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Anatomy of Speech, Language, and Hearing > Physiology of Mastication and Deglutition > Flashcards

Physiology of Mastication and Deglutition Flashcards

1
Q

Mastication

A

-prep of food for swallow
-involves oral muscles, teeth, all articulators

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2
Q

Deglutition

A

-swallowing

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3
Q

Dysphagia

A

-disorders of swallowing at any stage in process

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4
Q

Cricopharyngeus

A

-component of inferior constrictor involved in upper esophageal sphincter (UES)

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5
Q

Pharyngoesophageal (PE Segment)

A

-upper esophageal sphincter, immediate esophageal region, and immediate pharyngeal region

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6
Q

Infant Oral/Pharyngeal Space: Differences in Structure

A

-oral cavity smaller
-larynx higher descends during first 4 years
-hyoid elevated and forward
-velum large compared to pharynx
-no teeth

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7
Q

Infant Oral/Pharyngeal Space: Function of Differences in Structures

A

-large velum, large tongue, elevated larynx significant part in respiration and deglutition
-structural differences important for nipple feeding
-small mandible and large tongue important for piston like tongue movement for sucking
-high larynx protect airway by allowing tighter oral seal for sucking
-facilitating simultaneous breathing, swallowing, and sucking
-prevents food and liquid from entering trachea

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8
Q

Developmental Issues in Neonates: Tongue

A

-fills oral cavity

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9
Q

Developmental Issues in Neonates: Cheeks

A

-cheeks fat pads narrow oral cavity laterally

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10
Q

Developmental Issues in Neonates: Hyoid and Larynx

A

-both elevated
-provides natural protection of airway

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11
Q

Developmental Issues in Neonates: Velum

A

-hangs lower
-depressed during nursing

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12
Q

Developmental Issues in Neonates: Epiglottis

A

-visible, higher

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13
Q

Developmental Issues in Neonates: Uvula

A

-rests inside epiglottis forming pockets in valleculae

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14
Q

Valleculae

A

two depression in throat between base of tongue and epiglottis

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15
Q

Developmental Issues in Neonates: Bolus

A

-tends to collect at back of tongue while swallowing

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16
Q

Developmental Issues in Neonates: Teeth

A

-no teeth

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17
Q

Developmental Issues in Neonates: Mastication

A

-no mastication

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18
Q

Infant Growth: Jaw

A

grows down and forward

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19
Q

Infant Growth: Oral Cavity

A

-grows

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20
Q

Infant Growth: tongue

A

-descends
-ceases anterior movement during swallowing
-results in adult oral/pharyngeal system

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21
Q

Infant Growth: hyoid, larynx, epiglottis

A

all drop

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22
Q

Infant Growth: Pharynx

A

enlarges to compensate for drop of hyoid, larynx, and epiglottis

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23
Q

Infant Growth: Teeth

A

erupt

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24
Q

Infant Growth: most enlargement

A

-during puberty

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25
Infant Growth: face
-continues to grow until 21 years old
26
Suckling
-piston like movements of tongue with tongue cupping -tongue protrudes -presses on breast, extrudes milk -generally reflexive -tongue protrusion natural at this stage
27
Sucking
-tongue raises and lowers as protrudes and retracts -strong labial seal -milk drawn into oral cavity
28
Infant Swallowing
-begins in fetus with sucking movements -fetus drinks amniotic fluid: thumb in mouth
29
Neonate Swallowing
-repeatedly pumps tongue: tongue and jaw together initially -liquid collects at fauces or valleculae -uses 2-7 tongue pumps before swallow -adequate bolus triggers pharyngeal swallow -apneic period during swallowing
30
Apneic Period
-newborn must coordinate sucking, swallowing, and breathing -early: 3 sucks then swallow while suspending respiration -later: 1 suck then swallow -can range between 10-30 sucks in duration
31
Chewing Critical Period: 6 months of age
-development of skills due to plasticity of nervous system -experience promotes remodeling of neutral circuits that control movements
32
Chewing Critical Period: Beginning approx. 4 months
-respond to taste that shape motor function -eruption of dentition supports mastication via sensory awareness of chewing process
33
Infant: Mastication
-Bite achieved by 7 months -chewing begins at 10-12 months -normal chewing established by 4 years -by time child swallows pureed or soft food: adult form except less elevation
34
Presbyphagia
-age related changes in swallowing not classified as dysphagia
35
Sarcopenia
-as age all muscles weaken and get slower -produces reduction in transit times and force generation in swallowing: causes prolonged oral prep and oral stages
36
Aging: Reduced Sensation
-causes less brisk and robust reflexes: including protective reflexes
37
Older Adults: Mastication
-if dentition complete maintain good mastication -see more chewing strokes as get older: as teeth go bad, if dentures do not fit well
38
Older Adults: Deglutition
-laryngeal cartilages ossification makes easier to see swallow studies -after 70 years larynx lowers -cervical arthritis may occur -may decrease flexibility of pharynx, reduce strength of pharynx, may need second swallow to clear
39
Age Does Not Protect Aspiration: Penetration
-introduction of bolus into laryngeal aditus -penetration increases with age but no increase in aspiration
40
Age Does Not Protect Aspiration: Aspiration
-introduction of bolus past vocal folds
41
Age Does Not Protect Aspiration: 20-30 yrs old vs 80-96 yrs old
-reduced maximal laryngeal and hyoid movement -reduced neuromuscular reserve -reduced elevation and UES opening
42
Stages of Swallow
-oral stage: oral prep, oral transit -pharyngeal -esophageal
43
Oral Prep: Anticipation Food
-perceptual olfactory and visual provides motivation to ingest
44
Oral Prep: Food presented and mouth opens to receive food
-preparatory phase
45
Oral Prep: Tongue
-cups in anticipation
46
Oral Prep: Lips
-may be used to clear spoon
47
Oral Prep: Teeth
-may be used to clear fork
48
Oral Prep: Lips, Tongue, Velum
-lips sealed -tongue rises in rear -velum drops to keep food in oral cavity which allows nasal breathing
49
Oral Prep: Food Bolus
-must be ground up to pass through esophagus -reduction phase
50
Oral Prep: Tongue response for keeping food in oral cavity
creates seal along alveolar ridge
51
Oral Prep: Tongue can also compress food against hard palate
-partially crushing prepare for teeth
52
Oral Prep: Tongue Moves Food
-tongue moves food to molars for additional grinding
53
Oral Prep: Grinding Action
-crushes food -action milks salivary glands
54
Oral Prep: Food Pulled back
-food pulled back into oral cavity to mix saliva with food
55
Oral Prep: Tongue returns bolus
-tongue returns bolus to molars for additional grinding
56
Oral Prep: Facial Muscles
-facial muscles of buccal wall (risorius and buccinator) contact to prevent food from entering lateral sulcus
57
Oral Prep: Move Bolus
-move bolus onto tongue to test consistency -if not desired consistency, move back to molars -when desired consistency initiate swallowing
58
Oral Transit
-swallowing "initiation stage"
59
Oral Transit: Tip of tongue to raise alveolar ridge and hyoid elevates
-vocal folds close 0.1 seconds after initiation to stop breathing -hyoid elevation may be part of pharyngeal stage
60
Oral Transit: Tongue Tip and Dorsum
-tongue tip and dorsum squeeze bolus to faucial pillars
61
Oral Transit: Tippers
-some raise tongue during swallowing
62
Oral Transit: Dippers
-some lower tongue during swallowing
63
Oral Transit: Mandible
-elevates to counteract pressure of tongue to roof of mouth
64
Oral Transit: Velum
-remains depressed to keep bolus in oral cavity
65
Oral Transit: Bolus, faucial pillars, and soft palate
-either or both trigger pharyngeal stage
66
Oral Transit: Adequate Bolus
-adequate bolus required in oropharynx initiate pharyngeal stage
67
Pharyngeal Stage Airway Protection: as bolus moves down, airway protected
-tip of tongue to raise to alveolar ridge elevates hyoid -true vocal folds adduct: aka leading complex -larynx elevates -false folds adduct -lower vestibule closes via arytenoids pulling medially and anteriorly -upper vestibule closes via epiglottis dropping down after aditus
68
Pharyngeal Stage Pharynx Pressurization: Pressure developed through coordianted muscle contractions
-primarily tongue and pharyngeal constrictirs muscles
69
Pharyngeal Stage Pharynx Pressurization: Tongue Action
-tongue presses against hard palate generation pressure wave that propels bolus into oropharynx
70
Pharyngeal Stage Pharynx Pressurization: Pharyngeal Constrictor Muscles
-contract sequentially, creating a peristaltic wave that increases pressure and pushes bolus down pharynx
71
Pharyngeal Stage Pharynx Pressurization: Soft Palate Elevation
-contracts lateral and posterior pahryngeal walls closes nasopharynx -increasing pressure -prevents food from entering nasal cavity
72
Pharyngeal Stage Pharynx Pressurization: Hyoid and larynx elevate and move forward
-creates lower pressure at esophageal entry
73
Pharyngeal Stage Pharynx Pressurization
-relaxation of cricopharyngeus muscle superior to inferior pressure gradient
74
Pharyngeal Stage: Bolus Movement (Tongue)
-moves posteriorly and carries bolus to oropharynx
75
Pharyngeal Stage: Bolus Movement (Pharynx)
-elevates -contracts in peristaltic wave pushes bolus downward
76
Pharyngeal Stage: Bolus Movement (Pressure)
-pressure drives bolus inferiorly
77
Pharyngeal Stage: Bolus Movement (Bolus passes through)
-bolus passes through phryngoesophageal (PE) and clears larynx
78
Pharyngeal Stage: Bolus Movement (PE Segment)
closes
79
Pharyngeal Stage: Bolus Movement (Larynx)
lowers opens superior to inferior
80
Pharyngeal Stage: Bolus Movement (Velum)
lowers
81
Pharyngeal Stage: Bolus Movement (Expiration Occurs)
-blows residues from larynx aditus
82
Infant Pharyngeal Swallow Same As Adult
-except -larynx less elevation -posterior pharyngeal walls moves forward more than adults -airway can be open: always apneic period
83
Geriatric Individuals: Oral Stage
-generally weaker -tend hold bolus on floor of mouth -tend to pick bolus up with tongue tip -oral stage little longer than adults: chew more
84
Geriatric Individuals: Pharyngeal Stage
-increased delay triggering pharyngeal swallow due to loss in sensation -delay increases with bolus size and age -<30 yrs = 0.1 sec -30-59 yrs = 0.3 sec -60 yrs = 0.4 sec
85
Esophageal Phase
-initiates when bolus enters esophagus -triggered of upper 2 cm of esophagus by bolus -bolus triggered to lower esophageal segments (LES): transit via peristalsis of smooth and striated muscle and gravity -approx 2 secs from UES to LES -enters stomach for digestion
86
Geriatric Individual Esophageal Phase
-esophageal function deteriorates significantly with age: slower and less efficient
87
Geriatric Individual Esophageal Phase: 80-96 yrs
-reduced laryngeal and hyoid movement: reduced neuromuscular reserve -limits cricopharyngeal opening -in younger, have greater elevation as volume increases: not seen in elderly

Anatomy of Speech, Language, and Hearing (13 decks)

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