Protective Reflexes Flashcards
General concepts to make into flaschards
Most of the reflexes affect the diversity of muscles that compose the tongue, which is vital to all stages of feeding and which continually affects the potency of the airway.
Oral-pharyngeal reflexes are evident in mammalian fetus and continually emerge as teh animal or human matures.
Some of the first reflexes in the oral region are geared towards nourishment.
CNS matures and the oral and pharyngeal regions develop morphologically and new reflexes develop.
Many of these reflexes are protective of both the tissue in oral cavity and the upper airway to prevent aspiration.
While simple reflexes can be evoked in isolation, most reflexes combine with more complex oral and pharyngeal responses such as chewing and vocalization.
Some sensory stimuli will evoke a series of responses as is often evident in the infant and other stimuli will evoke a complex multi-level recruitment of muscles in a sequence as in pharyngeal swallowing.
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Synergy and simultaneous actions are necessary for proper function. If this doesn’t happen during swallowing there can be difficulty initiating swallow, nasopharyngeal regurgitation, pulmonary aspiration, or residual bolus.
How are the pharynx and the oral cavity related functionally?
The oral cavity and pharynx are anatomically separate but functionally integrated regions of the head.
The 2 regions are involved in complex motor responses that include feeding, chewing, swallowing, speech, and respiration. (oral cavity and pharynx work together for these functinons).
What provides the first link to reflexes controlling the muscles of the entire head, upper GI tract and airway?
The multiple sensory receptors that innervate these 2 regions provide the first link in reflexes that control muscles of the entire head upper GI tract, and airway.
What is the problem with trying to visualize the body/base of the tongue?
Body of the tongue is very hard to see or examine. This is because of the gag reflex as well as the tight position.
How does swallowing take place?
Positive pressure is applied to the bolus by pressing tongue to roof of the mouth and then dropping of the back part of the tongue.
Hyoid moves because of contraction of suprahyoid muscle to stabilize mouth for tongue movement.
Head of the bolus enters valecula and epiglottis which allows it to stay horizontal before it closes over the larynx.
Laryngeal compartment gets sealed by the epiglottis after bolus touches the valecula.
Superior constrictor muscles progresses and pushes against the bolus tail all the way until the PE segment.
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What are the complications of failure of oral feeding?
In respiratory it can lead to asphyxiation, in upper airway lobar collapse, in distal airway infection, nutrition and hydration can lead to weight loss
What are the mechanisms that can lead to failure of oral feeding?
Lateral and medial medullary syndrome
Middle cerebral artery territory stroke
Motor neurone disease
Multisystem atrophy
Oculopharyngeal muscular dystrophy?
What reflexes can be seen in the trigeminal nerve?
2 major reflexes produced via trigeminal nerve are the jaw reflex and the corneal reflex
The jaw reflex is a monosynaptic muscle stretch reflex that is elicited by a brisk tap witha reflex hammer on the front of the chin with mouth slightly opened and the jaw relaxed. The examiners thumb may be placed on the lower chin and tapped.
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What is dysphagic swallow and what causes it to occur?
Dysphagic swallow occurs when food gets stuck on the way down near the epiglottis or when the muscles lack coordination causing food to go the wrong way down.
