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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
Q

Oral transport stage

A

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

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26
Q

Parotid gland

A

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

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27
Q

Submandibular gland

A

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

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28
Q

Sublingual glands

A

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

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29
Q

Oral transport stage mandibular muscles

A

Masseter
Temporalis
Medial pterygoid

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30
Q

Oral transport stage tongue muscles

A

Superior longitudinal
Vertical
Mylohyoid
Genioglossus
Styloglossus
Palatoglossus

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31
Q

Pharyngeal stage

A

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

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32
Q

Pharyngeal stage intrinsic tongue muscles

A

Superior longitudinal
Inferior longitudinal
Transverse
Vertical

33
Q

Pharyngeal stage extrinsic tongue muscles

A

Mylohyoid
Geniohyoid
Digastricus
Genioglossus
Styloglossus
palatoglossus
Hyoglossus
Thyrohyoid

34
Q

Pharyngeal stage soft palate muscles (working to close vp port and out of the way)

A

Levator veli palatini
Musculus uvulae
Tensor veli palatini (contracts to open the eaustachian tube to clear ears

35
Q

Pharyngeal muscles in pharyngeal stage

A

Palatopharyngeus
Salpingopharyngeus
Stylopharyngeus
Crycopharyngeus
Superior constrictor
Middle constrictor
Inferior constrictor

36
Q

Pharyngeal stage laryngeal muscles (ensuring vocal folds are closed)

A

Lateral cricoarytenoid
Transverse arytenoid
Oblique arytenoid
Aryepiglottic muscle
Thyroepiglottic

37
Q

Pharyngeal trigger

A

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
Q

Esophageal stage

A

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
Q

Know diagram on slide 15

A

Know diagram on slide 15

40
Q

Know the development malformations of esophagus page 469 in book

A

Know the development malformation of esophagus

41
Q

Sensation associated with swallowing

A

Gustatory
Tactile
Temperature
Pressure

42
Q

Gustation

A

Taste
Critical component of chewing, sucking, and swallowing
Taste receptors are chemoreceptors for gustation
Transmit information to the brain about taste

43
Q

Taste

A

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
Q

Taste receptors

A

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
Q

Taste receptors mediated by 3 cranial nerves

A

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
Q

Know diagram on slide 19

A

Know diagram on slide 19

47
Q

Facial nerve

A

Taste is sent to the medulla, solitary tract nucleus in the gustatory region of the brainstem

48
Q

Glossopharyngeal nerve

A

Goes to the solitary tract nucleus

49
Q

Vagus nerve (epiglottis and esophagus)

A

Goes to the solitary tract nucleus

50
Q

From solitary tract nucleus taste goes to

A

Thalamus then the cerebral cortex

51
Q

KNow slide 20

A

Know slide 20

52
Q

Neuroanatomy of taste

A

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
Q

Olfaction

A

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
Q

Olfactory sensor nueroanatomy

A

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
Q

Slide 22

A

Slide 22

56
Q

Tactile sense (touch)

A

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
Q

Glabarous skin

A

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
Q

Tactile sense (vibration)

A

Subclass of tactile sense
Measured in frequency (Hz)
Amplitude of vibration indicates deep vs. superficial pressure

59
Q

Four classes of thermal receptors

A

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
Q

Pain sensors (nociception)

A

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
Q

Muscle stretch

A

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
Q

Muscle tension

A

Sensed by golgi tendon organs
Respond to active contraction of muscles, inhibit muscle spindle fibers

63
Q

Muscle tone

A

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
Q

Saliva glands stimulated by

A

Taste receptors and info is sent via the facial nerve, the sublingual and submandibular branch and glossopharyngeal

65
Q

Types of saliva

A

Parotid: serous saliva
Submandibular: serous and mucus
Sublingual: thick mucus

66
Q

5 elements of the oral preparatory stage of mastication and deglutition

A
  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
Q

List 3 of the elements of the oral transport stage of deglutition

A
  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
Q

List critical elements of the pharyngeal stage of deglutition

A
  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
Q

Perioral

A

Refers to mouth region

70
Q

Sucking reflex definition

A

Elicited by soft contact with the lower lip and results in tongue protrusion and retraction

71
Q

3 critical elements related to pressures of deglutition

A
  1. Velum elevates
  2. Tongue and lips form oral seal
  3. Cricopharyngeus opens as larynx elevates
72
Q

Chemoreceptor

A

Class of receptors that respond to chemical stimulation

73
Q

Oral chemesthesis

A

Detection of chemicals that stimulate pain and thermal sense within the oral cavity
Mediated by V Trigeminal cranial nerve

74
Q

Meisserner’s corpuscles

A

Respond to minute mechanical movements in the superficial epithelia

75
Q

Merkel disk receptors

A

Transmit the sense of pressure within the superficial epithelia

76
Q

Do thermal and pain sensors share the same morphology

A

YES

77
Q

Muscle stretch is sensed by

A

Muscle spindles, which can be found in facial muscles along with other places

78
Q

Golgi tendon organs

A

Sense muscle tension

SLP A & P Exam 2 (7 decks)

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