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Year 3 Oral Biology > Swallowing > Flashcards

Swallowing Flashcards

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1
Q

3 functions of swallowing

A
  • propels food/ saliva from oral cavity –> stomach
  • clears naso-pharynx and oro-pharynx
  • protects upper resp tract
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2
Q

compare 2 types of swallow

A
  • voluntary swallow: conscious, initiated by substances in mouth, involves cortex
  • spontaneous swallow: unconscious eg sleep, no cortical influence, protective
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3
Q

3 phases of swallowing in order

A
  • oral
  • pharyngeal
  • oesophageal
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4
Q

name the 2 stages of the oral phase of swallowing

A
  1. preparatory stage: bolus formation

2. oral phase proper: bolus moved towards oropharynx

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5
Q

details of preparatory stage of oral phase of swallowing including muscles involved

A

BOLUS FORMATION: -tip of tongue against incisors/ maxillary alveolar ridge

  • intrinsic muscles of tongue form trough to allow bolus formation
  • saliva helps form bolus
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6
Q

details of oral phase proper including muscles involved

A

oral phase proper: bolus moved towards oropharynx.

  • extrinsic muscles of tongue–> elevation, roll tongue back
  • aided by 3: muscles of mastication, mylohyoid muscles, buccinator
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7
Q

how long does it last:

a. oral phase
b. pharyngeal phase

A

a. oral phase: 1s

b. pharyngeal phase: 0.6s

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8
Q

which phases of swallowing are reflex/ voluntary

A

oral: voluntary (so CAN be interrrupted)

pharyngeal and oesophageal: reflex

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9
Q

difference/ function of pharynx and larynx

A

pharynx: first part of throat, made up of nasopharynx, oropharynx and hypopharynx
larynx: voicebox. made up of thyroid, cricoid and epiglottis cartilage + arytenoid, corniculate and cuneiform cartilage

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10
Q

movement of the pharynx during the pharyngeal phase of swallowing

A

superiorly

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11
Q

movement of the larynx during pharyngeal phase

A

anterior and superior

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12
Q

name the 4 elevator muscles of the pharynx/larynx

A 
suprahyoid muscles:
-digastric, 
longitudinal elevators :
-palatopharyngeus
-stylopharyngeus
-salpingopharyngeus
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13
Q

name the 3 constrictor muscles of the pharynx

A
  • superior constrictor
  • middle constrictor
  • inferior constrictors (thyropharyngeus + cricopharyngeus)
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14
Q

at what point does swallowing become irreversible

A

when bolus reaches oropharynx (can be slowed but not stopped)

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15
Q

3 ways LOWER airway is protected during pharyngeal phase of swallowing
1 way UPPER airway is protected during pharyngeal phase of swallowing

A

-larynx moves anterior and superiorly (MAIN ONE)
-epiglottis closes over larynx
-adduction (closure) of true + false vocal cords
UPPER AIRWAY: contraction of soft palate to seal off nasopharynx

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16
Q

name the 2 soft palate muscles involved in swallowing and their role

A

-tensor veli palatini
-levator veli palatini
both wall of nasopharynx –> food does not go to/ through the nose

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17
Q

3 inhibitory events of pharyngeal phase

A
  • inhibition of infrahyoid mm –> hyoid bone can move superiorly (to elevate pharynx/ larynx)
  • inhibition of posterior cricoarytenoid mm –> vocal cords adduct to protect airway
  • inhibition of upper oesophageal sphincter (cricopharyngeus m, lower part of inferior constrictor m of pharynx) so bolus can move down in to the oesophagus
18
Q

what muscle contributes to the upper oesophageal spincter?

A

lower (cricopharyngeus) part of inferior constrictor muscle of the pharynx

19
Q

4 factors that ensure maximal opening of oesophageal spincter

A
  • suprahyoid muscle contraction –> upper superior excursion of the larynx
  • tonic discharge from nucleus ambiguus –> inhibition of cricopharyngeus
  • descending pressure of the bolus
  • peristaltic movement (involuntary)
20
Q

how long does it take the cricopharyngeus m to relax

A

0.5s

21
Q

saliva moistens food. 2 reasons why this is important

A
  1. less inclined to swallow dry bolus

2. choking hazard

22
Q

describe position of piriform recess and its relevance

A

under arythenoid cartilage (posterior, top of larynx)
–> food can get trapped here (eg fish bones), tumours can form (poor prognosis as they can grow lots before symptoms begin)

23
Q

name the cell layers surrounding oesophagus in –> out

A
  • epithelium
  • submucosa
  • circular muscle
  • longutinal muscle
  • connective tissue
24
Q

how does the structure of the oesophagus vary from the rest of the digestive tract

A

connective tissue is ADVENTITIA (not serosa), as the oesophagus is not covered by peritoneum

25
Q

what parts of the oesophagus support vessels and nerves?

A

adventitia (outer connective tissue) and submucosa

26
Q

describe the muscle in different parts of the oesophagus

A
  • upper 1/3: striated
  • middle 1/3: striated + smooth
  • final 1/3: smooth
27
Q

what is unusual about the muscles involved in pharyngeal/ oesophageal phases of swallowing?

A

striated muscle NOT under voluntary control

28
Q

what causes relaxation of the cricopharyngeus m?

A

tonic discharge from nucleus ambiguus

29
Q

lesions in what 2 areas of the brainstem cause dysphagia

A
  • nucleus of solitary tract (NTS)

- reticular formation (RF)

30
Q

name/explain 2 theories about control of swallowing

A
  • reflex chain theory: each reflex stimulates next step
  • central pattern generator: afferents from cortex/ face/ mouth/ pharynx/ tongue –> NTS/ RF –> cranial/ cervical nerve efferents –> palate, tongue, pharynx etc
31
Q

relationship between swallowing and respiration in adults and explain

A

swallowing is DOMINANT to respiration: respiration stops when we swallow

32
Q

at what part of respiration does swallowing occur

a. when conscious
b. when unconscious

A

a. when conscious: expiratory

b. when unconscious: expiratory AND inspiratory

33
Q

why can’t you swallow with your mouth open

A

supra and infra hyoid muscles doing different things to depress mandible v swallow

34
Q

explain how swallowing differs to adults in infants 2

A
  • tongue protrudes (to help eject milk)

- can breathe throughout swallowing (epiglottis vertical + nasopharynx not sealed off by soft palate muscles)

35
Q

describe passage of milk in infants

A

oral cavity –> pharynx –> piriform recess –> larynx

36
Q

what is the gold standard of investigating a swallow

A

videofluorographic swallowing study (VFSS): real time monitoring of swallowing throughout aerodigestive tract, using radiation to see bolus

37
Q

alternative method to investigate swallow

A

intraluminal manometry: measures pressure at each phase of swallowing

38
Q

2 locations where pressure is highest during swallow

A
  • upper oesophageal sphincter

- lower oesophageal sphincter

39
Q

discuss the lower oesophageal sphincter

A

PHYSIOLOGICAL, not anatomical (ie not made up of 1 structure, like UOS is the cricopharyngeus muscle)
contributed to by 2:
-R crus of diaphragm
-R angle at which oesophagus meets cardia of stomach

40
Q

define dysphagia

A

delay/ disrupted passage of solids/ liq from oral cavity to stomach

41
Q

5 causes of swallowing disorders

A
  • muscular disorders eg muscular dystrophy
  • NMJ disorders eg myasthenia gravis
  • peripheral nerve disorders eg damage to laryngeal nerves during thyroid surgery
  • CNS disorders eg stroke
  • demyelination eg MS

Year 3 Oral Biology (13 decks)

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