Oral functions - speech Flashcards

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1
Q

What are the 3 stages of swallowing called?

A
  1. buccal phase (voluntary)
  2. pharyngeal stage (involuntary)
  3. esophageal stage (involuntary)
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2
Q

What are the two purposes of swallowing

A

Process by which the accumulated food bolus is transported through the lower pharynx and oesophagus to the stomach (feeding function)

Prevents ingested material from entering the lower airway (protective function)

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3
Q

Why is swallowing potentially dangerous

A

the ‘foodway’ crosses the ‘airway’

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4
Q

How are liquids swallowed

A
  1. Liquids are gathered on the tongue, anterior to the pillars of the fauces
  2. the mouth is separated from the pharynx by a POSTERIOR ORAL SEAL
  3. The liquid ‘bolus’ is then propelled through the oro- and hypo-pharynx, and then into the oesophagus
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5
Q

How are ‘solid’ bolus’s swallowed

A
  1. Chewed food material accumulates on the pharyngeal part of tongue and vallecula (oro-pharynx).

THERE IS NO TRUE POSTERIOR ORAL SEAL

  1. The ‘bolus’ is then propelled from the tongue through the hypo-pharynx, and then into the oesophagus
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6
Q

Where are liquids swallowed from

A

the mouth proper

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7
Q

Where are solids swallowed from

A

the oro-pharynx

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8
Q

When swallowing liquids do you have an oral seal

A

yes

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9
Q

When swallowing solids do you have an oral seal

A

no

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10
Q

What is similar between liquids and solids with how they are swallowed

A

both are moved rapidly through the hypophyarynx past the laryngeal inlet

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11
Q

The forward movement of the tongue during the occlusal and initial opening phases creates
a contact between the tongue and the hard palate.

The contact zone moves
progressively backwards, squeezing the processed food through the fauces.

What is this mechanism called?

A

the squeeze-back mechanism

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12
Q

Describe the squeeze back mechanism

A

The forward movement of the tongue during the occlusal and initial opening phases creates
a contact between the tongue and the hard palate.

The contact zone moves
progressively backwards, squeezing the processed food through the fauces.

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13
Q

What events happen during swallowing

A
  • propulsion of food
  • prevention of ‘reflux’
  • protecting the airway
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14
Q

What causes the duration of masticatory sequence to vary

A

food consistency

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15
Q

How strong are swallowing forces

A

very strong - strong enough to move a bolus ‘uphill’ as well as ‘downhill’

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16
Q

What actions during swallowing act to prevent reflux

A
  1. elevation of soft palate
  2. tongue (sides) contacts pillars of fauces
  3. tongue (dorsum) contacts posterior pharyngeal wall
  4. Upper oesophageal sphincter (reflux from oesophagus into pharynx)
  5. Lower oesophageal sphincter (reflux from stomach into oesophagus)
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17
Q

How can stomach acid erode teeth?

A

By:

  • reflux
  • vomiting
  • regurgitation
  • rumination
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18
Q

How often is stomach acid responsible for palatal surface erosion

A

in 2/3 of cases

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19
Q

What is a common characteristic of palatal erosion

A

cupping

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20
Q

Name types of tooth surface loss

A
  • erosion
  • attrition
  • abrasion
  • abfraction
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21
Q

define attrition

A

tooth wear occlusally caused by contact between occluding teeth (bruxism/parafunction)

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22
Q

what indicates attrition is occuring

A

the teeth inter-digitate (equal amounts between upper and lower ?)

23
Q

how does abrasion occur

A

Acids weaken the outer 3-5 microns of mineralised tissue and increase the susceptibility of the enamel and dentine to abrasion from tooth brushing with or without toothpaste.

24
Q

what is the most common presentation of tooth wear?

A

a combined lesion involving erosion and abrasion

25
Q

does abrasion occur on its own

A

unusual - it might be caused by biting or chewing objects between the teeth for example tobacco pipes, nails or pens.

26
Q

what are abfractions

A

Wedge-shaped notch caused by flexure and ultimate material fatigue of susceptible teeth at locations away from the point of loading (cervical regions).

27
Q

what causes abfractions

A

The break down is dependent on the magnitude, duration, frequency and location of the occlusal forces.

28
Q

how is the airway protected during swallowing

A
  • Upward and forward movement of larynx
  • Closure of laryngeal inlet (aryepiglottic muscles,
    epiglottis)
  • Adduction of vocal folds
  • Stop breathing (apnoea)
29
Q

what teeth do abfractions occur on

A

premolars

30
Q

what does dysphasia mean

A

inability to generate speech

31
Q

what does dysphagia mean

A

inability to swallow

32
Q

what word describes pain on swallowing

A

odynophagia

33
Q

what areas of the brain are affected with dysphasia

A
  • Broca’s area

- Wernicke’s area

34
Q

what word describes difficulty speaking that is caused by problems with the muscles used in speech

A

dysarthria

35
Q

what is the difference between dysphasia and dysarthria

A

dysphasia - caused by the brain (broca’s and wernicke’s area)

dysarthria - caused by muscles used in speech

36
Q

what causes dysarthria

A

caused by problems with the muscles used in speech.

  • due to neuro-muscular defects
  • lesions in descending neural pathways, cranial nerves, vocal muscles, neuromuscular junctions
37
Q

What are some oral causes of language and speech defects

A
  • Malocclusions
  • Loss of teeth and denture related
  • Cleft lip/palate
  • Tongue - related
  • Dry mouth
38
Q

what are causes of anterior open bite

A
  • digit-sucking
  • tongue thrust
  • skeletal origin
39
Q

what is a cleft palate

A

oral and nasal cavities are not separated (speech has a ‘nasal’ quality)

40
Q

How are cleft palates treated

A

repaired surgically or filled with an obturator

41
Q

What are conditions which affect the tongue

A
  • tongue tie
  • partial atrophy
  • tongue stud
42
Q

How does xerostomia cause impeded speech

A

With inadequate saliva production, pronouncing words becomes difficult.

People who have dry mouth and difficulty speaking cannot simply ‘swallow’ and start talking normally

43
Q

What is/ are torus mandibularis/ tori mandibular and torus palatinus/ tori palatinus

A

benign overgrowth of bone

44
Q

How can dentures cause speech impedment

A
  • restricted tongue space
  • denture base plate too thick
  • artificial teeth not set properly e.g. wrong occlusal planes
45
Q

The wrong shape of palate of a denture gives problems producing which sounds

A

s becomes sh

46
Q

The wrong shape of occlusal planes of a denture gives problems producing which sounds

A

f,v and ph (labio-dental sounds/ fricative sounds)

47
Q

The loss of which teeth may prevent the clear reproduction of certain sounds particularly F and V

A

maxillary anterior teeth (they are made by the lower lip contacting the edges of maxillary incisors)

48
Q

during fricative sounds, where should the lips of the maxillary incisor teeth touch

A

the vermilion border of the lip

49
Q

How can you assess speech when replacing missing teeth

A

by asking fundamental questions e.g. address, family details

50
Q

Apart from producing vocal sounds, what else do aerodigestive tract contribute to

A

the playing of wind and brass instruments

51
Q

What factors might influence the final choice of treatment of a musician with a missing tooth

A
  1. cost
  2. effects on adjacent teeth; OH; preparation as abutments
  3. aesthetics
  4. Function. The patient is a musician, so her embrouchure is v important. She may experience pain with pressure from the trumpet mouthpiece on the healing socket
  5. Life span of prosthesis and eventual replacement
52
Q

what does embouchure mean

A

the position and use of lips, tongue and teeth in playing a wind instrument

53
Q

How do embouchures very

A
  • between individuals

- particular wind instrument (intra oral = clarinet, oboe, saxophone etc), (extra oral = trumpet, flute, tuba etc)

54
Q

What might string players struggle with

A

TMJ