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Catalyst > Swallowing Anaphysio > Flashcards

Swallowing Anaphysio Flashcards

1
Q

What is mastication?

A

This is the process of preparing food for swallowing, also known as chewing;

Moving unchewed food onto the grinding surface of the teeth, chewing it, and mixing it with saliva

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2
Q

What is deglutition?

A

The processing of swallowing

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3
Q

This is the ball of food or liquid to be swallowed

A

Bolus

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4
Q

Moving unchewed food on the grinding surface of the teeth, chewing it and mixing it with saliva

A

Mastication

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5
Q

Why do we prepare the food for swallowing?

A

Answer: You chew to increase the food surface area –the food gets smaller but the surface area gets bigger (food surface area, meaning the area where the food is exposed to saliva or digestive enzymes). This aids in our digestion.

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6
Q

The act of chewing will trigger what?

A

The act of chewing will trigger the secretion of saliva and digestive enzymes–responsible for helping the breakdown of food in out stomach and intestine

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7
Q

When we say swallowing, how many phases are there?

A

3 but some include 4

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8
Q

What are the four phases of swallowing? (According to Seikel, et al.,)

A

Oral preparatory phase, oral stage, pharyngeal stage, esophageal stage

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9
Q

What are the three phases?

A

Oral phase, pharyngeal phase, esophageal phase

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10
Q

What is the oral preparatory stage?

A

The stage in which food is prepared for swallowing (mastication)

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11
Q

Stage of swallow in which the bolus is transmitted to the pharynx (propulsion of the bolus)

A

Oral stage

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12
Q

What is peristalsis?

A

The alternating contraction of the esophagus, responsible for propelling down the bolus to the esophagus to the stomach.

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13
Q

This is the roof of the mouth

A

Palate

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14
Q

Anterior part of the palate, and is known as a immobile bone. When we are chewing, the tongue rubs against this palate, thereby aiding the breakdown of the food.

A

Hard palate

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15
Q

This is the posterior part of the palate, and is a mobile muscle covered with mucous membrane. This keeps the nasal passages closed, elevating it which protects us from nasal regurgitation.

A

Soft palate

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16
Q

This is a pit “parang dimple” which is the origin of the thyroid gland. Marks the boundary between anterior ⅔ and posterior ⅓ of the tongue. This is where the thyroid gland originated from.

A

Foramen cecum

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17
Q

Taste buds are located at the palate. True or False.

A

True

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18
Q

The midline groove on our tongue or sulcus is called

A

Sulcus terminalis

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19
Q

What are faucial pillars?

A

Serve as boundary between oral cavity and pharynx

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20
Q

Difference between anterior pillars and posterior pillars

A

Anterior pillar are palatoglossal arches palato - palate, glossal - tongue, extend from soft palate to the sides of the tongue
Posterior pillars are palatopharyngeal arches, which extend from soft palate to the walls of the throat

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21
Q

Which mucous membrane builds up the anterior pillars?

A

Palatoglossus mucous membrane

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22
Q

Which mucous membrane counterparts the anterior pillars?

A

Palatopharyngeus mucous membrane

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23
Q

What is the eustachian tube?

A

This is an auditory tube also known as the pharyngotympanic tube which connects the middle ear to the back of the nose and throat (nasopharynx)
Equalizes pressure of the middle ear

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24
Q

It is a funnel-shaped conductive structure that is shared by the GIT and respiratory system
Ends at the level of C6 (where esophagus starts)

A

Pharynx

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25
Q

Describe the location of nasopharynx

A

Superior portion
Posterior to nasal cavity up to the uvula

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26
Q

Oropharynx

A

Middle chamber
Posterior to oral cavity

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27
Q

Also known as the hypopharynx. This is the inferior portion. Hyoid bone to lower margin of larynx

A

Laryngopharynx

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28
Q

This is the common passageway for food, air, and water

A

Oropharynx and laryngopharynx

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29
Q

Conditions inspired air

A

Nasopharynx

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30
Q

This is where you will see the Eustachian tube

A

Nasopharynx

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31
Q

This is where you see the tonsils

A

Oropharynx

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32
Q

This is what you call a spit trap or trap for the saliva to prevent saliva from triggering the swallow reflex when we sleep–Depressions to catch saliva and occasionally food to prevent the swallowing reflex

A

(Epiglottic) vallecula

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33
Q

This is a flap elastic cartilage located at the base of the tongue, which prevents food and liquids from entering the airway (trachea) during swallowing

A

Epiglottis

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34
Q

This is a false or superior vocal cords. It serves as a protective function.

A

Ventricular folds

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35
Q

This is a ring-shaped cartilage located in the lower part of the larynx. It maintains airway patency. Help support the structure so that the larynx won’t collapse.

A

Cricoid cartilage

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36
Q

It is a U-shaped bone located in the anterior midline of the neck and serves as attachments for different structures

A

Hyoid bone

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37
Q

Pyramid-shaped cartilage found in the larynx that is essential to the production of vocal sound. It plays a crucial role in closing the glottis

A

Arytenoid cartilage

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38
Q

What is the cavity size of an infant in comparison to an adult?

A

Infants have smaller oral and pharyngeal cavities, however, the oral cavity of infants takes a greater portion of the face in comparison to adults.

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39
Q

Difference of the size of the tongue of an infant and adult

A

Younger individuals occupy a larger portion of the oral cavity–higher tongue positioning in infants due to primitive sucking reflex, harder to manipulate food and bolus formation.

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40
Q

The larynx of an infant is more ________ in comparison to an adult

A

Anterior

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41
Q

High position of the larynx for infants located at the neck allows what?

A

Help compensate for the short airway, to prevent aspiration; it will accommodate shorter airways and aid with breathing when lying down.
Allows for nasopharyngeal channels for breathing during sucking–it helps in the sequential process of breathing while sucking.

42
Q

The larynx descends during the _____________ years

A

First four years

43
Q

The glottis of an infant is at

A

C3 - C4, while for the adult it is C5 - C6

44
Q

Describe the epiglottis of a child

A

Infants have long, floppy, and narrow epiglottis, which predisposes to aspiration or airways obstruction

45
Q

Describe the cricoid and trachea of an infant

A

Cricoid for an infant is the narrowest part of the child’s airways
Trachea is narrow and less rigid in children.

46
Q

The velum is proportionally _______ in infants

A

Larger

47
Q

Hyoid bone is more ________ and forward for infants

A

Elevated

48
Q

True or False. Presence/absence of mature teeth impacts chewing and formation of bolus.

A

True

49
Q

What are the immature swallowing patterns of an infant?

A

Sucking reflex
Rooting reflex

50
Q

What is the rooting reflex? It persists until?

A

Lightly stroking the lips or cheek on one side causes the infant’s mouth to open with tongue thrusting and its head to turn toward the stimulus

Persistence of this reflex is 4-6 months

51
Q

What stimulus is used to trigger the sucking reflex?

A

Tactile stimulation of the roof of the mouth.

52
Q

What is the response of the child when there is tactile stimulation of the roof of the mouth?

A

Purse lips and tongue protrusion

53
Q

What stimulus is used to trigger the rooting reflex?

A

Tactile stimulation of infant’s mouth/perioral space

54
Q

Describe the tongue-thrust swallow

A

After four or five thrusts of the tongue, a swallow is triggered. The tongue base lowered to permit the milk bolus to enter the oropharynx during the next forward pumping action of the tongue.

55
Q

Difference between the suckling pattern and sucking pattern? What age do they transition?

A

Suckling pattern is a front-to-back movement. Suckling’s function is to release the milk out of the breast (forward-backward movement). Around 3 months of age, the suckling pattern matures into a sucking pattern. The sucking pattern is the straight up-and-down movement of the tongue and jaw; this shows greater control in terms of the jaw and tongue of the infant, and it also prepares the infant to take in other food consistencies.

56
Q

Features of infantile swallow

A

Jaws are apart with tongue placed between the gum pads
Mandible is positioned by muscles of facial expression
Swallow is guided by lips and tongue

57
Q

Typical characteristics of a sucking and swallowing

A

Cheeks caving in
Bobbing hyoid bone
Tongue elongation
Head extension
Anterior mandibular thrust
Pursed lips (around the nipple)

CBT HAP

58
Q

What are the key differences between immature and mature swallowing?

A
  • The mature swallow requires the contraction of mandibular muscles (present in adults, absent in infants), to counteract the force of the tongue.
  • While for immature swallow, contraction of mandibular muscles is not needed; what is critical for immature swallowing is the maxillary dental arches and proper development of hard palate.
59
Q

What are the stages of mastication and deglutition?

A

Oral preparatory phase (mastication)
Oral stage (bolus propulsion)
Pharyngeal stage
Esophageal stage

60
Q

This is the oral transport, when the tongue propels the bolus backwards, or bolus propulsion. What stage is this?

A

Oral stage

61
Q

The bolus is at the pharynx

A

Pharyngeal stage

62
Q

This is the stage where the food is prepared for swallowing. This is also the voluntary process but can be automatic

A

Oral preparatory stage

63
Q

When does oral preparatory start?

A

It will start via sensory perception, when food is introduced to the mouth. If liquid, it is sealed within the oral cavity by lips (anterior) and hard palate (posterior)

64
Q

The posterior portion of the tongue bunches up (elevated) and the soft palate is pulled down. This is to keep the food inside the oral cavity. What stage is this?

A

Oral preparatory stage

65
Q

The food is kept inside the oral cavity because of these structures

A

Tongue and soft palate

66
Q

This structure keeps the food in place and compress against hard palate

A

Tongue

67
Q

What are the salivary glands?

A

Parotid
Submandibular
Sublingual

68
Q

The grinded food mixes with saliva to lubricate the food, making it easier to swallow during the oral preparatory phase. True or false.

A

True

69
Q

What facial muscles are active during the oral preparatory stage?

A

Orbicularis oris
Mentalis
Buccinator
Risorius
4 muscles

70
Q

What mandibular muscles are active during the oral preparatory stage?

A

Masseter
Temporalis
Medial pterygoid (Internal pterygoid)
Lateral pterygoid (External pterygoid)
4 muscles

71
Q

The function of these mandibular muscles during the oral preparatory stage is to elevate the mandible.

A
  • Masseter - elevates mandible
  • Temporalis - elevates mandible; retracts and protrudes mandible
  • Medial pterygoid - Elevates mandible; moves mandible laterally; grinds mandible
72
Q

What mandibular muscle protrudes and grinds the mandible (oral preparatory stage)?

A

Lateral pterygoid

73
Q

What tongue muscles are active during the oral preparatory stage?

A

Mylohyoid, geniohyoid, digastric, superior longitudinal, inferior longitudinal, vertical, genioglossus, styloglossus, palatoglossus (9 tongue muscles)

To help you remember:
- Extrinsic muscles of the tongue: (Depressors of mandible: digastric, mylohyoid, geniohyoid; Tongue retractors: Styloglossus and genioglossus (anterior);
- Tongue elevator: Palatoglossus (the palatoglossus elevates the tongue and also depresses the velum) 6 MUSCLES

Intrinsic muscles of the tongue: Superior longitudinal, inferior longitudinal and vertical

74
Q

What soft palate muscles are active during the oral preparatory stage?

A

Palaglossus and palatopharyngeus

75
Q

What cranial nerve helps during the oral preparatory phase?

A

CN V, CN VII, CN XII, CN IX, CN X, CN XI (Pharyngeal plexus)

76
Q

What is the function of the orbicularis oris?

A

Maintains oral seal

77
Q

This muscle elevates lower lip

A

Mentalis

78
Q

These muscles flatten cheeks (maintains cheek tension)

A

Buccinator and risorius

79
Q

What is the function of the buccinator and risorius?

A

Buccal wall muscle is to tense the cheeks to avoid the food from entering the lateral sulcus (between the gums and cheek)

80
Q

Occurs when bolus is ready to be swallowed. What stage is this?

A

Oral stage

81
Q

Contact with faucial pillar, soft palate, or posterior tongue will trigger what?

A

Pharyngeal stage

82
Q

Mandibular muscles responsible for oral stage. What innervates these muscles?

A

TIM (Temporalis, internal pterygoid (medial pterygoid), masseter). CN V

83
Q

What are the tongue muscles responsible for the oral stage?

A

Mylohyoid, superior longitudinal, vertical, genioglossus, styloglossus, palatoglossus

84
Q

This is the stage where respiration ceases

A

Pharyngeal stage

85
Q

Respiration ceases reflexive due to:

A

Velum elevated
Tongue retracted
Lips sealed

86
Q

Pharyngeal stage starts with the _______________

A

Elevation of the soft palate, separating oropharynx from nasopharynx

87
Q

Pharyngeal swallow response happens when bolus reach? If older?

A

Faucial pillars
Posterior base of tongue near vallecula (older individual)

88
Q

What happens to the oral and nasal outlets during the pharyngeal phase

A
  • Oral and nasal outlets are closed (airways are sealed)

Food is entering the pharynx so airway must be protected via: vocal folds tightly adduct, constriction of the false vocal folds, and depression of epiglottis via aryepiglttic muscles and elevation of larynx relative to the tongue

89
Q

What happens to the larynx and epiglottis during swallowing?

A

Larynx moves up and forward, while epiglottis descends assisted by the aryepiglottic muscles

90
Q

The movement of pero-anterior of the larynx contributes to the esophagus in what way?

A

Gives more safe to the esophagus, which increases the chance for the food to enter the esophagus rather than the larynx

Explanation: As the larynx moves up and forward, this allows the esophagus to have more space preventing aspiration. The forward motion of the laryn also helps pyll the UES open, allowing the bolus to pass from the pharynx into the esophagus more easily.

91
Q

Also known as the upper esophageal sphincter (UES)

A

Cricopharyngeus

92
Q

During swallowing, this muscle is inhibited by the elevation of the larynx

A

Cricopharyngeus

The cricopharyngeus muscle remains tonically contracted to keep the upper esophageal closed. However, during the swallowing process, the muscle must be inihibted (it is relaxed) so that the UES can open to allow the bolus to pass from the pharynx into the esophagus.

93
Q

What are the tongue muscles involved during the pharyngeal stage?

A

Mylohyoid, geniohyoid, stylohyoid, thyrohyoid, digastric, superior longitudinal, inferior longitudinal, vertical, genioglossus, styloglossus, palatoglossus, transverse, hyoglossus

94
Q

What are the soft palate muscles during pharyngeal stage?

A

Levator veli palatini, tensor veli palatini, musculus uvulae

95
Q

What are the pharyngeal muscles during the pharyngeal stage?

A

Palatopharyngeus (narrows pharynx; lowers soft palate), salpingopharyngeus (elevates lateral pharyngeal wall), stylopharyngeus (elevates and opens pharynx), cricopharyngeus, middle constrictor (narrows the diameter of the pharynx), inferior constrictor

96
Q

This stage is purely reflexive and starts when bolus reaches the orifice of esophagus

A

Esophageal stage

97
Q

Bolus is transported through esophagus until the LES through:

A

Peristaltic contraction and gravity

98
Q

When bolus enters the UES, what happens after?

A

Cricopharyngeus will contract again
Larynx and soft palate depresses
Respiration resume

99
Q

Pressure during oral preparation stage

A

Oral and pharyngeal pressure = atmospheric pressure due to open nasal airway

100
Q

Kung saan mababa ang pressure doon pupunta ang bolus. True or False

A

t

101
Q

Cricopharyngeus contracts most during

A

Inspiration

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