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SLP A & P Exam 2 > Physiology Of Swallowing > Flashcards

Physiology Of Swallowing Flashcards

1
Q

What is mastication

A

Chewing process, preparing food for swallowing
Salivary glands start to salivate to create the bolus

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2
Q

What is deglutition

A

Swallowing the food

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3
Q

Bolus

A

Ball of food (liquid or solid)
Helps propel from oral cavity to stomach

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4
Q

Anatomy of a child versus adult

A

Infant: smaller oral cavity, elevated larynx and hyoid bone, larger velum (aids in sucking)
Adult: Larger oral cavity, lower larynx, proportional size velum, dentition

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5
Q

Rooting reflex

A

Gain nutrition for infants
Turns toward stimulus and opens mouth
Diminishes around 3-4 months

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6
Q

Sucking reflex

A

Allows infant to receive food
Diminishes around 5-7 months
Primary reflex in order for the baby to maintain nutrition

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7
Q

Swallow pattern of the infant

A

Suck swallow breathe is reflexive around 5-7 months
Velum of infant locks into space b/w epiglottis and tongue at valleculae
Seals off infant’s airway
Prevents bolus from entering airway
Infant can breathe while swallowing

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8
Q

Physiological changes in infant

A

Mandibular grows to make space for the tongue
Pharynx elongates with the hyoid
Epiglottis and larynx descend in relation to the soft palate

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9
Q

Age of diminishing reflexes

A

Gallant reflex - 3-6 months
Mora reflex (startle reflex) - 3-5 months
Rooting - 3-4 months
Grasping hand - 4-7 months
Grasping feet 9-12 months

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10
Q

Uvula gag reflex

A

Ensure we are not ingesting things that might be harmful to us
Can be elicited by taste
Causes respiration to cease
Causes pharynx to elevate and constrict
Cranial nerve damage if not present

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11
Q

Chewing reflex

A

Triggered by deep pressure on roof of mouth
Involves rotary motion of mandible
Bolus is moved into and off of the molars
Chewing center located within midbrain - involved in reflexive movements of tongue for sucking and licking
Dentition helps develop chewing musculature

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12
Q

Palatal reflex

A

Triggered by putting a lot of heavy pressure on the hard and soft palate
Cranial nerve damage if not present

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13
Q

Retch reflex

A

Involuntary attempt at vomiting
Caused by noxious smells, tastes, gastrointentestinal distress, vestibular dysfunction, upsetting visual stimuli

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14
Q

Vomiting

A

Oral expulsion of gastrointetestinal contents

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15
Q

Cough reflex

A

Initiated by noxious stimuli of the pharynx, larynx, or bronchial passageway
Involves laryngeal adduction and abdominal contraction
Increases subglottal pressure
Produces forceful exhalation

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16
Q

Tongue base retraction/elevation

A

Retraction: stimulated by pulling tongue forward. XII hypoglossal
Elevation: stimulated by pushing down on posterior tongue. XI accessory and X vagus

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17
Q

Pain reflex

A

Pain withdrawal reflex, can happen if something is hot, spicy, etc
Affects mastication and swallowing
Causes a natural withdrawal from noxious stimulus
Oral and pharyngeal pain responses

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18
Q

Respiratory reflexes

A

Under partial voluntary control
Found in the inferior end of the medulla oblongata
Causes of respiration
Inadequate oxygenation in the blood
Increased carbon dioxide in the blood
Increased acidity
Includes the airway, lungs and blood vessels

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19
Q

Stages of mastication and deglutition

A

Oral stage (oral preparatory stage and oral transport)
Pharyngeal stage
Esophageal stage

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20
Q

Oral preparatory stage3

A

Food is prepared for swallowing
Bolus is kept in mouth by sealing lips and cheek muscles

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21
Q

Muscles involved in oral preparatory stage

A

Orbicularis oris
Mentalis
Buccinator
Risorious
Soft palate (palatoglossus and Palatopharyngeus)

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22
Q

Oral prep stage lingual muscles

A

Superior longitudinal
Inferior longitudinal
Vertical
Mylohyoid
Geniohyoid
Digastric
Styloglossus
Palatoglossus

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23
Q

Oral prep stage mandibular muscles

A

Masseter
Temporalis
Medial pterygoid
Lateral pterygoid

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24
Q

Oral prep stage

A

Soft palate muscles keep food/liquid from entering the Nasopharynx
Food mixed with saliva to form a bolus in preparation for swallowing
Parotid gland
Submandibular glands
Sublingual glands
Velum is depressed to prevent nasal regurgitation

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25
Oral transport stage
Bolus is pushed back toward the oropharynx by the tongue Tongue base drops and pulls posteriorly Anteriorly tongue elevates to the hard palate to push bolus back Tongue does majority of work with assistance from mandibular muscles When bolus contacts faucies pharyngeal swallow is triggered Mandibular muscles help so that your jaw isn’t just lax
26
Parotid gland
2 parts of lobes, superficial and deep, facial nerve b/w the lobes Saliva is secreted into the mouth from under the tongue Posterior to mandibular ramus Secretions empty into the pharynx
27
Submandibular gland
Size of a walnut Located just below the jaw Superficial and deep B/w mylohyoid and submandibular fossa Secretions empty into the oral cavity lateral to lingual frenulum
28
Sublingual glands
Smallest of the major salivary glands Almond shaped under roof of mouth and below either side of tongue Secretions empty in to mouth through ducts in the sublingual fold
29
Oral transport stage mandibular muscles
Masseter Temporalis Medial pterygoid
30
Oral transport stage tongue muscles
Superior longitudinal Vertical Mylohyoid Genioglossus Styloglossus Palatoglossus
31
Pharyngeal stage
Begins when bolus reaches faucial pillars Bolus propelled through pharynx to relaxed esophageal sphincter which receives bolus, relaxed because of the recurrent laryngeal nerve A tight seal is formed to protect the airway Respiration ceases for milliseconds Velum elevates as bolus passes Constrictor muscles squeeze bolus through pharynx Food passes over epiglottis through the pyriform sinuses to the esophagus INVOLUNTARY
32
Pharyngeal stage intrinsic tongue muscles
Superior longitudinal Inferior longitudinal Transverse Vertical
33
Pharyngeal stage extrinsic tongue muscles
Mylohyoid Geniohyoid Digastricus Genioglossus Styloglossus palatoglossus Hyoglossus Thyrohyoid
34
Pharyngeal stage soft palate muscles (working to close vp port and out of the way)
Levator veli palatini Musculus uvulae Tensor veli palatini (contracts to open the eaustachian tube to clear ears
35
Pharyngeal muscles in pharyngeal stage
Palatopharyngeus Salpingopharyngeus Stylopharyngeus Crycopharyngeus Superior constrictor Middle constrictor Inferior constrictor
36
Pharyngeal stage laryngeal muscles (ensuring vocal folds are closed)
Lateral cricoarytenoid Transverse arytenoid Oblique arytenoid Aryepiglottic muscle Thyroepiglottic
37
Pharyngeal trigger
Sensory information comes from the trigeminal and glossopharyngeal nerves Nucleus tractus solitarius and nucleus abiguus assist as well Stimulus is the bolus Between the anterior faucial pillars and tongue base
38
Esophageal stage
Final stage of swallowing Completely REFLEXIVE and not within voluntary control Involves peristaltic movement of the bolus through the esophagus Bolus of food enters stomach All smooth muscle in this phase, all involuntary, this is the peristaltic movement Upper and lower esophageal sphincter. Opens and immediately closes to let bolus move. This is important so gastric contents don’t back up into the pharynx or larynx
39
Know diagram on slide 15
Know diagram on slide 15
40
Know the development malformations of esophagus page 469 in book
Know the development malformation of esophagus
41
Sensation associated with swallowing
Gustatory Tactile Temperature Pressure
42
Gustation
Taste Critical component of chewing, sucking, and swallowing Taste receptors are chemoreceptors for gustation Transmit information to the brain about taste
43
Taste
Can be sensed all over the tongue via taste pores Salty, sweet, sour, bitter, umami Taste determines whether a bolus is ingested or ejected from the mouth
44
Taste receptors
Papillae Filiform papillae: tactile info, most common. Sweet, bitter and umami Fungiform papillae: taste and tactile Circumvallate papillae: taste, posterior 1/3. Sweet and bitter Foliate papillae: taste, leaf shaped posterior edge. Sweet
45
Taste receptors mediated by 3 cranial nerves
Facial VII: taste anterior 2/3 of tongue, palate. Sweet, salty, sour Glossopharyngeal IX: taste posterior 1/3 of tongue. Bitter Vagus X: epiglottis and esophagus
46
Know diagram on slide 19
Know diagram on slide 19
47
Facial nerve
Taste is sent to the medulla, solitary tract nucleus in the gustatory region of the brainstem
48
Glossopharyngeal nerve
Goes to the solitary tract nucleus
49
Vagus nerve (epiglottis and esophagus)
Goes to the solitary tract nucleus
50
From solitary tract nucleus taste goes to
Thalamus then the cerebral cortex
51
KNow slide 20
Know slide 20
52
Neuroanatomy of taste
Info from the nest projects into the motor cortex where nutritional needs are stimulated (sweet, protein, salt) to elicit salivation, release of insulin, mastication and deglutition Bitter and sour can be interpreted as poison and stimulate protective responses such as gagging, coughing, apnea, salivation tastes can elicit motor responses that may not be under our control
53
Olfaction
Sense of smell Plays vital role in appetite and taste Sensors have a short life and are continually replaced Pleasant food odors produce salivation Unpleasant food odors produce gagging or even vomiting
54
Olfactory sensor nueroanatomy
Sensor is stimulated a signal is sent To the olfactory bulb Then via the olfactory tract to the cortex Frontal lobe: discrimination of smell Hypothalamus: physiological responses Hippocampus: memory encoding
55
Slide 22
Slide 22
56
Tactile sense (touch)
Sense of touch mediated by many mechonoreceptors Sensitive to physical contact Broadly distributed throughout the body Differentiated by type of stimulus causing response Can be used as a form of therapy
57
Glabarous skin
Meissners’s corpuscless: mechanical movement, more superficial, smaller receptor fields Merkel disk receptors: pressure Pacinian corpuscles: respond to rapid (deep) pressure, large receptors Ruffini ending: sense (deep) stretch within the deep layers of epithelium
58
Tactile sense (vibration)
Subclass of tactile sense Measured in frequency (Hz) Amplitude of vibration indicates deep vs. superficial pressure
59
Four classes of thermal receptors
Warm, hot, cool, cold Bare nerve endings Constant state of response and increase as the stimulus changes Can be used as a form of therapy
60
Pain sensors (nociception)
Produces perception of pain when traumatized Important in development of structural disorders of swallowing, and/pharyngeal lesions May respond to traumatic or thermal trauma
61
Muscle stretch
Stretch receptors are not present in facial muscles Sensed by muscle spindle fibers Found within the oral musculature Mandibular elevators, genioglossus, palatoglossus, richly endowed with sensors
62
Muscle tension
Sensed by golgi tendon organs Respond to active contraction of muscles, inhibit muscle spindle fibers
63
Muscle tone
Perception of resistance to passive movement of stretching High muscle tone results from deficits to the muscle spindle fibers Low muscle tone results from inadequate tension
64
Saliva glands stimulated by
Taste receptors and info is sent via the facial nerve, the sublingual and submandibular branch and glossopharyngeal
65
Types of saliva
Parotid: serous saliva Submandibular: serous and mucus Sublingual: thick mucus
66
5 elements of the oral preparatory stage of mastication and deglutition
1. Food is received in mouth, and food is impounded in mouth by lip sealing, tongue dorsum elevating, and velum depressing 2. Food is moved onto molars by the tongue 3. Food is mixed with saliva 4. Food is formed into a bolus 5. Food is removed from buccal cavity by tongue action
67
List 3 of the elements of the oral transport stage of deglutition
1. tongue tip elevates to alveolar ridge 2. Bolus is propelled posteriorly by squeezing action 3. Bolus makes contact with faucial pillars and velum
68
List critical elements of the pharyngeal stage of deglutition
1. Bolus enters oropharynx 2. Velum elevates 3. Larynx elevates 4. Vocal folds adduct 5. Epiglottis inverts to protect airway 6. Tongue contacts posterior pharyngeal wall 7. Upper esophageal sphincter opens 8. Pharynx contracts with peristaltic action
69
Perioral
Refers to mouth region
70
Sucking reflex definition
Elicited by soft contact with the lower lip and results in tongue protrusion and retraction
71
3 critical elements related to pressures of deglutition
1. Velum elevates 2. Tongue and lips form oral seal 3. Cricopharyngeus opens as larynx elevates
72
Chemoreceptor
Class of receptors that respond to chemical stimulation
73
Oral chemesthesis
Detection of chemicals that stimulate pain and thermal sense within the oral cavity Mediated by V Trigeminal cranial nerve
74
Meisserner’s corpuscles
Respond to minute mechanical movements in the superficial epithelia
75
Merkel disk receptors
Transmit the sense of pressure within the superficial epithelia
76
Do thermal and pain sensors share the same morphology
YES
77
Muscle stretch is sensed by
Muscle spindles, which can be found in facial muscles along with other places
78
Golgi tendon organs
Sense muscle tension

SLP A & P Exam 2 (7 decks)

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