The normal swallow Flashcards
What cranial nerves are involved in swallowing?
V, Trigeminal VII, Facial IX, Glossopharyngeal X, Vagus XI, spinal acessory XII, Hypoglossal
What is the trigeminal nerve important for in sallowing
Motor - Chewing
Sensory- tactile sensation from anterior 2/3 of tounge
What is the role of the glossopharyngeal nerve in swallowing?
Motor - upper and middle pharangeal muscles and stylopharyngeus – (which then helps with opening the cricopharyngeus muscle)
Sensory- from pharynx and posterior 1/3 of tounge and velum
taste from posterior 1/3 of tounge
What is the role of the facial nerve in swallowing?
Sensory - taste from anterior 2/3
moror- oral containment of bolus
Why is the vagus nerve important
Motor - pharyngeal constrictor muscles and the intrinsic laryngeal muscles, and palatal moovment
Sensory- velum, posterior and inferior portions of the pharynx and the larynx.
What does the spinal acessory nerve do?
Contains motor fibres that primarily depresses and tenses the velum and innervates the muscles of the neck.
What does the hypoglossal do?
Contains motor fibres that primarily innervate the tongue
Innervates ALL intrinsic and extrinsic tongue muscles.
What are the stages of swallowing?
- Pre oral
- oral prep phase (voluntary)
- pharygeal phase
- oseophageal phase
What happens in the pre oral phase?
- Senses stimulated > saliva production >prep for bolus
What happens in the oral prep phase? 1 2 3 rotary jaw moovment 4 5 6 lips seal 7 8 9 posterior oral cavity sealed off 10 11
1 mouth floor stabalised 2 Food positioned between teeth by tounge 3 rotary jaw moovment 4 bolus prep / mastication 5 Tounge collects bolus and holds this towards centre front 6 lips seal 7 Tounge middle becomes grooved 8 Buccle muscalate tenses 9 posterior oral cavity sealed off 10 Soft pallate lowered 11 nasal breathing (airway open)
What happens in the oral phase? 1- Lips and buchal muscles contract 2- posterior tounge depresses 3- 4- 5- base of tounge mooves forwards/ flattens into shoot 6-
1- Lips and buchal muscles contract
2- posterior tounge depresses
3- Anterior tounge elevates and stripes accross palate
4- bolus transport
5- base of tounge mooves forwards/ flattens into shoot
6- tounge flexes back on hyoid bone, propelling bolus into oropharynx
How long does the oral phase last?
1s
What happens in the early pharyngeal phase?
- Respiration ————
- _____________________ soft palate _________
- Pharyngeal wall buldge _________
- tounge base _______
- anterior hyoid ________
- Larygeal _______(under tounge base)
- pharynx ________
- pharyngeal constrictions moove ________
- Respiration interupted
- Elevation and contraction of the soft palate agains the posterior pharyngeal wall
- Pharyngeal wall buldge to meet tounge base
- tounge base retraction
- anterior hyoid excursion
- Larygeal elevation (under tounge base)
- pharynx widens
- pharyngeal constrictions moove up and foreward
What happens in the late pharyngeal phase?
- Laryngeal vestibular closure
- arytenoids cause vocal folds to adduct
- True vocal folds, vestibular folds, ary-epiglotal folds shorten adn fform sphincteric action
- epiglotis tips backwards and down
- epiglots covers laryngal opening
- bolus is diverted into pyriphorm sinuses
- Splits to left and right of pharynx
- contractual pharyngeal striping squeezes bolus down
- cricopharyngeus relaxes and opens
- Laryngeal vestibular closure
- arytenoids cause vocal folds to adduct
- True vocal folds, vestibular folds, ary-epiglotal folds shorten adn fform sphincteric action
- epiglotis tips backwards and down
- epiglots covers laryngal opening
- bolus is diverted into pyriphorm sinuses
- Splits to left and right of pharynx
- contractual pharyngeal striping squeezes bolus down
- cricopharyngeus relaxes and opens
What happens in the oesophegeal phase?
Peristaltic wave passes through cricopharyngeus and oesophagus carrying bolus to stomach
Cricopharyngeus closes
Respiration resumes
