Quiz #1 Flashcards
Sucking
1) Second intake pattern to develop
2) Tongue develops raising/lowering w/ strong activity of intrinsic muscles
3) With up/down movement of tongue jaw makes a smaller up and down excursion
4) Negative pressure builds in mouth as a result of tongue pattern in combo w/ firmer lip approximation
MOVEMENTS WORK TOGETHER TO PULL LIQUIDS OR SOFT SOLIDS INTO THE MOUTH!!
Suckling
1) Earliest intake pattern observed in infants
2) Backward -forward movement of the tongue
3) “lick-sucking” = extension and retraction movement
4) liquid is drawn into the mouth through rhythmical licking action combined w/ pronounced opening and closing of the jaw
5) loose approximation of the lips
6) Tongue protrusion does not past the lips
7) Forward direction for 1/2 of pattern ( backward more pronounced)
Respiratory Rate: 0-12 months
30/40 bpm
Respiratory Rate: 1-2 years
25-35 bpm
Respiratory Rate: 2-5 years
25-30 bpm
Respiratory Rate: 5-12 years
20-25 bpm
Respiratory Rate: >12 years
15-20 bpm
Tachycardia
High
Bradycardia
Low
Vagus Nerve Brainstem Source: Dorsal Motor Nucleus
1) fibers are unmyelinated
2) fibers in ternate intradiaphragmatic organs of digestion
Vagus Nerve Brainstem Source: Nucleus Ambiguous (NA)
1) fibers are myelinated
2) coordinates sucking/swallowing/breathing
3) Efferent pathways of the vagus nerve originate in the NA terminate in the:
larynx
pharynx
esophagus
soft palate
bronchi
Sino-atrial node of the heart
Heart Rate: Full term infant feeding
1) heart rate during feeding was significantly higher than pre-feeding
2) heart rate during feeding was significantly higher than post-feeding
3) heart rate post feeding was higher than pre-feeding although not statistically significant
PATTERN DID NOT DIFFER BY AGE !!
Oxygen Saturation: Full term infant feeding
No change in oxygen saturation
SaO2 did NOT differ between feeding trials !!
Anatomical and Physiological Changes due to Growth
Eustachin tube assumes more vertical position
Base of tongue and larynx descend inferiority during first 4 years of life
Increased need for coordinated vocal fold closure to protect airway during swallow
Mandible-maxillary relationship eligns
Mouth is longer
Tongue rest on floor of mouth
Teeth erupt
Tongue rests behind teeth and not against palate
Buccinators muscles used for chewing (not fat)
Epiglottis becomes wide/flatter
True vocal folds less than 1/3 cartilage
Anatomical and Physiological CHANGES due to Growth
1) begins at 4-6 months ( reaches aduct at 4 years)
2) Angle of the nasopharynx at the skull base becomes more acute and approaches 90 (140 to 90)
3) Pharynx elongates so Oropharynx is created
4) Laryngeal decenstion begins
Laryngeal Descend Timeline
At 1st cervical until 6 months (descend begins at 6 MONTHS)
3rd cervical at 6 months
6th cervical at 5 years
7th cervical vertebrae by adulthood
Anatomical and Physiological Differences in Infants: EUSTACHIAN TUBES
1) Run horizontally from the middle ear to the nasopharynx ( Adults @ 45 degree angle)
( high incidence of middle ear infections)
( greater opportunity for reflux into nasopharynx due to suck/swallow and breath coordination)
2) Adenoids located at the roof of the nasopharynx and increase in size the first year of life
Anatomical and Physiological Differences in Infants: LARYNX
1) “touched under” the base of tongue in infancy with no true oropharynx
2) less need for coordinated closure of vocal folds to protect airway in swallowing because it is directly under the tongue
3) Pyriform sinuses are elevated and smaller
4) 1/3 adult size
5) Half of true vocal folds is cartilage
Anatomical and Physiological Differences in Infants: EPIGOTTIS
1) Narrow vertical epiglottis (funnel the liquid)
2) Omega-shaped ( adult c-shaped)
Anatomical and Physiological Differences in Infants: SOFT PALATE/VELUM
Touches epiglottis and possibly overlap until age of 3/4 months
Anatomical and Physiological Differences in Infants: HARD PALATE
1) short, broad/slightly arched at birth
2) contains 5-6 folds that aid in nipple hold ( has more folds and pockets compared to adults)
Anatomical and Physiological Differences in Infants: LIPS AND CHEEKS
1) Have sucking pads (adipose tissue with maester muscle)
2) Fat pads create firmness in cheeks for stability ( new borns do not have stability at temporamandubular joint)
3) Sulci important for sucking
Anatomical and Physiological Differences in Infants: TONGUE
1) fills the mouth of the oral cavity
2) touches the floor and roof of mouth simultaneously
3) laterally contracts gum ridges and often side of cheeks
Anatomical and Physiological Differences in Infants: JAW/MANDIBLE
1) relatively small mandible
2) retracted in position
3) natural jaw recession (sometimes physician is needed)
Anatomical and Physiological Differences in Infants: ORAL CAVITY
1) not very present
2) filled by the tongue ( not a lot of range of motion)
3) tongue rests between lips and sits against palate
4) Edentulous
5) Palatine tonsils attached to the lateral pharyngeal walls between anterior and posterior tonsillar pillors
6) lingual tonsils located at base of tongue
Anatomical and Physiological Differences in Infants: NOSE
1) Preferntial nasal breathing neonate to 6 months
2) warms and humidifies the air
3) flat bridge of nose
4) flared nares (breast feeding)
5) soft cartilage
