swallowing

Question 1

Sequence of complex reflex

Answer 1

1. initiated by pressure receptors in pharyngeal walls

2. receptors signal the medulla which coordinates the following sequence of events

Question 2

Anticipatory phase

Answer 2

also called the oral prep phase

1. there is an increase in salivary production
2. food is masticated and with tongue movements made into a bolus

Question 3

Oral Phase

Answer 3

1. bolus to posterior of tongue and anterior tongue elevates to hard palate and retracts which forces bolus into oropharynx
2. posterior tongue elevates by mylohyoid and soft palate elevates

Question 4

is the oral phase voluntary or involuntary?

Answer 4

voluntary by CN, V, VII, XII

Question 5

pharyngeal phase

Answer 5

1. soft palate to nasopharyngeal wall
2. pharynx constriction by superior pharyngeal constrictor
3. elevation of hyoid and larynx and anteriorly to epiglottis

Question 6

Is the pharyngeal phase voluntary or involuntary?

Answer 6

it is involuntary

Question 7

in the pharyngeal phase the passive reflex is controlled by what nerves?

Answer 7

CN, V, X, XI, XII

Question 8

where is the respiratory located at and what does it do?

Answer 8

located in the center of medulla and briefly gets inhibited for swallowing

Question 9

what is Deglution apnea?

Answer 9

not breathing while swallowing

Question 10

Esophageal Phase

Answer 10

1. Relaxation of upper esophageal sphincter
2. Esophageal contractions: peristalsis
3. lower esophageal sphincter relaxes which allows food to enter the stomach

Question 11

what should be evaluated for swallowing

Answer 11

1. thyroid cartilage: should be mobilized gently side to side
2. Anterior neck: palpated for masses
3. Laryngeal elevation: during swallowing

Question 12

What 3 steps are required to assess swallowing

Answer 12

1. drink a few ounces of water
2. swallow promptly
3. no significant retention after swallowing

Question 13

what would happen in order to need a referral after swallowing

Answer 13

1. delaying swallowing initiation
2. drooling
3. coughing
4. throat clearing
5. change in voice quality