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anatomy & physiology > swallowing (W10, 11 & 12) > Flashcards

swallowing (W10, 11 & 12) Flashcards

1
Q

Mechanical processing

A

physical breakdown of food into smaller particles, mixes with secretions & move contents

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2
Q

Order – structures of gastrointestinal tract

A

Oral cavity

Pharynx

Esophagus

Duodenum of the small intestine

Jejunum of the small intense

Ileum of the small intense

Large intestine

Anus

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3
Q

function gastrointestinal tract

A

Oral cavity - form bolus through mastication

pharynx - passage to oesophagus

oesophagues - moves bolus to stomach

stomach - storage of ingested food

small intetines - absorbs carbs, amino acids

large intestine - absorbs water - propells feces

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4
Q

oral cavity

A

Opening where food is broken down from a large substance into a smaller substance that can be swallowed

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5
Q

oral cavity - mechanisms

A

activates muscles of mastication

elevates & deresses mandible

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6
Q

oral cavity - components

A

~ tongue = manipulates food between teeth

~ palate = rough surface helps tongue manipulate

~ H&S palate = work to keep food anteriorly to form bolus before swallowing

~ salivary glands = saliva

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7
Q

Esophagus

A

= muscular tube that moves bolus from pharynx to the stomach via peristalsis

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8
Q

Esophagus - components

A

Upper third – consists of strained muscles

Lower 2/3rds - consists of smooth muscles

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9
Q

Esophagus - function

A
  • Moves bolus down the body

-Sits behind the trachea

  • Has two end points that squeeze together (upper & lower esophageal sphincter)
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10
Q

Upper esophageal sphincter

A

regulates movement into esophagus

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11
Q

Lower esophageal sphincter

A

regulates movement into stomach

  • Sphincters are normally tightly shut – because of the high muscle tone
  • Help to prevent refluxes
  • is innervated by the vagus nerve & sympathetic divisions of NS
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12
Q

Peristalsis

A

= A series of wave like muscle contractions that move the food through the digestive tract

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13
Q

Peristalsis - process

A
  • Contraction of the esophagus sweeps the bolus along
  • Bolus is propelled (seen in initial stage – 3rd stage)
  • Alternating ways of contractions & relaxing
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14
Q

Stomach

A

= stores our ingested food

  • Muscular wall allows for mechanical digestion
  • Is smooth muscle – made up of mucosa & tissue
  • Connects to the esophagus via the lower esophageal sphincter
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15
Q

Small intestines

A

absorbs carbs fats, proteins from food so they can be used by the body.

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16
Q

Small intestines - components

A
  • Duodenum
    (receives digestive secretions)
  • Jejunum
    (chemical digestion & nutrient absorption)
  • Ileum
    (moves food towards LI)
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17
Q

large intestine

A

absorbs water and vitamins, forms and propels fasces toward the rectum for elimination.

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18
Q

large intestine - components

A
  • Cecum
    A pouch that forms the first part of the large intestine
  • Colon
    removes water & some nutrients from digested food
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19
Q

Pharynx role - airflow

A

(connected posteriorly to the nasal cavity where we breathe in & out)

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20
Q

Pharynx role - filtering

A

makes adjustments to our oral aparatus

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21
Q

Pharynx role - swallowing

A

transport of our bolus into our esophagus by squeezing it downwards

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22
Q

nasopharynx - function

A
  • Respiration (passing & filtering air downwards)
  • Protects body from airborne virsues via lymphatic tissue
  • Resonance variation in speech
  • stablize middle ear for hearing – clearing any built up mucous
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23
Q

oropharynx - function

A
  • directs bolus in appropriate direction
  • Palatine tonsils
  • Accessory airways
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24
Q

Laryngopharynx - function

A

~ Upper boundary = the hyoid bone

~ Lower boundary = the cricoid cartilage

  • Important for our inspired & expired air moving to the appropriate area
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25
Q

Epiglottic Valleculate

A
  • Depression behind the root of the tongue between the epiglottis
  • Saliva can pool here & is directed towards the piriform sinus
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26
Q

Pyriform sinus

A

recess on both sides of laryngeal orifice

Bolus passes into the left & right pyriform sulcus

Internal laryngeal nerve supplies sensation

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27
Q

CONSTRICTORS

A

Act in a squeezing motion

Ensure food is efficiently moved along the tract

Prevents the bolus from coming back up

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28
Q

Superior pharyngeal constrictors

A

upper part of the pharynx that constricts the upper part of the pharyngeal tube allowing us to get food from the mouth into the throat

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29
Q

Superior pharyngeal constrictors ACTIONS

A

~ decreases the cross section of the pharynx tube regionally

~ moves posterior pharyngeal wall forward

~ moves lateral walls inwards – squeezing them together

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30
Q

Middle pharyngeal constrictors

A

continues to contract, pushing the food further down the pharynx towards the esophagus

Uppermost fibers = cause obliquely upward movements

Lowermost fibers = run obliquely downward

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31
Q

Middle pharyngeal constrictors ACTIONS

A

~ decreases the cross section of the pharynx regionally

~ squeezes pharynx together bring the walls in

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32
Q

Inferior pharyngeal constrictors

A

performs a final squeeze, moving the food into the esophagus to travel down our gastrointestinal tract towards our stomach

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33
Q

Inferior pharyngeal constrictors ACTIONS

A

~ during contraction it draws the lower parts of the posterior walls forward and pull the lateral walls forward & inward

~ this creases the cross sectional area of the pharynx

~ closes our upper esophageal sphincter

34
Q

Superior pharyngeal constrictors INNERVATION

A

pharyngeal branch of CNX (vagus nerve) & pharyngeal plexus

35
Q

middle pharyngeal constrictors INNERVATION

A

pharyngeal branch of CNX (vagus nerve) & pharyngeal plexus

also branches of external nerves

36
Q

inferior pharyngeal constrictors INNERVATION

A

pharyngeal branch of CNX (vagus nerve) & pharyngeal plexus

37
Q

Palatopharyngeal

A

Pull lateral pharyngeal wall inward – reducing width of the pharynx

(raises pharynx)

38
Q

Palatopharyngeal INNERVATION

A

pharyngeal branch of CNX (vagus nerve) & pharyngeal plexus

39
Q

Salpingopharyngeus

A

Narrow muscles that originates near the lower border of the auditory tubes opening

Its fibers run downwards & insert into the lateral wall of the lower pharynx

This blends the fibers with the palatopharyngeal muscle

(Raises pharynx & opens auditory tube)

40
Q

Salpingopharyngeus INNERVATION

A

pharyngeal branch of CNX (vagus nerve) & pharyngeal plexus

41
Q

Stylopharyngeus

A

Pulls pharyngeal tube upwards & lifts the pharynx + larynx

42
Q

Stylopharyngeus INNERVATION

A

glossopharyngeal nerves (CNIX)

43
Q

Pharyngeal plexus

A

Innervated by motor fibers (CNIX & CNX)

44
Q

vagus nerve - innervation

A

~ pharyngeal branch = (supplies mucosa for the levator veli palatini, superior and middle pharyngeal constrictors)

~ internal branch – Superior laryngeal = (nerve Supplies for the hypopharynx, epiglottis & subpharyngeal structures)

~ recurrent laryngeal branch Supplies = (subglottic larynx & inferior pharyngeal constrictor)

45
Q

Gag reflex

A

body involuntarily attempts to eliminate unwanted objects from the oral cavity through muscle contraction at the base of the tongue and the pharyngeal wall

46
Q

efferent / motor functions

A

CN IX & X (pharyngeal plexus)

Contraction of muscles of pharynx; soft palate & fauces

47
Q

afferent / sensory functions

A

Glossopharyngeal CN IX

Stimulation of oropharynx

48
Q

Phases of swallowing

A

Oral preparatory phase

Oral Transit phase

Pharyngeal phase

Oesophageal phase

49
Q

Oral Preparatory Phase

A
  • lasts for 3 seconds or longer
50
Q

Oral Preparatory Phase process

A

open and depressed - Lip sealed (CNVII)

mandible elevated (CNV3)

Mastication of solids (CNV3) - grind & manipulate solid substance into a cohesive bolus

Anterior pulling of soft palate (CNX – palatoglossus muscle) to rest against the back of the tongue (CNXII) which is elevated serving to keep material in the oral cavity

Cheeks press in to limit the food in our buccal cavity

CNXII - Tongue sweeping to sweep up any crumbs in the buccal cavity

51
Q

oral transit phase

A

Transport (a.k.a. oral propulsion phase or oral transit phase)

Lasts less than 1 second long

52
Q

oral transit phase process

A

Bolus is transported back through oral cavity

Lip sealed – help keep the bolus over the tongue (CNVII)

Velum begins to elevate in preporation for the esophageal phase

The tongue – tip used to squeeze bolus against the hard palate (CNXII)

Tongue moves the bolus back towards the pharynx

(Propells the bolus)

53
Q

cranial nerves & anatomical structures

A

lips sealed = CNVII
mandible lifts = CNV3
mastication = CNV3
soft palate pulls = CNX
Tongue elevates = CNXII
Tongue sweep = CNXII
oral cav sens =CNV2 + 3

54
Q

pharyngeal phase

A
  • velum moves the bolus by closing off the path to the nasal cavity & directing it toward the esophagus
55
Q

Pharyngeal phase (Reflexive/involuntary)

A

~ Involuntary and is “triggered” once the bolus passes the anterior faucial pillars

~Rapid complex movements simultaneously to move bolus

56
Q

Pharyngeal phase - key events

A

Velopharyngeal closure: Velum elevation and pharyngeal walls constriction (closure is forceful to prevent substances from passing through our nasal cavity)

Elevation of the hyoid bone: Elevates larynx fold over epiglottis (result of contracting the tognue)

Opening of the upper esophageal sphincter

Tongue root moves backward

57
Q

movement of bolus

A

As bolus passes the anterior faucial arch pharynx is drawn upwards (to receive/ catch bolus)

Constriction of pharynx by sequential peristaltic (squeezing) action to cause downward movement of bolus towards oesophagus

Relaxation of the cricopharyngeal sphincter (or UES) to allow material to pass from pharynx into the oesophageus

58
Q

oesophageal phase

A

Last between 8 to 20 seconds

Movement of bolus into the esophagus

59
Q

oesophageal phase - process

A

Bolus is propelled through the esophagus by peristaltic actions of the esophageal walls.

Peristaltic contraction raises pressure behind the bolus and relaxation lowers pressure in front of the bolus, creating the pressure differential needed to propel it toward the stomach.

Relaxation of the lower esophageal sphincter to allow material to pass into the stomach.

60
Q

variables effecting swallowing

A
  • bolus
  • body position
  • development/aging
  • sex
61
Q

Dysphagia - swallowing

A
  • An abnormality in the transfer of a bolus from the mouth to the stomach
  • May involve one or more stages
  • Impairment could be a delay/absence/misdirection of bolus transfer
  • Transient, long term (chronic) or progressive
62
Q

swallowing assessments

A

Video fluroscopy
= uses x-rays to image the movements associated with swallowing

63
Q

Video fluroscopy process

A
  • Substance mixed with barium sulfate
  • consists of the swallowing of a series of liquid and solid substances (mixed with barium or accompanied by ingestion of a barium capsule to provide contrast)
  • Provides the most comprehensive evaluation of swallowing
64
Q

Dysphagia

A

Difficulty swallowing foods or liquids

(abnormality in bolus transfer)

65
Q

Dysphagia causes

A

Neurogenic (e.g., stroke, PD, MND, Ageing)

Structural (e.g., glossectomy, cleft palate, frenulum)

Psychogenic

66
Q

Classification of dysphagia

A
  • Oropharyngeal dysphagia (moving bolus from the OC to the esophagus)
  • Esophageal dysphagia
    (passage of solid or liquid material through the esophagus)
  • Esophagogastric dysphagia
  • Paraesophageal dysphagia
67
Q

what bone forms most of the hard palate & upper teeth

A

maxillae / maxilla

68
Q

what bone is mobile and contains the lower teeth

A

mandible (lower jaw)

69
Q

what muscles are involved in smiling

A

zygomatic major + minor

70
Q

sound production - movement & location of tongue

A
  • tip of the tongue elevates/depresses
  • it articulates with the alveolar ridge
71
Q

swallowing - mechanisms that protect airways

A

soft palate = elevates to block nasal passage

epiglottis = tilts down to cover the opening of the larynx, to prevent food from entering the trachea

vocal cord = close tightly as an additional barrier

72
Q

muscles involved in the velum (pharyngeal movement)

A
  • palatine muscles
  • TVP
  • LVP
  • palaglossus
  • palatopharyngeus
73
Q

muscles involved in the epiglottis (pharyngeal movement)

A

closes passively when larynx is elevated by suprahyoid muscles

74
Q

muscles involved in the vocal cords (pharyngeal movement)

A

adducted by lateral cricoarytenoids

75
Q

Velum/soft palate - airway protection

A

separates the oropharynx from the nasopharynx during swallowing to prevent food and liquids from moving into the nasal cavity

76
Q

Epiglottis - airway protection

A

covers the larynx and trachea during swallowing to prevent food and liquids from entering the airway

77
Q

Vocal folds - airway protection

A

adduct to protect the airway during swallowing

78
Q

velum - dysfunction

A
  • could cause nasal Regurgitation
  • Inadequate closure can cause food or liquids to flow back into the nose, leading to discomfort and potential for aspiration
79
Q

epiglottis - dysfunction

A
  • food + liquid may enter the airway
  • could cause problems with aspiration + choking
80
Q

Vocal folds - dysfunction

A
  • may lead to aspiration and choking
81
Q

muscles of mastication

A

= muscles used for chewing + breaking down food

  • Temporalis
  • Masseter
  • Lateral pterygoid
  • medial pterygoid
82
Q

muscles that depress the soft palate to stop food from moving into pharynx

A

Palatoglossus – palatine aponeurosis to side of tongue

Palatopharygeus – hard palate and palatine aponeurosis to lateral wall of pharynx

anatomy & physiology (11 decks)

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