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Speech & Swallowing Anatomy Flashcards

1
Q

Name the muscle of mastication which opens the jaw

A

Lateral pterygoid

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2
Q

Name the 3 muscles of mastication that close the jaw

A

Temporalis
Medial pterygoid
Masseter

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3
Q

Which muscle of the face aligns the food bolus between the teeth?

A

Buccinator

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4
Q

What 2 structures form the temporomandibular joint?

A

The
-Mandibular condyle of the mandible
slots between the
-Glenoid fossa and articular tubercle of the zygomatic arch of the temporal bone

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5
Q

What is the function of the…
-Intrinsic
-Extrinsic
… groups of skeletal muscles in the tongue?

A

Intrinsic: changes the shape of the tongue
Extrinsic: moves the tongue around the oral cavity

These both facilitate swallowing and speech production

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6
Q

Name the 4 extrinsic muscles of the tongue

their names help in remembering their origins

A

Palatoglossus (hard palate to tongue)
Styloglossus (styloid process to tongue)
Hyoglossus (hyoid bone to tongue)
Genioglossus (chin to tongue)

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7
Q 
State the innervation to the extrinsic muscles of the tongue (one is different)
Palatoglossus 
Styloglossus 
Hyoglossus 
Genioglossus
A

Palatoglossus: vagus nerve CN X

Styloglossus, hyoglossus, genioglossus: hypoglossal nerve CN XII

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8
Q

Where are the intrinsic skeletal muscles of the tongue located?

A

Dorsally and posteriorly in the inner tongue

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9
Q

What are the 4 fibre directions associated with the intrinsic tongue muscles?

A

Superior longitudinal
Inferior longitudinal
Horizontal
Vertical

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10
Q

What is the function of the muscles of the soft palate?

A

To elevate and tense the fibrous palatine aponeurosis during swallowing to prevent passage of food into the nasal cavity

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11
Q

The soft palate makes up the posterior 2/3rds of the palate. T/F?

A

False

The soft palate makes up the posterior 1/3rd of the palate

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12
Q

Name the 5 skeletal muscles of the soft palate

A 
Tensor veli palatini
Levator veli palatini
Palatoglossus
Musculus uvulae
Palatopharyngeus
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13
Q

All of the skeletal muscles of the soft palate are supplied by CN ? except ?

A

All of the skeletal muscles of the soft palate are supplied by CN X - the vagus nerve

Except tensor veli palatini

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14
Q

Which nerve innervates tensor veli palatini?

A

CN V3 - mandibular division of trigeminal

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15
Q 
State the function of the skeletal muscles of the soft palate:
Tensor veli palatini
Levator veli palatini
Palatoglossus
Musculus uvulae
Palatopharyngeus
A

Tensor veli palatini: tenses the palatine aponeurosis

Levator veli palatini: lifts the palatine aponeurosis

Palatoglossus: depresses soft palate towards tongue

Musculus uvulae: shortens the uvula

Palatopharyngeus: elevates the pharynx and depresses the soft palate

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16
Q

What are tonsils?

What is their function?

A

Clusters of lymphatic nodules containing a high concentration of lymphocytes

The provide immunological protection of the shared entry to the respiratory and GI tracts

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17
Q

Name the 4 tonsils involved in Waldeyer’s tonsillar ring, starting at the roof of the mouth and working around the mouth to the tongue

A

Pharyngeal tonsil
Tubal tonsil
Palatine tonsil (‘the tonsils’)
Lingual tonsil

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18
Q

Saliva is produced by major and minor seromucous glands. What are the 3 major salivary glands?

A

Parotid gland
Submandibular gland
Sublingual gland

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19
Q

State the drainage sites of the major salivary glands into the oral cavity
Parotid gland
Submandibular gland
Sublingual gland

A

Parotid gland: next to upper 2nd molar

Submandibular gland: the lingual caruncle in the floor of the mouth

Sublingual gland: via several superior ducts in the floor of the mouth

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20
Q

The salivary glands are mainly controlled by the sympathetic/parasympathetic autonomic nervous system

A

Parasympathetic

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21
Q

Which nerve senses unwanted materials in the gag reflex?

A

CN IX - the glossopharyngeal nerve

supplies the offended posterior 1/3rd of tongue, palatine tonsils and wall of oropharynx

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22
Q

Which 3 cranial nerves are involved in the motor aspect of the gag reflex i.e., closing off the oropharynx by muscular contraction?

A

CN IX - the glossopharyngeal nerve (pharynx)

CN X - the vagus nerve (pharynx + soft palate)

CN XII - the hypoglossal nerve (tongue)

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23
Q

Name the 3 muscles involved in the outer circular muscle layer of the pharynx

A

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor

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24
Q

What is the function of the 3 muscles involved in the outer circular muscle layer of the pharynx?

A

Sequential contraction from superior to inferior forces the food bolus inferiorly

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25
Each of the bilateral pairs of constrictor muscles inserts on its contralateral counterpart to form...
A midline raphe
26
Name the 3 muscles involved in the inner longitudinal (vertical) muscle layer of the pharynx
Stylopharyngeus Salpingopharyngeus Palatopharyngeus
27
What is the function of the 3 muscles involved in the inner longitudinal (vertical) muscle layer of the pharynx?
They elevate the larynx and shorten the pharynx
28
All of the ipsilateral longitudinal blend together and insert onto...
The posterior border of the thyroid cartilage
29
All of the skeletal muscles of the pharynx are supplied by CN ? except ?
All of the skeletal muscles of the pharynx are supplied by CN X - the vagus nerve Except stylopharyngeus
30
Which nerve innervates stylopharyngeus?
CN IX - the glossopharyngeal nerve
31
What are the 3 phases of deglutition (swallowing)? | Which are voluntary and involuntary?
1. Oral phase (voluntary) 2. Pharyngeal phase (involuntary) 3. Oesophageal phase (involuntary)
32
How can the pharyngeal and oesophageal phases be involuntary when they are controlled by skeletal muscle?
Due to pattern recognition in the medulla
33
Name the 4 nerves involved in the oral phase of deglutition
CN V3 - the mandibular division of trigeminal CN VII - the facial nerve CN X - the vagus nerve CN XII - the hypoglossal nerve
34
What do each of the nerves in the oral phase of deglutition do? CN V3 - the mandibular division of trigeminal CN VII - the facial nerve CN X - the vagus nerve CN XII - the hypoglossal nerve
CN V3 - supplies the muscles of mastication CN VII - supplies muscles of the face that close the lips (orbicularis oris) and push the food between the teeth (buccinator) CN X - depresses the soft palate to close of the nasopharynx and causes the tongue to push the bolus posteriorly CN XII - supplies intrinsic and extrinsic tongue muscles to manipulate and align the bolus
35
``` Which nerves provide secretomotor and general sensation to the... -Hard palate -Soft palate ? These are all branches of...? ```
Hard palate: Incisive branch of nasopalatine nerve, greater palatine nerve Soft palate: Lesser palatine nerve These are all branches of the pterygopalatine ganglion
36
The hypoglossal nerve (CN XII) gives somatic motor innervation to all of the extrinsic and intrinsic muscles of the tongue except ? which is innervated by CN ? instead
Except palatoglossus which is innervated by CN X (the vagus nerve) instead
37
Describe the route of the hypoglossal nerve from the medulla to the floor of the mouth
- Medulla - Passes through hypoglossal canal (near styloid foramen) - Descends close to carotid sheath - Courses lateral to hyoglossus into the floor of the mouth
38
How long does the pharyngeal phase of deglutition last?
< 1 second
39
Which two factors lead to the epiglottis being forced to cover and protect the laryngeal aditus during swallowing?
- Hyoid bone is dragged superiorly and anteriorly (by suprahyoid and longitudinal pharyngeal muscles) - Posterior tongue pressure (from stylohyoid and hyoglossus)
40
Movement of food through the oesophagus is aided by cricopharyngeus muscle relaxation/contraction?
Relaxation The cricopharyngeus is the upper oesophageal sphincter (UOS) and so relaxes when food is swallowed. It is contracted in the resting state.
41
The oesophageal phase of deglutition lasts ~X seconds?
8-20 seconds
42
What is the parapharyngeal space?
A column of tissue allowing communication between the base of the skull and the lower neck, containing a large number of different structures (e.g., cranial nerves, blood vessels) within it
43
What is the retropharyngeal space?
A space posterior to the pharynx and anterior to the vertebral column that forms a connection between the base of the skull and the mediastinum and can lead to spread of infection there
44
Which 2 nerves form the pharyngeal plexus?
CN IX - glossopharyngeal | CN X - vagus
45
What is the 'gateway to the mouth'?
A gap between the superior and middle pharyngeal constrictor muscles that allows the glossopharyngeal nerve (CN IX) to pass through
46
Why is the 'gateway to the mouth' of clinical importance?
The tonsils lie close to the gateway of the mouth so be careful not to damage the glossopharyngeal nerve during tonsillectomy
47
What are the functions of the muscles of the larynx? (3)
They control the true vocal cords which facilitates... - Passage of air for respiration - Protection against aspiration - Generation of voice
48
Which nerve supplies all of the intrinsic muscles of the larynx?
CN X - the vagus nerve
49
Name the 5 intrinsic muscles of the larynx
``` Cricothyroid muscle Thyroarytenoid muscle Lateral cricoarytenoid muscle Arytenoid muscle Posterior cricoarytenoid muscle ```
50
During normal resting respiration, the laryngeal muscles are relaxed. T/F?
True
51
Contraction of which laryngeal muscle abducts the vocal cords to widen the rima glottidis during forced respiration e.g., during running?
Posterior cricoarytenoid muscle
52
Contraction of which 2 laryngeal muscles adducts the true vocal cords to firmly close the rima glottidis during swallowing?
Arytenoid muscle | Lateral cricoarytenoid muscle
53
How does the laryngeal musculature form speech?
- Air is forced through the closed rima glottidis - This vibrates the true vocal cords, forming sound - The upper respiratory tract modifies the sound to form speech
54
Contraction of which 2 laryngeal muscles adducts the vocal cords to close the rima glottidis to allow air to be pushed through for speech?
Arytenoid muscle | Lateral cricoarytenoid muscle
55
Is contraction of both the arytenoids and lateral cricoarytenoids required to facilitate a whisper?
No Contraction of the lateral cricoarytenoids alone leaves a small posterior opening between the arytenoid cartilages This opening allows air to pass through without ausciltating the vocal cords This disrupts the flow of sound
56
Contraction of which laryngeal muscle decreases the pitch of the voice? How?
The thyroarytenoid muscle Contraction relaxes the true vocal cords
57
Contraction of which laryngeal muscle increases the pitch of the voice? How?
The cricothyroid muscle Contraction tenses the vocal cords
58
Which nerve supplies the mucosa of the larynx above the vocal folds?
The internal laryngeal nerve (a branch of the superior laryngeal nerve of the vagus nerve)
59
Which nerve supplies the mucosa of the larynx below the vocal folds, and all of the intrinsic muscles of the larynx (except one)?
The inferior laryngeal nerve (a branch of the recurrent laryngeal nerve of the vagus nerve)
60
Which intrinsic laryngeal muscle is not supplied by the inferior laryngeal nerve? What nerve is it supplied by?
The cricothyroid It is supplied by the external laryngeal nerve (a branch of the superior laryngeal branch of the vagus nerve)
61
What is Galen's anastomosis?
The point where the internal and inferior laryngeal nerves meet (just above the thyroid cartilage)
62
Which nerve detects sensory stimuli in the cough reflex?
The internal laryngeal nerve (a branch of the superior laryngeal nerve of the vagus nerve) (supplies the mucosa of the supraglottis i.e., the laryngeal vestibule and ventricle)
63
Which nerve causes glottic closure in the cough reflex? | Which muscles is it acting on?
The recurrent laryngeal nerve The arytenoid and lateral cricoarytenoid muscles
64
In the cough reflex, what must occur once the rima glottidis has closed?
The diaphragm and/or intercostal muscles must contract to increase body cavity pressure
65
In the cough reflex, when is the 'cough' noise generated?
Once subglottal pressure threshold is reached, a high pressure air jet is released from the glottis
66
The majority of glottic tumours do not spread from the vocal cords. T/F?
True 95% stay on the cords
67
What are the 4 functions of the hyoid bone?
- Allows attachment for the supra- and infra-hyoid muscles - Maintains the patency of the airway - Facilitates swallowing - Facilitates speech
68
Name the 4 infrahyoid muscles | their names help remember their attachments
Sternohyoid (sternum to hyoid) Omohyoid anterior and posterior bellies (shoulder to hyoid) Thyrohyoid (thyroid to hyoid) Sternothyroid (sternum to thyroid)
69
Name the 4 suprahyoid muscles | their names help remember their attachments
Stylohyoid (styloid process to hyoid bone) Mylohyoid (mandible near the molars to hyoid bone) Geniohyoid (chin to hyoid bone) Digastric anterior and posterior bellies
70
The vagus nerve supplies sensation to...?
The inferior portion of the external acoustic meatus and some of the external surface of the tympanic membrane
71
The vagus nerve supplies motor innervation to...?
The soft palate, pharynx (except styloparyngeus) and larynx
72
The vagus nerve supplies the special sensation of taste to...?
The epiglottis
73
Which foramen does the vagus nerve exit through?
The jugular foramen
74
Name 3 other structures that travel through the jugular foramen with the vagus nerve
CN IX - glossopharyngeal nerve CN XI - spinal accessory nerve Internal jugular vein
75
Describe the route of the glossopharyngeal nerve (CN IX)
- Leaves the CNS at the upper medulla oblongata - Passes through the jugular foramen - Enters the parapharyngeal space and lies on the stylopharyngeus muscle
76
What is the only muscle receiving motor supply from the CN IX?
Stylopharyngeus (longitudinal pharyngeal muscle)
77
The glossopharyngeal nerve gives parasympathetic secretoromotor innervation to...
The parotid gland
78
How does the glossopharyngeal nerve reach the parotid gland?
- Its tympanic branch passes through the middle ear - Becomes the lesser petrosal nerve and exits the cranial cavity via the foramen ovale - Synapses in the otic ganglion - Joins the auriculotemporal nerve (of CN V3) which travels to the carotid gland
79
What sort of innervation does the glossopharyngeal nerve (CN IX) give to the tongue?
Taste and general sensation to the posterior 1/3rd of the tongue
80
How does the glossopharyngeal get into the oral cavity to supply the posterior tongue?
It passes through the 'gateway of the mouth' between the superior and middle pharyngeal constrictors

LR ENT (3 decks)

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