OMA and Cranial Nerves (RJ) Flashcards
What is the Central Nervous System?
The CNS consists of the brain and spinal cord, both of which are encased in protective bone. It’s job is to integrate and coordinate sensory and motor information coming in and going out from the Peripheral Nervous System.
What is the Peripheral Nervous System?
The PNS comprises of the Cranial Nerves plus the Sensory Nerves.
What are Cranial Nerves?
CN attach to the base of the brain, representing both the beginning and the end of the PNS. They carry sensory and motor nerve fibres between the brain and structures in the head/neck.
Name the Cranial Nerves associated with speech and swallowing and describe key function and impact of lesions.
CN V Trigeminal
- general sensory (forehead, lip, cheeks)
- voluntary motor (TMJ muscles)
=> atrophy/weakness, jaw may hang open
CN VII Facial
- special sensory (taste) anterior tongue
- voluntary motor to muscles of facial expression (lips, eyebrows)
- parasympathetic to the salivary glands controls release when eating
=> significant affect on articulation and facial expressions
CN IX Glossopharyngeal
- special sensory (taste) posterior tongue
- general sensory from mucosa of pharynx, posterior tongue
- parasympathetic- controls saliva release during digestion
=> reduced gag reflex, loss of general sensation posterior tongue and oropharynx
CN X Vagus
- voluntary motor to soft palate, pharynx, intrinsic laryngeal muscles
=> deficit in swallowing, reduced gag reflex, paralysis of vocal folds, hypernasality, dysphasia
CN XI Accessory
- voluntary motor to pharynx and soft palate and sternocleidomastoid muscle
=> unable to turn head
CN XII Hypoglossal
- voluntary motor to intrinsic and extrinsic tongue muscles
=> profound impact on articulation, muscle atrophy, deviation towards affected side
NB CN VIII Vestibulocochlear is very important for hearing with special sensory for hearing and balance in the inner ear
What is an OMA?
An Oromotor Muscular Assessment is an examination of structure and function of anatomy required for speech and swallowing.
NB Also known as a Cranial Nerve/Bulbar Assessment in hospital settings.
Why do an OMA?
Because the structures and functions of these structures are integral to speech and swallowing function.
Because impairment of groups of muscles often indicates underlying neurological dysfunction and assists differential diagnosis.
Because this assessment forms the basis for further assessment and guides intervention planning.
When is an OMA required?
An OMA is required for all clients who are presenting with speech, voice or swallowing difficulties.
What do you need to look for when checking the structure and state of the oral cavity?
Dentition State of mucosa Saliva Abnormalities of structures eg palate, tonsils Denture fit Presence of lesions Thrush Over/underbite
Name and describe CN V
CN V (5) Trigeminal
- general sensory (forehead, lip, cheeks)
- voluntary motor (TMJ muscles)
=> atrophy/weakness, jaw may hang open
Name and describe CN VII
CN VII (7) Facial
- special sensory (taste) anterior tongue
- voluntary motor to muscles of facial expression (lips, eyebrows)
- parasympathetic to the salivary glands controls release when eating
=> significant affect on articulation and facial expressions
Name and describe CN IX
CN IX (9) Glossopharyngeal
- special sensory (taste) posterior tongue
- general sensory from mucosa of pharynx, posterior tongue
- parasympathetic- controls saliva release during digestion
=> reduced gag reflex, loss of general sensation posterior tongue and oropharynx
Name and describe CN X
CN X (10) Vagus - voluntary motor to soft palate, pharynx, intrinsic laryngeal muscles => deficit in swallowing, reduced gag reflex, paralysis of vocal folds, hypernasality, dysphasia
Name and describe CN XI
CN XI (11) Accessory - voluntary motor to pharynx and soft palate and sternocleidomastoid muscle => unable to turn head
Name and describe CN XII
CN XII (12) Hypoglossal - voluntary motor to intrinsic and extrinsic tongue muscles => profound impact on articulation, muscle atrophy, deviation towards affected side
