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Dent Y3 > Swallowing and Vomiting > Flashcards

Swallowing and Vomiting Flashcards

1
Q

What is the technical term for swallowing?

A

deglutition

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2
Q

How many phases are there in swallowing?

A

3

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3
Q

What are the phases of swallowing?

A

Oral, Pharyngeal and Esophageal

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4
Q

Which of the swallowing phases are voluntary?

A

oral phase

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5
Q

Which of the swallowing phases are involuntary?

A

pharyngeal and esophageal

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6
Q

How long does the entire swallowing process take on average?

A

6 seconds

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7
Q

Where is the soft palate positioned at the start of the oral phase of swallowing?

A

down and forward

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8
Q

What is the position of the food bolus in the start of the oral phase of swallowing?

A

pressed against the hard palate

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9
Q

Which cranial nerves are involved in the oral phase of swallowing?

A

Trigeminal, Facial, Hypoglossal

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10
Q

Where is the food bolus towards the end of the oral phase of swallowing?

A

pushed posteriorly towards the soft palate

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11
Q

What marks the end of the oral phase and the start of the pharyngeal phase of swallowing?

A

the elevation of the hyoid bone

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12
Q

What five things occur simultaneously in the pharyngeal phase?

A

elevation of the soft palate, contraction of palatine-pharyngeal folds, pulling together of the vocal cords, contraction of pharyngeal constrictor muscles, inhibition of the oesophageal sphincter by the vagal nerve

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13
Q

What is the purpose of the elevation of the soft palate in the pharyngeal phase of swallowing?

A

allows food bolus to move to the base of the tongue

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14
Q

What is the purpose of the contraction of the palatine-pharyngeal folds in the pharyngeal phase of swallowing?

A

pushes the food bolus down

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15
Q

What is the purpose of the pulling together of the vocal cords in the pharyngeal phase of swallowing?

A

prevents food entering the trachea and protects the airways

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16
Q

What is the purpose of the contraction of the pharyngeal constrictor muscles in the pharyngeal phase of swallowing?

A

pushes food to the esophagus

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17
Q

What is the purpose of the inhibition of the esophageal sphincter by the vagal nerve in the pharyngeal phase of swallowing?

A

prevents food entering the esophagus before it should

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18
Q

What are the suprahyoid muscles?

A

digastric, stylohyoid, mylohyoid, geniohyoid

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19
Q

Aside from the suprahyoid muscles, which muscles of the pharynx are involved with raising the hyoid bone?

A

palatopharyngeus and stylopharyngeus

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20
Q

Where is the epiglottis positioned in the oesophageal phase of swallowing?

A

down to close the airway

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21
Q

What is the purpose of the posterior cricoid cartilage in the oesophageal phase of swallowing?

A

it works with the posterior pharyngeal wall to create a pharyngeal oesophageal segment where the food bolus waits for the sphincter to open

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22
Q

What type of epithelium lines the oesophagus?

A

stratified epithelium

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23
Q

How long is the oesophagus?

A

20cm

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24
Q

What type of muscle forms the upper third of the oesophagus?

A

striated muscle fibres

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25
Q

What type of muscle forms the middle third of the oesophagus?

A

mixed striated and smooth muscle fibres

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26
Q

What type of muscle forms the lower third of the oesophagus?

A

smooth muscle fibres

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27
Q

Is the striated muscle of the oesophagus under voluntary or involuntary control?

A

involuntary

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28
Q

What marks the end of the oesophageal phase of swallowing?

A

the opening of the upper oesophageal sphincter

29
Q

How does the upper oesophageal sphincter open?

A

contraction of the suprahyoid muscles causing lifting of the hyoid bone and larynx

30
Q

Which cranial nerves supply innervation for the motor sections of swallowing?

A

glossopharyngeal, vagus, accessory

31
Q

Which cranial nerves supply innervation for the sensory sections of swallowing?

A

hypoglossal, glossopharyngeal, vagus

32
Q

Which brainstem nucleus is responsible for the motor portion of swallowing?

A

nucleus ambiguus

33
Q

Which brainstem nucleus is responsible for the sensory portion of swallowing?

A

nucleus solitarius

34
Q

How is swallowing controlled?

A

via a central pattern generator in the nucleus of the solitary tract and the reticular formation

35
Q

Is swallowing or respiration dominant?

A

swallowing

36
Q

When does swallowing occur in the masticatory cycle?

A

when the jaws are closed

37
Q

Why does swallowing occur when the jaws are closed?

A

it stabilises the mandible and keeps the entrance to the pharynx stable

38
Q

In infants, where is the epiglottis positioned compared to adults?

A

superiorly

39
Q

What is the name for the collection of swallowing disorders?

A

dysphagia

40
Q

What is the definition of dysphagia?

A

delay or disrupted passage of solids/ liquids from the oral cavity to stomach

41
Q

Name four causes of dysphagia

A

muscle disorders, neuromusclar disorders, peripheral nerve disorders, CNS disorders

42
Q

What is the technical word for vomiting?

A

Emesis

43
Q

What is the definition of nausea?

A

a very unpleasant sensation that one may soon vomit

44
Q

What is the definition of retching?

A

muscular activity of the abdomen and thorax, often voluntary, leading to forced inspiration against a closed mouth and glottis

45
Q

What is dry heaving also known as?

A

retching

46
Q

What is the definition of vomiting?

A

involuntary contractions of the abdominal, thoracic and GI muscles leading to forceful expulsion of stomach contents from the mouth

47
Q

What is the definition of regurgitation?

A

effortless return of esophageal or gastric contents into the mouth unassociated with nausea

48
Q

What is the definition of rumination?

A

food that is regurgitated in the postprandial period, re-chewed, and then re-swallowed

49
Q

Is nausea always associated with vomiting?

A

no

50
Q

Which sphincter is open during retching?

A

upper esophageal sphincter

51
Q

What is the purpose to gagging?

A

to protect the airway

52
Q

Is the gagging response the same for everyone?

A

no, it can vary from a small contraction of the soft palate to spasm in the pharynx

53
Q

What is the purpose of vomiting?

A

rid the body of toxins

54
Q

What controls the vomiting reflec?

A

a central pattern generator

55
Q

What area of the brain is the chemoreceptor trigger zone?

A

area postrema

56
Q

What are some gastrointestinal signals that can trigger vomiting?

A

activation of the 5-HT receptors, chemoreceptors of toxins, mechanoreceptors of distention

57
Q

What are some central signals that can trigger vomiting?

A

area postrema activation

58
Q

Why is the area postrema relevant?

A

it detects emetic signals from the blood and cerebrospinal fluid as well as receiving information from vagus and vestibular complex

59
Q

What are some signals in the vestibular complex that can trigger vomiting?

A

motion stimuli can send signals to area postrema which can cause vomiting

60
Q

What are some other general things that can trigger vomiting?

A

pregnancy, postoperative, alcohol excess, eating disorders

61
Q

Is just one region in the brain responsible for the vomiting reflex?

A

no

62
Q

What is the position of the soft palate and glottis in retching/vomiting?

A

soft palate is raised and the glottis is closed

63
Q

Which cranial nerve controls the movement of the soft palate and glottis in retching and vomiting?

A

vagus

64
Q

What is the efferent pathway of muscles involved in retching?

A

duodenum contraction, movement to stomach, stomach squeezed between abdominal muscles and diaphragm, relaxed lower esophageal sphincter

65
Q

What is the efferent pathway of muscles involved in vomiting?

A

prolonged abdominal contraction, relaxed inner hiatal diagphram, relaxed oesophagus and lower oesophageal sphincter

66
Q

What are some complications of prolonged and excessive vomiting?

A

weight loss, acid erosion of teeth, potential development of barretts oesophagus, inflamation of the oesophagus, mallory-weiss tears, electrolyte imbalance, metabolic alkalosis, renal issues

67
Q

What receptors do emetics work on and how do they interact with them?

A

5-HT agonist, dopamine D2 agonist, opioids

68
Q

What receptors do anti-emetics work on and how do they interact with them?

A

5-HT anatgonist, D2 antagonist

69
Q

What imaging method can you use to investigate swallowing?

A

videofluorographic swallowing study

Dent Y3 (23 decks)

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