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oral physiology Flashcards

1
Q

changes in contractile properties leads to

A

Altered power output, fatigability

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2
Q

can contractile protein isoform changes occure

A

yes under some conditions

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3
Q

why are fiber types compartmentalized in oral musculature

A

specific tasks served by different sets of muscle fibers

- good control of mandible

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4
Q

what fibers are found in the genioglossus

A

Very fast, high fast-twitch fibers

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5
Q

what kind of muscle is genioglossus

A

extrinsic tongue muscle

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6
Q

what forms a majority of the body of the tongue

A

Genioglossus

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7
Q

speed of digastric

A

Mainly fast

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8
Q

does the Digastric have to work synchronously

A

No, allowing adjustment of forces from one head

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9
Q

what muscles have 2 heads

A

Digatric

Hyoideus

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10
Q

action of the lateral pteryoid

A

Protractor (accompanies opening)

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11
Q

what are the jaw openers

A

Lateral pterygoid
Digastric
geniohyoid
Mylohyoid

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12
Q

dysfuction of the superior head ot the lateral pteryoid leads to

A

anterior displacement of the TM disc in TMJ dysfunction

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13
Q

parts of the masseter muscle

A

deep

superficial

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14
Q

what fibers predominate in the masseter muscle

A

slow fibers predominate in both parts of the masseter

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15
Q

what myosin isoforms are found in the masseter

A

Adult slow (predominant)
embyronic
neonatal
alpha cardiac

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16
Q

roll of alpha cardiac fibers in the masseter

A

rhythmic contractions

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17
Q

what is the myosin gradient in the masseter muscle

A

Antierior: slow

Posterior(near joint): fast

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18
Q

cause of bruxing

A

Hypertrophy in the masseter

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19
Q

what causes hypertrophy in limb muscle

A

Upregulation of slow myosin

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20
Q

bruxism affect on muscle

A

Increase in level of slow myosin

- less powerful contraction which could affect shewing and speech

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21
Q

speed of temporalis

A

faster than masseter(more fast type myosin than masseter

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22
Q

Compartmentalization of temporalis

A

Slower fibers anterior

faster fibers posterior

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23
Q

EMG studies of the temporalis shows

A

mean power frequency higher in females and decreases with aging

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24
Q

compartmentalization of temporalis means that lesions/injury could lead to

A

differential effects

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25
Q

fiber orientation of the temporalis

A

anterior: verticle
Posterior: horizontal

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26
Q

superficial vs deep temporalis fiber types

A

Superficial: faster
Deep: slower

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27
Q

what myosin is found in the medial pterygoid

A

SLow myosin

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28
Q

medial pteryoid gradient anterior and poster

A

Anterior: slow
Posterior: fast

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29
Q

general pattern for all jaw closes in speed of myosin

A

Anterior: slower
Posterior: fast
Superficial: fast
Deep: slow

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30
Q

Kinesthesia

A

Sense of movement and position

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31
Q

why are masticatory muscles are under exiquiste control

A

Protects teeth and soft tissues from damge and ensures effective chewing

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32
Q

Roll of the rich sensory info from within the masticatory muscles

A

provide feedback to CNS to provide neural drvie fro contraction

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33
Q

are we aware of kinesthesia

A

Not aware of it and continuously on goind

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34
Q

why is kinesthesia important

A

drive very different motor functions to control precise forces

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35
Q

parts of muscle spindles

A

Polar region
Equatorial Region
Polar region

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36
Q

size of muscle spindles

A

1-3 mm in length

200 micrometers in diamter

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37
Q

what determines the limit of a muscle spindle

A

External capsule

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38
Q

parts of the muscle spindle

A 
External capsule
Muscle fibers
Efferent nerve fibers
Sensory nerve fibers
 Lymph
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39
Q

what type of muscle fibers are found in the muscle spindle

A

nuclear bag intrafusal fibers(2-3 per spindle)

Nuclear chain intrafusal fibers (4-6 per spindle)

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40
Q

roll of most of the fibers in a muscle are what

A

Extrafusal doing the work and muscle contractions

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41
Q

where are nuclear bag intrafusal fibers

A

at the swelling in the equitorial region of the spindal

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42
Q

where are nuclear chain intrafusal fibers found

A

along the length of the equitorial region of the spindal

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43
Q

how is the polar region of the muscle spindle constructed

A

Striated

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44
Q

what efferent nerve fibers are foudn in the muscle spindle

A

Gamma fusimotor fibers (Most common)

Beta fusimotor fibers (rare, 1/3 of all spindles)

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45
Q

what sensory nerve fibers are found in the muscle spindle

A

1a afferent fibers

II afferent fibers

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46
Q

what are Ia afferent fibers

A

Primary endings

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47
Q

what are II afferent fibers

A

Secondary endings

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48
Q

where are Ia afferent fibers found

A

wrap around the equitorial region

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49
Q

wheree are II afferent fibers found

A

wrap around the jucntion of the equitorial and polar region

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50
Q

what do muscle spindles sense

A

Sense length not tension and report that to CNS

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51
Q

Roll of gamma motor neurons in muscle spindles

A

Maintain a high level of spindle sensitivity in shortened muscles

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52
Q

what happens to the afferent activity of the muscle spindle as the muscle shortens

A

Afferent activity decreases

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53
Q

What is the decreasing of afferent activity as muscle shortens important

A

an important component of kinesthesia

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54
Q

what would happen if internal adjustments in the spindle would not occur after a muscle shortens

A

the muscle would function over a range of short lengths where spindles would remain inactivity

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55
Q

action of gamma motor neurons for muscle spindle sensitivitty

A

cause polar region of intrafusal fibers to shorten, ultimately stretching the equatorial regions and restoring the spindles sensitivity

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56
Q

does the lack of an AP matter for a muscle spindle when reporting to the CNS

A

Yes, just as important as an AP

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57
Q

what kind of fibers do muscle spindles tend to associate with

A

with posterior/slow muscle fibers

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58
Q

where are golgi tendon organs found

A

in junction between ends of muscle fibers and tenden *in the tendon and in series with muscle fibers)

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59
Q

what do golgi tendon organs do

A

Generate signals that are proportional to amount of force generated by extrafusal muscle fibers

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60
Q

how do golgi tendon organs fire

A

in relation to the force generated(more firing for more force)

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61
Q

presence of free nerve endings in joints

A

lots of free nerve endings in joints

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62
Q

what do free nerve endings (without specialized endings sense):

A

Nociceptive(activated by pain)
also mechanical stimuli(provide info for joint position)
- to the CNS

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63
Q

what does an EMG do

A

recording and analysis of muscle activators

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64
Q

an EMG works by sensing

A

action potion along sarcolemma of muscle fibers

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65
Q

does EMG reflect forces generated across a joint

A

Not necessarily(antagonistic muscles generating equal forces)

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66
Q

what did the EMG show about mastication

A

very precise timing of masticatory events relative to each other

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67
Q

what components interact during mastication

A

Motor and sensory

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68
Q

how specialized is the muscles of mastication

A

Highly specialized

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69
Q

what afferent info comes from mastication

A

From muscles, oral cavity, and facial regions

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70
Q

what control and coordinates mastication

A

The CNS

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71
Q

how does the mandible move during mastication

A

Highly rhythmic and specific depending on food consistancy

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72
Q

what muscles does lowering of the jaw

A

Digastric and lateral pterygoid

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73
Q

what muscles do elevation

A

masseter
temporalis
medial pterygoid

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74
Q

what mastication muscle is found to be large in carnivors

A

large temporlis

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75
Q

what mastication muscle found to be large in herivors

A

large masseter

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76
Q

myosin differences in carnivors and herbivors

A

carnivores: express masticatory myosin
Herbivores: express alpha cardiac myosin and no masticatory myosin

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77
Q

specialization of muscles in omnivores

A

relatively unspecialized due to varied diet

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78
Q

how do squirels open nuts if they lack masticatory mucosa

A

single hole in the nut

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79
Q

how do squirrels open nuts if they have masticatory mucosa

A

obliterated shells

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80
Q

what are the 4 phases of the chewing cycle

A

slow opening
fast opening
fast closing
slow closing

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81
Q

what are the masticatory phases

A

Prepartory
Reduction
pre-swallowing

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82
Q

why does chewing slow near the teeth

A

to protect the teeth

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83
Q

what happens in the preparatory phase of mastication

A

tranport

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84
Q

what is involved in the preparatory phase of mastication

A

tongue
lips
buccinatory
(highly variable depending on food consistency)

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85
Q

what happens in the reduction phase of mastication

A

food breakdown

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86
Q

what happens in the pre-swallowing phase of mastication

A

food bolus formation

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87
Q

EMG activtiy in jaw closers during prep phase

A

Little EMG activity

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88
Q

EMG activity in openers and closers in all phases

A

Alternating EMG activitiyopeners and closers in all phases

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89
Q

EMG activity during prep phase

A

fairly variable

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90
Q

EMG activity during reduction phase

A

REgular and rhythmic

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91
Q

EMG activity in preswallowing phase

A

Regular

92
Q

speicific characterisits are depending on what for EMG actiivty during mastication

A

Dependent on food consistency

93
Q

the primary site of control of mastication

A

brain stem and cerebral cortex

94
Q

what is found in the brainstem and cerebral cortex for control and communication of mastication

A

Nuclei
Afferent (sensory) tracts
Efferent (motor) tracts

95
Q

what sensory nuclei are used for mastication

A

Trigeminal sensory nucleus

Trigeminal mesencephalic nucleus

96
Q

what does the trigeminal sensory nucleus innervate

A

Face and oral cavity

97
Q

what does the trigeminal sensory nucleus project to

A

Cerebellar and cerebral cortex

98
Q

what does the trigeminal mesencephalic nucleus sense

A

Spindles afferents from jaw closers

mechanoreceptors in periodontal ligaments, gingiva, and palate

99
Q

MOtor nuclei for mastication

A

Trigmeinal motor nucleus
Hypoglossal motor nucleu
Facial motor nucleus

100
Q

what does the trigeminal motor nucleus project as for mastication

A

Alpha and gammma motor neurons of jaw muscles

101
Q

orginization of the trigeminal motor nucleus

A

High degree of topographic organization

102
Q

what does the hypoglossal motor nucleus project out to as

A

Motor nuerons of tongue muscles

103
Q

what does the facial motor nucleus do

A

it is the motor nueons of facial muscles

104
Q

how is the facial motor nucleus organized

A

topographically

105
Q

does the brain stem need anything else to control mastication

A

No, can function autonomously in the control of mastication (but this is not normal)

106
Q

what does the brain stem do for mastication

A

Contains a pattern generator (neural oscillator) for mastication

107
Q

path of the jaw closing reflex

A
  • Afferent fibers from Muscle spindles have cell bodies in the mesencephalic (sensory) nucleus)
  • Mesencaphalic snsory nucleus sends its axon to synpase on Alpha motor neurons in trigeminal motor ncuelus
  • trigeminal motor nucleus sends out axons to induce closing
108
Q

synapses in the jaw closing reflex

A

Monosynaptic

109
Q

characteristics of monosynaptic reflexes

A

very fast with basically no modulation from higher centers

110
Q

steps of the jaw-opening reflex

A
  • stimulus in oral cavity excites afferents(cell bodies in trigeminal gnaglion) that terminate in speinal trigeminal tract nucleus to synapse with interneurons
  • interneurons synpase on alpha motor neurons in trigeminal motor nucleus
  • trigeminal motor nucleus innervates jaw openers
111
Q

number of synapses in the reflex of jaw opening

A

polysynpatic reflex

112
Q

characteristics of polysynaptic reflexes

A

highly modulated for specific stimulus

113
Q

roll of higher centeres in mastication

A

Modulation of mastication and voluntary (jaw opening somtimes and jaw opening)

114
Q

Roll of afferents in mastication

A

Modulation of mastication depending on specific food consistency

115
Q

what do afferents sense in mastication

A

Variale receptors invovled with several types of input

116
Q

what do afferents input to

A

to the brain stem components and higher centers

117
Q

when does swallowing occur

A

Reflex after initiation(can be voluntary); normally unconscious

118
Q

how common is swallow

A

about 1000 per day (1 per minute except sleep or eating

119
Q

how complex is swallowing

A

very complex

120
Q

Components of swallowing

A

Large area of brain stem
6 cranial nerves
receptors
muscles

121
Q

4 phases of the movement of food bolus

A

Preparatory phase
Oral phase
Pharyngeal phase
Esophageal phase

122
Q

what happens to food during the preparatory phase

A

bolus formation

123
Q

what is the preparatory phase the same as

A

Pre-swallowing phase at the end of mastication

124
Q

what is formed during the preparatory phase

A

Bolus is formed

glossopalatal sphincter

125
Q

where is the Bolus positioned during the preparatory phase

A

on the dorsum of the tongue

126
Q

action of the tongue during the preparatory phase

A

tip presses against max incisor or anterior hard palate

Region where bolus is positioned rises lateral against posterior teeth and palatal mucosa

127
Q

when does the glossopalatal sphincter form

A

when the pharyngeal (posterior) part of the tongue rises and contact the soft palate and the soft palate pushes down

128
Q

roll of the glossopalatal spinciter

A

prevents the bolus from entering the pharynx prematurely

129
Q

does the glossopalatal sphincter exist for a long time

A

No, temporary

130
Q

what happnens in the oral phase

A

Movement of the bolus from oral cavity to pharynx

131
Q

time of the oral phase

A

about .5 seconds

132
Q

what happens first in the oral phase

A

Lips close, upper and lower incisory move closer together

133
Q

what does the Lips close, upper and lower incisory move closer together during the oral phase

A

to form an oral seal

134
Q

what happens after the Lips close, and the upper and lower incisory move closer together

A

anterior 2/3 of the tongue moves up agianst the maxillary alveolar ridge and the anterior hard palate

135
Q

consequence of the anterior 2/3 of the tongue moves up agianst the maxillary alveolar ridge and the anterior hard palate during the oral phase

A

pushes the bolus towards the pharynx

136
Q

what happens after the anterior 2/3 of the tongue moves up agianst the maxillary alveolar ridge and the anterior hard palate during the oral phase

A
  • base of tongue moves downward and forward
  • palate moves
  • palate contacts posterior pharyngeal wall and the wide wals of the nasopharynx are opposed
137
Q

consequence of the base of tongue moving downward and forward during the oral phase

A

expands hyopharynx and opens a chute to the pharynx

138
Q

what is the consequnce of the palate moving up during the oral phase

A

Opens the glossopalatal sphincter

139
Q

what is the consequence of the palate contacting the posterior pharyngeal wall and side walls of the nasopharynx opposing during the oral phase

A

Prevents the bolus from entering the nasal cavity

140
Q

what muscles are involved in the preparatory and oral phases of swallowing

A 
Mandibular muscles (masseter, medial pterygoid, temporalis)
Facial muscles (labial and buccinatory
141
Q

are the muscles invovled in preparatory and oral phases always the same

A

Variable and facultative (depending on food consisteny)

142
Q

what does the contraction of the labial and buccinatory muscles do

A

Form the oral seal and stabilize the mandible

143
Q

what happens in the pharyngeal phaes

A

Movement of bolus from oropharynx to the esophagus

144
Q

what happens first in the pharyngeal phase

A

Piston-like movement of the posterior tongue

145
Q

what is the conseqeunce of the piston-like movment of the posterior tongue in the pharyngeal phase

A

Propels the bolus through the oropharynx and into the hypopharynx

146
Q

what happens after the pirston-like movment of the posterior tongue during the pharyngeal phase

A

pharyngeal contrictors contract several times

147
Q

what is the consequence of the pharyngeal constrictors contracting several times during the pharyngeal phase

A

moves the bolus through the pharynx

148
Q

what happens after the pharyngeal constrictors contract sever times during the pharyngeal phase

A

Upper esophageal sphinctor opens

149
Q

what does the upper esophageal sphincter opening lead to

A

Allows the bolus to enter the esophaus

150
Q

whathappens after the upper esophageal sphinctor opens

A

Epiglottis movement (from upright to horizontal) caused by eleveation of thehyoid bone and larynx and contraction of the thyrohyoid muscle

151
Q

consequence of the epiglottis moving from upright to horizontal

A

Closes the opening to the larynx

152
Q

is the epiglottis absolutely required to prevent aspiration of food

A

No( removed in some people who can still swallow without aspiration

153
Q

what stages use more consitent muscles, pharyngeal or prep/oral

A

Phayngeal

154
Q

what are the muscles called in the pharyngeal phase of swallowing

A

Obligate group of muscles

155
Q

what are the muscles called in the oral and prep phases

A

faculating

156
Q

what groups of muscles are included in the obligate group

A

Leading complex of muscles

and others

157
Q

what does the leading complex of muscles consist of

A

Mylohyoid geniohyoid etc

158
Q

how does the leading complex of muscles act

A

contract fiarly synchronously

159
Q

how do the muscles after the leading complex of muscles act

A

more sequential (thyrohyoid, thyroarytenoid, middle constrictor, cricothyroid, inferior constrictor)

160
Q

what happens in the esophageal phase

A

movement of food along entire esophagus

161
Q

how long is the eosphageal phase

A

3 sec for liquids

9 sec for solids

162
Q

how does the bolus move during the esophageal phases

A

Peristaltic waves oof contraction (primarily smooth muscle)

163
Q

what must open to allow bolus to enter stomach

A

Lower esophageal sphincter

164
Q

activity of the esophageal sphincters

A

Tonically active

basal activity stops before bolus enters esophagus

165
Q

when does the upper esophageal sphincter relax

A

when the tongue and the upper pharynx contract and is open before the pressure wave passes through the pharynx

166
Q

when does the upper esophageal sphincter contract

A

after the food bolus enters the esophagus and its pressure rises well above resting level for several seconds

167
Q

how long is the esophageal spincter relaxes

A

about 3 seconds before peristaltic waves reach it and until the last series of swallows is complete

168
Q

how does the lower esophageal sphincter contract

A

for 1-2 seoncds so that developed pressure is well above the resting level

169
Q

what prevents aspiration of food during the pharyngeal phase

A

Respiration inhibited
Larynx and upper esophageal sphincter elevate
Intrinsic muscles of glottus move vocal cords toward each other
Bolus moves through sinuses in pharynx

170
Q

what phases of swallowing are voluntary and normally subconsious

A

Preparatory and oral phases

171
Q

what phases of swallowing are involuntary

A

Phayngeal and esophageal phases

172
Q

what is the swallowing center

A

The brain stem

173
Q

what are the three components of the brain stems swallowing center

A

Sensory nuclei
Interneuronal network nuclei
Motor nuclei

174
Q

what are the sensory nuclei of the swallowing center

A

Nucleus Tractus Solitarius

trigeminal sensory nucleus

175
Q

what are the motor nuclei of the Swallowing center

A

Nucleus Ambiguous

Facial, trigeminal and hypoglossal nuclei

176
Q

what does the interneuronal network do in the swallowing center

A

Mediates interactions between motor na dsensory nuclei

177
Q

where is the interneuronal network found for the swallowing center

A

not discreet, rather distributed and ventral and dorsal medulla

178
Q

what do dorsal internueoons do for the swallowing center

A

Initiation and programming (timing) of swallowing)

179
Q

can the initiaiton and programming (timing) of swallowing occur without snesory input

A

Yes, but normally many afferent fibers send info to these interneurons through the NTS

180
Q

what do ventral interneurons in the swallowing center do

A

Distribute the excitation to the swallowing motor nuclei

181
Q

what not part of the brain stem swallowing center is also in control of swallowing

A

Cervical motoneurons

182
Q

where does Afferent info of swallowing originate

A

In the pharynx, larynx, esophagus

183
Q

where is afferent infor of swallowing send

A

To the NTS

184
Q

what does afferent info during swallowing result in

A

Modulation of swallowing depending on food consistency

185
Q

what may be inhibited due to activation of afferent fibers

A

some motoneurons (esophageal motoneurons during oral and pharyngeal phases

186
Q

is the cortex needed for smooth efficient swallowing

A

cortex can initiate swallowing but not needed for smooth efficient swallowing

187
Q

what mucles are programmed in utero for swollowing

A

Obligate muscles (timing and sequence of contraction, pharyngeal phase of swallowing)

188
Q

how are facultative muscles patterned

A

before and after tooth eruption

189
Q

BEfore tooth eruption what is invovled in sealing the oral caivty

A

Orbicularis oris and buccinator muscles (tongue thrust)

190
Q

jaw closer muscles roll before eruption

A

Not prominent role

191
Q

when do jaw closer muscles become involed

A

After tooth eruption

192
Q

what muscles work less after tooth eruption

A

Labial and buccinator muslces (also tongue thrust)

193
Q

what happens if the infantile style of swallowing is maintied after tooth eruption

A

Malocclustion(anterior open bite)

194
Q

can babies breath while swollowing

A

No

195
Q

Are infant and adult sucking differnt

A

Yes

196
Q

Infant sucking occures how

A

Lips seal around nipple
Mandible lowered to make negative pressure
Elevation of jaw and tongue espresses the milk

197
Q

what muscles have important roles in infant suckling

A

Jaw opening and jaw closing muscles

198
Q

is respiration maintained during sucking episode

A

YEs

199
Q

when does suckling begin

A

In utero

200
Q

How does Adult sucking occur

A

Similar to inspiration through the mouth (driven by inspiratory muscle, not jaw muscles)

201
Q

Purpose of emsis

A

Vomiting to rid stomach of contenets (Toxic)

202
Q

stimuli for vomiting

A
  • Physiological (pain,vestibular imbalance, distention or injury to stomac, intestine, bladder or uterus, iritiation of gut or peritoneus. substance in blood can directly stimulate chemoreceptors in medulla)
  • disease releated (increase intracranial presss (heart attack), stenosis of pyloric valve, raditation therapy, anesthesia, psychological stress
203
Q

Vomiting phases

A

Pre ejection
Retching
Expulsing
Post ejection

204
Q

Characteristics of the pre-ejection phases of vomitign

A

Licking, salivation, tachycardia, and relaxiation of the proximal part of stomach

205
Q

duration of the pre-ejection phase of vomiting

A

Few minutes to several days (pregnancy)

206
Q

what happens during retching

A

Glottis closed

inspiratory muscles contract decreasing in intra-thoracic pressure and increse in intra-abdominal pressure

207
Q

what happens to the upper esophageal sphincter during each retch

A

relaxes then contracts between each one

208
Q

what happens during expulsion

A

Atrum of stomach relaxes
Rectus abdominus and external oblique contract
Upper esophageal sphincter relaxes
Intra-thoracic and intra-abdominal pressure rise to 100mmhg comared to resting 10 mmhg of lower esophageal sphincter

209
Q

what happens in post ejection

A

Cycle can terminate or repeat several times

210
Q

what coordinates vomiting act

A

Group of nuclei in medulla

211
Q

where does the afferent info from stimuli to vomit terminate

A

In the sensory nuclei of the medullar complex

212
Q

Direct stimulation near the NTS in animals causes what

A

Vomiting

213
Q

what does the NTS connect to

A

Area postrema

214
Q

what does the area postrema contain

A

Chemoreceptor trigger zone

215
Q

what stimulates the chemorecptor trigger zone

A

Emetic agents in the blood

216
Q

characteristiscs of bruxism

A

Forceful tooth clenching, grining during sleep

Rhythmic chewing, sustained contraction

217
Q

what is similar to bruxxism in the day due to mandibular mech

A

Daytime tooth clench

218
Q

oringially thought cause of bruxism

A

Interferences in occlusion (wrong because tooth stimulation leads to inhibition of jaw closerse

219
Q

what shows that Bruxism has CNS origin

A

Certain sleep phases relating to stress

220
Q

stimulation of certain brain areas have shown what for bruxism

A

Hypothalamus stimulation leads to stresss and excitation of jaw closer motoneurons

221
Q

Consequences of bruxism

A

PAin, muscle damage
Tooth wera, mobility, fracture
TMD, headaches, remodeling of condyles if severe

222
Q

how to treat brusims

A

Reduce stress

bite appliances

223
Q

two major issues with TMD

A

pain and impaired chewing efficiency

224
Q

do men or women have TMD

A

Women have more TMD with more pain while guys have more problem chewing and jaw opening

225
Q

do old people have TMD

A

lower probablity

226
Q

what Might TMD be a part of

A

TM (fibromyalgia) -more common in women, muscular pain, and depression
similar treatment

227
Q

why might TMD not be part of FM

A

FM more common in old

physiology (32 decks)

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