Week 1 Flashcards by Valerie Bolte

What is the goal of the oral prep phase?

create a bolus

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What is the goal of the pharyngeal phase?

protect the airway and get the bolus into the esophagus

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What is the goal of the esophageal phase?

get the bolus through the esophagus

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How long des the oral pre phase take?

variable

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How long does the oral phase take?

.3-1.5 seconds

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How long does the pharyngeal phase take?

about 1 seconds

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How long does the esophageal phase take?

8-20 seconds

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What cranial nerves aid in swallowing?

V-Trigeminal
VII-Facial
IX-Glossopharyngeal
X-Vagus
XI-Spinal Accessory
XII-Hypoglossal

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How does the trigeminal nerve aid in swallowing?

important for chewing
Motor: controls the tensor veli palatini, mylohyoid, anterior digastric
Sensory: proprioceptive information about chewing, pain and pressure info, pressure sensation for the anterior 2/3 of the tongue

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What phases of swallowing does the Trigeminal aid in?

1, 2, and 3

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What does the facial do for swallowing?

voluntary movement of facial muscles
aids in saliva production
sensation of of taste for anterior 2/3 of tongue

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How does the glossopharyngeal nerve aid in swallowing?

stylopharyngeus innervation
parotid salivary gland
sensation of the posterior 1/3 of the tongue
sensation of the pharynx

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What phases of swallowing does the glossopharyngeal nerve aid in?

1, 2, and 3

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How does the vagus nerve aid in swallowing?

pharyngeal branch: helps with VP closure
superior laryngeal branch: pitch, sensation of the laryngeal vestibule (above the VFs)
recurrent laryngeal branch: adduction of the VFs, sensation of the laryngeal vestibule below the VFs

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How does the spinal accessory aid in swallowing?

helps the vagus nerve

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What is the name of the three salivary glands?

submandibular
sublingual
parotid

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What ground of muscles is primarily responsible for laryngeal elevation?

extrinsic laryngeal muscles

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What are the four suprahyoid muscles?

digastric (anterior and posterior bellies)
mylohyoid
stylohyoid
geniohyoid

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What stabilizes the larynx?

when the suprahyoids and infrahyoids work together

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What does the digastric muscle do?

anterior belly: brings the larynx up and forward

- posterior belly: brings the larynx up and back

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What does the mylohyoid do?

pull the larynx up and forward

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What does the stylohyoid do?

pulls the larynx up and back

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What does the geniohyoid do?

pulls the larynx up and forward

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What CN innervates the suprahyoid muscles that pull the larynx up and forward?

*except the geniohyoid

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What cranial nerve innervates the suprahyoid muscles that pull the larynx up and back?

XII

What CN are all the instrinsic laryngeal muscles innervated by?

X (mostly the recurrent laryngeal branch)

What are the four functions of the intrinsic laryngeal muscles?

- adduct - abduct - tense - relax

What three sets of muscles help with VF adduction

- lateral criocarytenoid - interarytenoids - thyroarytenoid complex

What muscle aids in lip closure?

orbicularis oris

What are the three types of surface muscles around the lips?

- transverse - angular - vertical

What are the four portions of the tongue?

tip, blade, dorsum, root

What are the intrinsic muscles of the tongue?

- superior longitudinal - inferior longitudinal - vertical muscle - transverse muscle

What does the superior longitudinal muscle do?

-causes the tip and sides of the tongue to turn up

What des the inferior longitudinal muscle do?

- makes the tongue tip go down and the dorsum to become conves * important for mashing food

What happens if you engage both the superior and inferior longitudinal muscles of the tongue?

it will lateralize

What does the vertical muscle of the tongue do?

compresses and flattens the tongue | *assists with BOT-R

What does the transverse muscle do?

narrows the tongue and makes it ticker | *may help with mashing the bolus

What are the extrinsic muscles of the tongue?

- genioglossus - styloglossus - palatoglossus - hypoglossus

What does the genioglossus do?

flattens the tongue and pushes the bulk back /g/ /k/

What does the styloglossus do?

pulls the tongue up and back

What does the palatoglossus do?

can pull the palate down or the back of the tongue up

What does the hyoglossus do?

pulls the tongue down and makes the bulk of the tongue go back

What are the four muscles used for mastication?

- temporalis - masseter - internal pterygoids - external pterygoids

What is the general function of the palate?

separate the oral and nasal cavities

What are the elevators of the soft palate?

- levator veli palatini (like a sling) | - uvulus (runs in the midline of the soft palate)

What is the main tensor of the soft palate?

tensor veli palatini

Name the pharyngeal constrictors

- superior pharyngeal constrictor - middle pharyngeal constrictor - inferior pharyngeal constrictor

What sits on top of the pharyngeal constrictors?

the criocopharyngeus (or UES)

What do the pharyngeal constrictors do?

creates pressure for the swallow

What causes residue?

a lack of pressure somewhere in the system

What is something that matters in the esophageal phase?

viscosity

The less thick a material is....

the more the esophagus will let in at one time

The thicker something is.....

the less the esophagus will let in at one time

What is different about an infants swallow?

- hyoid bone and larynx sit higher (better airway protection) - tongue is relatively large - infants do a lot of tongue pumping - trigger for the pharyngeal swallow is often based on bolus size - better posterior pharyngeal wall movement

what are some swallowing differences from infancy-21

- the jaw begins to move downward | - the larynx and pharynx move downward

What are some differences in swallowing for old age

- more chewing - possible ossification of thyroid cartilage - decreased pharyngeal wall flexibility - oral stage takes longer - pharyngeal stage takes longer - more penetration - taste and smell are reduced

What is the goal of the oral prep phase?

create the bolus

What are some signs of dysphagia?

- coughing/choking - wet vocal quality - multiple cases of pneumonia - malnourishment - unexplained weight loss - dehydration - pocketed food - nasal regurgitation

What are symptoms of dysphagia that require equipment to see them?

- penetration - aspiration - residue/stasis - nasal regurgitation - backflow

What is the first step of a non instrumental evaluation?

chart review

What are some things to look for on a chart review?

- referral - pt diet - allergies - diabetes - history of pneumonia

What are examples of thin liquids?

- water - coffee - juice - tea

What are examples of nectar-thick liquids?

- agave nectar - peach nectar - syrup

What are some examples of honey-thick liquids?

-honey

What are some examples of puree consistencies?

- apple sauce - pudding - yogurt

What are some examples of mechanical soft foods?

- diced fruit cup (drained of juice) - bananas - bread

What are some examples of regular solids?

graham crackers

What is an example of a mixed consistency?

cheerios with milk