Lecture 2- Neurological Control of Swallowing Flashcards
What is the Nucleus Tractus Solitarius (NTS)?
This is the “sensory swallowing centre” in the brainstem that integrates sensory information about the bolus & programs the required swallow. And triggers the VSG.
What is the Ventral Swallowing Group (VSG)?
The “motor swallowing centre” that then enables execution of the programmed swallow.
What motor functions is the cortical region responsible for?
Intent, Initiation, Programming, Execution
What motor functions is the Subcortical (basal ganglia) region responsible for?
Initiation, Refinement and inhibition
What motor functions is the Brainstem (pons, medulla) responsible for?
Junction between UMN and LMN, Motor/sensory centres- swallow, respiration, heart
What motor functions is the Cerebellum responsible for?
Refinement, Inhibition
What motor functions is the Peripheral nerves responsible for?
LMN, Drive movement
What motor functions is the Muscles and Sensory Receptors responsible for?
Effect- movement
What sensory functions is the cortical region responsible for?
Recognition, Awareness, Motor tuning
What sensory functions is the subcortical region responsible for?
Motor tuning, awareness, conveys sensory information
What sensory functions is the brain stem (pons, medulla) responsible for?
Conveys sensory information
What sensory functions is the Cerebellum responsible for?
Conveys sensory information
What sensory functions is the Peripheral nerves responsible for?
Conveys sensory information
What sensory functions is the Muscles and Sensory Receptors responsible for?
Sensation reception
UMN’s
Voluntary control of musculature
Higher level connections
Includes cortex, cerebellum and thalamus
Bundled together in tracts
E.g. cortico-spinal- carries impulse from the cortex to the motor nucleus in brainstem
Neural message then affects nuclei of LMN
(if UMN damage then can raise eyebrows)
LMN’s
Extend from motor nuclei of brainstem to the muscle
Cranial Nerve Nuclei and Cranial Nerves with motor function
Clinical implications of UMN lesion
Weak or absent voluntary movements of the muscle, which leads to increase in muscle tone and spasticity. Reflexes can become jerky & exaggerated.
Clinical implications of LMN lesion
Complete paralysis of the affected muscle, with ultimate atrophy, wasting & fasciculations of the muscle due to absence of use.
Name Cranial Nerve VI’s name
Trigeminal Nerve
Cranial Nerve VI Motor function
Muscles of mastication
Mylohyoid, anterior belly of digastric (hyolaryngeal excursion),
Tensor veli palatini (tenses soft palate; assists velopharyngeal seal)
Cranial Nerve VI Motor function
General sensation of the face, anterior 2/3 tongue, hard palate, cheeks.
Name Cranial Nerve VII’s name
Facial
Cranial Nerve VII Motor function
Muscles of facial expression (lip seal & buccinator press)
Stylohyoid, posterior belly of digastric (hyolaryngeal excursion)- hyoid elevation
Secretomotor - Submandibular & sublingual salivary glands
Cranial Nerve VII Sensory function
Special taste sensation anterior 2/3 of tongue
Name Cranial Nerve IX’s name
Glossopharyngeal
Cranial Nerve IX Motor function
Stylopharyngeus- elevates pharynx and larynx
Pharyngeal plexus – travels with X to help innervate the pharyngeal constrictors
Secretomotor – Parotid Salivary Gland
Cranial Nerve IX Sensory function
Special taste sensation posterior 1/3 of tongue
General sensation posterior 1/3 of tongue, soft palate, faucial arches (triggering reflexive swallow)
Gag sensation (gag reflex)
Name Cranial Nerve X’s name
Vagus
Cranial Nerve X Motor function
Muscles of the Soft Palate (velopharyngeal seal & glossopalatal seal)
Pharyngeal constrictors (pharyngeal constriction)
Intrinsic muscles of the larynx (vocal fold adduction / glottal seal, cough)
Cricopharyngeus / UES (UES relaxation)
Oesophagus (peristaltic wave)
Cranial Nerve X Sensory function
General sensation: epiglottis, pharynx, valleculae, pyriform sinuses, larynx / vocal folds
Name Cranial Nerve XI’s name
Accessory
Cranial Nerve XI Motor function
Muscles of the head & neck
What is the Pharyngeal plexus
Many of the muscles of the oropharynx are supplied by the pharyngeal plexus, which is made up of various branches from cranial nerves IX, X, XI.
Name Cranial Nerve XII’s name
Hypoglossal
Cranial Nerve XII Motor function
Intrinsic muscles of the tongue
Extrinsic muscles of the tongue
Geniohyoid- involved in hyoid elevation
