial pterygoid
10
Q
What is the function of the lateral pterygoid?
A
opens the jaw
11
Q
The mature pattern of diagonal and rotary chewing is due to which muscles?
A
lateral and medial pterygoid
12
Q
The hard palate helps in what?
A
bolus formation
13
Q
What structures elevate the soft palate?
A
tensor veli palatini, levator veli palatini, palatopharyngeus + uvula
14
Q
What is the function of faucial arches?
A
passageway of bolus
15
Q
What structure lowers the mandible and raises the hyoid?
A
digastric
16
Q
What is the function of the mylohyoid, stylohyoid, and geniohyoid?
A
raises the hyoid
17
Q
Palatoglossus, Styloglossus, Hyoglossus, and Genioglossus is responsible for what?
A
control of tongue
18
Q
What fibers found in the tongue is responsible for tongue control?
A
vertical, transverse, and longitudinal intrinsic fibers
19
Q
What is the common space for the nose, mouth, and throat?
A
pharynx
20
Q
True or False. The larynx is a passageway for both air and food.
A
False. The pharynx is the common passageway.
21
Q
Why should the hyoid be raised when swallowing?
A
to close the airway
22
Q
What structure narrows the lumen of the pharynx?
A
pharyngeal constrictors
23
Q
What is the function of the stylopharyngeus?
A
raise and shorten the pharynx
24
Q
What structures raise the pharynx and larynx?
A
Palatopharyngeus and Salpingopharyngeus
25
What is the space formed by the base of the tongue, epiglottis, and aryepiglottic folds?
valleculae
26
What is the resting area for bolus prior to the swallow reflex?
pyriform sinuses
27
What structure stops foreign entry into the airway?
epiglottis
28
What is the function of aryepiglottic folds and cartilages?
protect lower airway, direct food into the pyriform sinus and away from the larynx
29
What structure has the following functions?
1. prevents the egress of air
2. prevent expectoration of air and phlegm
False Vocal Cords
30
What is the function of true vocal cords?
prevent ingress of air + more on sound production
31
What are the main "gatekeepers" of air?
false and true vocal cords
1. false = prevents air going out
2. true = prevents air going in
32
What is known as the "first portion of airway"?
larynx
33
What muscle adducts vocal cords?
arytenoid muscles
34
What is the function of the upper esophageal sphincter?
prevents air from entering the esophagus during respiration
35
What is the function of the lower esophageal sphincter?
prevents regurgitation of stomach contents
36
What CN gets the general sensation from anterior 2/3 of the tongue + sensation from teeth, gums, hard & soft palate?
CN 5
37
What cranial nerve is responsible for sensing taste from anterior 2/3 of the tongue?
CN 7
38
What is the sensory function of CN 9?
Sensation and taste from posterior 1/3 of the tongue + sensation from soft palate, posterior nasopharynx
39
What cranial nerve is responsible for feeling sensation from the lower pharynx?
CN 10
40
Muscles for mastication is controlled by which CN?
CN 5
41
What are the motor functions of CN 7?
1. Facial Muscles
2. Sublingual and Submandibular glands
42
What CN controls muscles involved in the upper lateral pharyngeal wall during swallowing and the parotid salivary gland?
CN 9
43
What are the motor functions of CN 10?
Muscles of palate and pharynx + elevates larynx
44
The intrinsic and extrinsic muscles of the tongue is controlled by which CN?
CN 12
45
Which cranial nerves are responsible for the gag and swallowing reflex?
CN 9 and CN 10
46
Which CN is responsible for the cough reflex?
CN 10
47
When is the swallowing reflex stimulated?
when food bolus is pushed
into the oropharynx
48
The swallowing reflex is activated by which receptors?
receptors on the posterior part of oral cavity and oropharynx
49
Cleaning the nasopharynx and oropharynx + closing the larynx and nasopharynx protects what?
respiratory tract
50
The contraction of pharynx muscles when they are stimulated prevents aspiration of food particles. What reflex is described?
gag reflex
51
What reflex is the last line of defense for the larynx when materials manage to slip into the vocal folds and below?
cough reflex
52
__________ is the entry of materials into the larynx and lower respiratory tract.
aspiration
53
What structure in the brain is also known as the "primary deglutition and respiratory center"?
medulla oblongata
54
What is the function of the pons with regards to swallowing?
plays a small part in inhibiting respiration during swallowing
55
What are the phases of swallowing?
1. oral preparatory
2. oral
3. pharyngeal
4. esophageal
56
The bolus is held in the oral cavity. And so, the oral preparatory phase is considered to be involuntary.
a. The first statement is T and the second is F.
b. The first statement is F and the second is T.
c. Both statements are true.
d. Both statements are false.
A
57
Is the larynx and pharynx contracted during the oral preparatory phase?
No. They are at rest
58
What happens during the oral preparatory phase?
1. Food is manipulated and masticated
2. Bolus is formed
3. Bolus is held in oral cavity
4. Larynx and pharynx are at rest
5. Voluntary
59
The oral phase begins when the _________________________________.
tongue initiates posterior
movement of bolus
60
What happens during the oral phase?
1. bolus push backward in the tongue between tongue and palate
2. soft palate moves up
3. bulge forms on the upper posterior pharyngeal wall approaching rising soft palate (Passavant's ridge)
4. tongue pushes bolus backward into oropharynx
*voluntary
61
When the swallow reflex is triggered, which stage of swallowing is initiated?
pharyngeal phase
62
What phase is described below:
1. Bolus passes between the anterior faucial arches
2. Receptors at posterior wall is
stimulated
3. Swallow center receives signals
4. Swallow reflex is triggered
*Reflex / involuntary
Pharyngeal Phase
63
What are the 4 automatic responses to the swallow reflex during the pharyngeal phase?
1. velopharyngeal closure
2. hyolaryngeal elevation
3. pharyngeal contraction
4. upper esophageal sphincter relaxation
64
What is described below?
1. Soft palate is drawn upward to
contact the Passavantʼs ridge
2. Roof of tongue moves slightly
forward
3. Pharyngeal wall draws upward over bolus
Velopharyngeal closure
65
What happens during hyolaryngeal elevation?
the hyoid bone and larynx move UPWARD and FORWARD, which is crucial for airway protection and opening the upper esophageal sphincter (UES) to allow food to pass into the esophagus.
66
What happens during a velopharyngeal closure?
the velum (soft palate) rises to meet the posterior pharyngeal wall, effectively sealing off the nasal cavity from the oral cavity, which is crucial for producing most speech sounds and other functions like swallowing.
67
What is "Progressive Pharyngeal Contraction"?
Segmental and sequential contraction of pharyngeal wall + guides bolus efficiently to the UES
68
UES relaxation permits entry of bolus into the esophagus. What are the factors contributing to UES opening?
1. Cricopharyngeus muscle relaxes
2. Suprahyoid and thyrohyoid
muscles relaxes → Pulls hyoid and
larynx forward
3. Pressure of descending bolus
69
Which structures return to resting position during the esophageal phase?
epiglottis, hyoid and larynx, soft palate
70
What is the systematic squeezing of muscle segment before bolus
with simultaneous relaxation of segment preceding the bolus? (note: specifically at the esophagus)
esophageal peristalsis
71
What is the swallowing and respiration pattern?
Exhale--Swallow--Exhale
(for airway protection)
72
It is impossible to breathe and swallow at the same time, this is due to what?
the swallowing and respiration pattern (Exhale--Swallow--Exhale)
73
Briefly describe what happens when we drink. (specific)
1. Pharyngeal response follow each swallow
2. Esophagus is inhibited until the last swallow
3. Peristalsis happens during exhalation
74
Briefly describe what happens during belching. (specific)
1. Prolonged drop in UES pressure
2. Vocal folds and arytenoids adduct
3. UES opens (Cricopharyngeus muscle and inferior pharyngeal constrictor relaxes)
4. Small anterior hyoid movement
75
What is belching? (general)
swallowed air or gas builds up in the stomach, causing it to stretch, which triggers a reflex that relaxes the lower esophageal sphincter, allowing air to escape upwards through the esophagus and out the mouth.
76
During Pre-Retch, _________ and _________ tone increases.
diaphragm; UES
77
During retching, which muscle is most used for breathing?
external intercostal muscles
78
After retching the glottis opens and the UES strongly closes to prevent what?
aspiration
79
The UES is pulled open by the ________ muscles during a vomit expulsion?
hyoid
80
What happens as a means for airway protection during a vomit expulsion?
activation of laryngeal adductors
81
This is the entry of material into the larynx and lower respiratory tracts.
aspiration
82
What problems may arise when there is a dysfunction affecting the oral preparatory phase?
1. poor bolus formation
2. poor lip closure and drooling
3. pocketing of food
83
Aspiration before swallowing and nasal regurgitation indicates a dysfunction at which phase of swallowing?
oral phase
84
Dysfunctions during the pharyngeal and esophageal phase leads to what?
aspiration
85
When does the bolus reach the valleculae?
During hyolaryngeal elevation - Pharyngeal Phase
86
During hyolaryngeal elevation, the oropharyngeal cavity closes via what?
Contraction of UES
87
What factors contribute to UES opening?
1. Cricopharyngeus muscle relaxes
2. Suprahyoid and thyrohyoid
muscles relaxes → Pulls hyoid and
larynx forward
3. Pressure of descending bolus
88
What is aspiration?
entry of material into the larynx and lower respiratory tract
89
What dysfunctions could occur during the oral preparatory phase?
1. poor bolus formation
2. poor lip closure and drooling
3. pocketing of food
90
What dysfunctions could occur during the oral phase?
aspiration before swallow & nasal regurgitation
91
What dysfunction could occur during the pharyngeal and esophageal phase?
aspiration
92
What is the UES tone during retching?
phasic
93
What is the importance of the diaphragm contracting while the glottis is closed?
it creates a vacuum that pulls the gastric contents upward
94
Breathing is primarily facilitated by what muscle during retching?
external intercostal muscles
95
During vomit expulsion, the UES is opened by which muscle?
hyoid muscle
96
What mechanism occurs to protect the airway during vomit expulsion?
activation of laryngeal adductors
97
After a retch, the UES strongly ________ to prevent aspiration.
closes
98
Bolus flows in two streams around the ________ to go to the pyriform sinus,
epiglottis
99
How many seconds does the esophageal phase last?
5-6 seconds; 3-4 cm per sec
100
How many seconds does the oral phase last?
1-1.5 seconds
