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Speech and Language Therapy Y1 > BIOMED 5 > Flashcards

BIOMED 5 Flashcards

Mouth + tongue + jaw, laryngectomy (88 cards)

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1
Q

What are the 2 parts of the mouth?

A

Oral vestibule
Oral cavity proper

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2
Q

What is in the oral vestibule?

A

The sulci between the cheeks (or lips) and the teeth

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3
Q

What is the lining mucosa?

A

Varies in colour + shape
Translucent/ seethrough
If less translucent, more involved in chewing

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4
Q

What are the 6 parts of the oral cavity proper?

A

Vermillion border (lips)
Uvula
Palatoglossal arch
Palatopharyngeal arch
Soft palate
Palatine tonsil

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5
Q

What is normal anatomical variation of the uvula?

A

Some don’t have
Some are split

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6
Q

What are 3 key clinical issues from the mouth?

A

Oral thrush (fungal infection)
Poor oral hygiene and aspiration pneumonia risk
Radiotherapy changes (mucosa stripped/inflamed = less saliva = harder to eat)

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7
Q

What are the 7 features on the dorsal surface of the tongue?

A
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8
Q

Which papillae contain taste buds?

A

Circumvallate
Fungiform

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9
Q

Which papillae doesn’t contain taste buds?

A

Filiform

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10
Q

What are the 4 features on the ventral surface of the tongue?

A

Lining mucosa
Lingual veins
Lingual frenulum
Sublingual papillae

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11
Q

What is the lingual frenulum

A

Attaches tongue to floor of mouth

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12
Q

What does the sublingual papillae contain?

A

Opening of Wharton’s ducts

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13
Q

What occurs if the lingual frenulum is too short? When is this picked up and resolved?

A

Ankyloglossia (tongue-tie)
Usually picked up after birth → surgically resolved

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14
Q

What are the 2 sets of muscles of the tongue?

A

Extrinsic
- attach to tongue + skull
- change position of tongue

Intrinsic
- both attachments within the tongue
- change shape of tongue

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15
Q

What are the 4 extrinsic muscles of the tongue, and which cranial nerves are they innervated by?

A
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16
Q

What does the extrinsic palatoglossus muscle do?

A

Elevates posterior tongue / depresses soft palate

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17
Q

What does the extrinsic styloglossus muscle do?

A

Retracts tongue + elevates sides of tongue

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18
Q

What does the extrinsic genioglossus muscle do?

A

Wide range of actions: protrudes, flatten

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19
Q

What does the extrinsic hyoglossus muscle do?

A

Depresses tongue + depresses sides of tongue

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20
Q

What are the 4 intrinsic muscles of the tongue, and which cranial nerve are they innervated by?

A
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21
Q

What does the intrinsic superior longitudinal muscle do?

A

Shortens tongue
Curls apex upwards

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22
Q

What does the intrinsic inferior longitudinal muscle do?

A

Shortens tongue
Curls apex downwards

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23
Q

What does the intrinsic transverse muscle do?

A

Narrows + lengthens tongue

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24
Q

What does the intrinsic veritical muscle do?

A

Broadens + flattens tongue

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25
Which cranial nerve is responsible for motor innervation of the tongue?
Hypoglossal (XII)
26
Which cranial nerves are responsible for sensory innervation of the tongue?
27
What are 2 key clinical issues from the tongue?
Glossectomy Neurological events
28
What are 3 features of the hard palate?
Alveolar ridge Rugae oral masticatory mucosa
29
What is the hard / soft palate made of?
Hard = bone Soft = muscle
30
What are the 7 muscles of the soft palate?
Auditory tube Levator veli palatini Tensor veli palatini Palatoglossus Palatopharyngeus Uvula Pterygoid hamulus
31
What does the levator veli palatini do?
Elevates soft palate
32
What does the tensor veli palatini do?
Tenses soft palate
33
What do the palatoglossus and palatopharyngeus do?
Depresses soft palate
34
Which cranial nerves are the muscles of the soft palate innervated by?
Vagus (X) Except tensor veli palatini by a branch of V3
35
What does the auditory tube do?
Drains secretion from middle ear
36
What are 3 key clinical issues from the palate?
Cleft lip & palate Velopalatal insufficiency (VPI): soft palate not strong enough to open/close → bolus through nose Palatal resection: middle ear infection → conductive hearing loss
37
What are the anatomical features of the mandible?
Projections of bones... Coronoid process Condylar process: head + neck Ramus Body Angle
38
What does the ramus of the mandible do?
Where masseter muscle attaches
39
What does the body of the mandible do?
Houses lower dentition
40
What is the temporomandibular joint (TMJ) formed by?
Underside/articular surfaces of temporal bone + head of mandibular condyle
41
When is the condyle stable/unstable?
Stable = in glenoid Unstable = on articular eminence
42
What are the movements the temporomandibular joint can do?
Rotate, axis through condyle Slide so head of condyle moves from glenoid cavity on to articular eminence (synovial)
43
What is the purpose of the articular disc on the temporomandibular joint?
Fibrocartilage Attaches lateral pterygoid muscle to posterior aspect of joint Shock absorber: pulled forward by lateral pterygoid to pack space when head of condyle is on articular eminence, stabilises joint
44
Is the articular disc essential?
No - if removed, joint still functions - if perforated in old age, joint still functions
45
What are the 3 main ligaments of the temporomandibular joint?
Temporomandibular/lateral Stylomandibular Sphenomandibular
46
How is the range of movement of the temporomandibular joint defined?
Pain
47
What are 3 key clinical issues from the temporomandibular joint?
TMJ dysfunction, from over tightening of jaw Abscess/infection Trismus (limited ROM)
48
What are the 2 pairs of muscles of mastication?
2 superficial: masseter + temporalis 2 deep: medial + lateral pterygoid muscles
49
What cranial nerve are the muscles of mastication supplied by?
Motor branches of V3
50
What does the temporalis muscle do?
Elevator + retractor of mandible
51
To what is the temporalis muscle attached?
Lateral aspect of skull in temporal region Coronoid process of mandible
52
What does the masseter muscle do?
Powerful elevator of mandible
53
To what is the temporalis muscle attached?
Zygomatic arch Lateral aspect of mandibular ramus
54
What does the lateral pterygoid muscle do?
Protrudes mandible
55
What does the medial pterygoid muscle do?
Powerful elevator of mandible
56
Which muscles are used to depress the mandible?
Suprahyoid + infrahyoid muscles
57
How do the suprahyoid + infrahyoid muscles depress the mandible?
Contract together Hyoid bone is stabilised Suprahyoids pull down on mandible Lateral pterygoids protrude mandible
58
What are 3 other muscles involved in mastication that don't act on the temporomandibular joint?
Buccinator (pushes cheeks out) Orbicularis oris (keeps lips closed) Tongue muscles
59
What do teeth do?
Grind food into cohesive bolus
60
What is the tooth position of the molars?
Upper molars overhang lower molars by half a tooth
61
What is the tooth position of the incisors?
Upper incisors project ~2mm in front of lower incisors, and overhang by ~2mm
62
What is lateral excursion?
When we chew, mandible moves side to side and molars brought into contact
63
For incision, what must the mandible be?
Depressed sufficiently to open mouth for size of object Protrude enough to bring incisors into edge-to-edge bite when mandibe elevated
64
For mastication, what must the mandible be?
Depressed enough to get food between molars Deviated laterally to bring molars into cuspal contact
65
What is the range of movement of the jaw?
Extreme ROM only when yawning Mastication only near limited for large objects eg: apple
66
What is the range of movements of the jaw needed for speech?
No lateral excursion opening ~2cm Protrusion <1cm for lip support (bilabials) Retraction <1cm (alveolar phonemes + fricatives)
67
What are 3 key clinical issues from the muscles of mastication?
Mandibulectomy / maxillectomy (part of jaw removed) Abscess/infection Neurological events
68
What % of all cancers is head and neck cancer? How is this changing?
3% 32% increase in incidence since 1990, projected to rise as HPV increases (but vaccines...)
69
What is the peak age for head and neck cancer?
70-74
70
Where can head and neck cancer occur?
Upper aerodigestive tract Salivary glands Skin Thyroid Sarcoma
71
What is the most common type of head and neck cancer?
Squamous cell carcinoma (SCC)
72
What are some factors affecting the risk of head and neck cancer?
Tobacco Alcohol HPV ... preventable by fruit + veg intake
73
How are head and neck cancers categorised?
T1-4 (size of tumour) Nodes present (lymph) Metastases (spread to other parts, eg lung)
74
What are signs/symptoms of head and neck cancer?
Enlarged nodes Dysphonia Dysphagia Odynophagia Non-healing ulcer
75
What are treatment options for head and neck cancer?
Surgical... - Trans-oral robotic surgery (TORS) - Trans-oral laser resection (TOLR) Chemoradiotherapy (CRT) Best supportive care to manage symptoms (if not treatable)
76
What can head and neck cancer impact on?
Speech Voice Swallowing Breathing Cosmesis
77
What is a laryngectomy?
Surgical voice box removal
78
What are 4 indications for someone to have a laryngectomy?
Advanced laryngeal/hypopharyngeal malignancies with invasion of thyroid/cricoid cartilage and extra laryngeal soft tissue Failed response to primary radiotherapy or chemoradiotherapy Extensive tumours of histologic entities not suitable for conservative treatment Have no voice and have chronic aspiration due to palsy of CN IX / X / XI
79
What are the different types of laryngectomy?
Partial laryngectomy Total laryngectomy - primary - salvage
80
What is normal anatomy pre-laryngesctomy?
Respiration/EDS shares larynx Humidification occurs via nose
81
What is anatomy post-laryngesctomy?
2 distinct systems of respiration + digestion Altered airway + swallow + communication Stoma Neopharynx
82
After laryngectomy, what are the 4 options for communication?
Oesophageal speech Artificial larynx Surgical voice restoration AAC
83
What is an artification larynx?
Vibration device, buzz which articulators pick up on
84
What is tracheoesophageal voice prothesis (surgical voice restoration)?
Puncture and button over stoma Valve Redirects airflow Vibrates for voice
85
What is oesophageal speech?
Technique to swallow + redirect air
86
When is AAC used after a laryngectomy?
If no language difficulties
87
What are the impacts of a laryngectomy on swallowing?
No aspiration risk Use technique of pharyngeal constriction Altered muscular contraction and pressure If other mouth surgeries: pre-stage phase dysphagia Tissue reconstruction Radiotherapy
88
What are the impacts of a laryngectomy on breathing?
Neck breathing Loss of filtering, warming, humidifying air Artification humidification (constant filter placed on baseplate, in pic)

Speech and Language Therapy Y1 (14 decks)

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