Day 3 Flashcards
(118 cards)
1
Q
3 anatomical planes of reference
A
coronal, horizontal/transverse, saggital
2
Q
Transverse plane
A
divides top (head) and bottom (toes)
3
Q
Coronal plane
A
Divides front (stomach) from back (back)
4
Q
Saggital plane
A
Divides left from right
5
Q
Superior
A
above, over
6
Q
Inferior
A
below, under
7
Q
Lateral
A
side/outer part of body
8
Q
Medial
A
near middle/midline
9
Q
Anterior
A
in front of, front
10
Q
Posterior
A
behind, near back/rear
11
Q
Supine
A
laying face up
12
Q
Prone
A
laying face down
13
Q
Define: pathophysiology
A
the study of the changes of normal mechanical, physiological, and biomechanical functions, either caused by a disease, or resulting from an abnormal syndrome.
14
Q
Define: kinematics
A
the branch of mechanics that studies the motion of a body or a system of bodies without consideration of the forces acting upon it
15
Q
Define: biomechanics
A
the study of the action of external and internal forces on the living body, especially the skeletal system
16
Q
Define: rheology
A
the branch of physics that deals with the deformation and flow of matter
17
Q
Efferent/motor nerve function
A
flow of info from brain INTO muscle
18
Q
Afferent/sensory nerve function
A
flow of info AWAY from sensory receptor in the muscle to the brain
19
Q
Definition and purpose of muscle
A
The principal mediator of all of our movements
•Responsible for voluntary and involuntary movements
20
Q
3 types of muscle
A
striated (skeletal), smooth (visceral), cardiac (heart)
21
Q
Explain striated/skeletal muscle, how many? Paired? Innervated by?
A
- Innervated by the peripheral nervous system (PNS)
* ~329 skeletal muscles, most are paired
22
Q
Names of 2 attachments of striated muscle that develop during embryonic development
A
origin and insertion
23
Q
Muscle name is usually a composite of its ______ and _________
A
origin and insertion points
24
Q
Muscle contraction _______ the distance between origin and insertion, so we can predict what a particular muscle contraction will do.
A
shortens
25
What is the purpose of striated/skeletal muscle?
Move the skeleton
26
Define: muscle hydrostat
biological structure found in animals used to manipulate items (food)
muscles with no skeletal support interdigitated muscle orientation
deforms, many trajectories
27
3 examples of muscle hydrostats
tongue, trunk, tentacles
28
Action in a living body is _____ a laboratory model of muscle activity
NOT
29
Muscles act in _______ groups, so the lab model often ((does/doesn't) account for opposing or complementary muscles in the group.
functional, doesn't
30
5 special senses
vision, hearing, balance, smell, taste
31
Touch is a _______ sensation
general
32
What defines a special sense?
Does not have a specialized organ devoted to it
33
More info about touch
Touch includes mechanoreception (pressure, vibration and proprioception), pain (nociception) and heat (thermoception), and such information is carried in general somatic afferents and general visceral afferents.[1]
34
Sensation carried to brain by (various/similar) forms of (sensory/motor) receptors
various, sensory
35
Thermoreceptors
respond to heat energy
36
Chemoreceptors
respond to chemical energy (smell, taste)
37
Photoreceptors
respond to light energy (rods, cones)
38
Mechanoreceptors
respond to mechanical energy (pressure, distortion)
39
Nocioceptor
specialized chemoreceptor that detects pain via chemicals released from injured tissue
40
Proprioreceptors
specialized mechanoreceptors, particularly in joints, that detect body position
41
Golgi tendon
specialized mechanoreceptor (i.e. proprioreceptor) that detects shape change in tendon (i.e. knee jerk reflex)
42
Muscle spindles
specialized mechanoreceptors (i.e. proprioreceptor) that detect stretch in muscles
43
Hair cells
specialized mechanoreceptors that detect hearing and equilibrium in middle ear
44
3 common items used to test receptors
cold laryngeal mirror, flavored tongue depressor, needle
45
Intrinsic lingual (tongue) muscles
Intrinsic lingual muscles are within the body of the tongue (all cranial nerve XII)
46
Extrinsic lingual (tongue) muscles
Extrinsic lingual muscles connect the body of the tongue with surrounding structures (all cranial nerve XII, except palatoglossus X)
47
Purpose of tongue
rich, diverse sensory perception
48
3 receptors of general sensation in tongue
Mechanoreceptors – pressure/touch Thermoreceptors - temperature Nociceptors - pain
49
3 nerves that innervate tongue, their proportion/location
Cranial nerve V- anterior 2/3 general sensory, cranial nerve IX- posterior 1/3 general and special sensory, cranial nerve VII- anterior 2/3 special sensory
50
1 receptor of special sensation in tongue
Chemoreceptors- taste
51
CN-V innervates
anterior 2/3 of tongue, palate
52
CN-IX innervates
posterior 1/3 tongue, palatal arches, upper pharynx, valleculae
53
5 main points: normal posterior lingual propulsion
1. Primary driving force of the bolus
2. Active bolus containment
3. Lingual compression due to intrinsic and extrinsic muscles
4. Propulsion very brief (168msec)
5. Healthy elders may adjust lingual propulsion pressures alter residue
54
Define: mucosa
an epithelial tissue that secretes mucus and that lines many body cavities and tubular organs including the gut and respiratory passages
55
Mucosa function
lines structures of the oral cavity
56
Cranial nerves that innervate the oral cavity, their function
CN V- general sensation, CN-IX- taste
57
The richest, most diverse sensory region is the _______
oral cavity
58
Define: two point discrimination
is the ability to discern that two nearby objects touching the skin are truly two distinct points, not one. It is often tested with two sharp points during a neurological exam.
59
The primary goals of the oral cavity for oropharynegal swallowing are
1. Processing food for safe swallowing
| 2. Posteriorly propelling the food into the pharynx to be swallowed (tongue).
60
What happens when there is reduced oral sensation?
Absent, late, reduced pharyngeal response
61
What happens when there is increased oral sensation?
Early, robust pharyngeal response
62
Airway protection movements are modified when _________, likely due to _________.
bolus sizes vary, oral sensory information that helps to plan swallowing movements
63
Are there swallowing kinematic differences between oropharyngeal swallows and isolated pharyngeal swallows?
NO- both 5 mL
64
Are there swallowing kinematic differences by bolus volume between oropharyngeal swallows and isolated pharyngeal swallows?
YES for OP swallows, NO for IP swallows
65
Oral sensation (is/is not) required to induce adequate swallowing kinematics
is not
66
Oral sensation (can/can't) optimize swallowing kinematics
can
67
Purpose of oral movements
Oral movements break food down for safe swallowing
68
Purpose of oral sensation
Oral sensation allows planning for swallowing kinematics that best accommodate the approaching bolus
69
A swallow is triggered by (sensory/motor) stimulation to the _______ region
sensory, oropharyngeal
70
Once triggered, _______ should follow.
a cascade of sequential swallowing events
71
Define stage transition duration
Time between bolus at ramus of mandible and time of hyoid burst of swallow-related activity.
72
2 steps in processing the signal of triggering a swallow. Where does trigger go?
```
To brainstem
Oral horizontal (time to process the bolus)
Pharynx, larynx vertical (gravity=danger)
```
73
Explain the critical area in a swallow trigger
Critical area – sensory region to trigger patterned, automatic neuromuscular events
74
Transition between oral and pharyngeal (difficult/seamless) in normals, but (sometimes/always) in patients
seamless, sometimes
75
When transition between oral and pharyngeal not seamless, it causes a _______
delayed swallow onset
76
Swallow normal range (decimal #)
-0.22 --> 0.54 seconds
77
Sensory innervation from oropharynx
CNV – anterior 2/3 tongue, palate
CNIX – posterior 1/3 tongue, palatal arches, upper pharynx, valleculae
CNX – lower pharynx, upper esophagus, intrinsic larynx, valleculae
78
Sensory nerves for triggering the swallow provide input to what 2 brainstem regions:
Nucleus Tractus Solitarius (NTS) •Trigeminal Nucleus
79
4 main points: normal swallow trigger
1. Bolus position at swallow onset varies in healthy adults
2. Bolus position at swallow onset varies in healthy adults
3. Bolus position at swallow onset varied is sequen-tial swallowing
4. Healthy elders have longer swallow onset delays
80
Theme of sliding door analogy
timing is critical!
81
4 swallowing structures
velum, pharynx, larynx, UES
82
Define velar elevation
Posteriorly directed elevation of the velum (soft palate) that contacts the pharyngeal wall. Contact should be COMPLETE
83
Motor nerve innervation to palatal muscles
CNV (mandibular branch, pharyngeal plexus)- tensor veli palatini
CNX (pharyngeal branch)- levator veli palatini, palatoglossus, palatopharyngeus, muscularis uvulae
84
Sensory innervation to palatal muscles
CNV (maxillary division, lesser palatine n)- general sensory
| CN-IX- general sensory (palatal arch); special sensory (taste)
85
Main point about velopharyngeal closure
More power in swallowing than speech, blowing
86
Pharyngeal swallowing process
Horizontally aligned muscle fibers in the superior, middle and inferior constrictors sequentially contract to help move the bolus downward through the pharynx.
87
pharyngeal stripping wave is (typically, not typically) seen on fluoro in normal adults
typically
88
Longitudinal pharyngeal muscles are connected to (higher, lower) structures (i.e. palate, styloid process) and to the hyo-larynx to (elevate, lower) both the _____ and the _______.
higher, elevate, pharynx and larynx.
89
3 primary muscles of the pharynx
Superior, Middle, and Inferior pharyngeal constrictors
90
Pharynx is innervated by
Pharyngeal plexus: CN IX and X
91
2 primary functions of the pharynx
Elevate and constrict, facilitate downward bolus movement
92
3 longitudinal pharyngeal muscles, innervation, function
Salpingopharyngeus (CNX) Pharyngeal elevation
Stylopharyngeus (CNIX) Pharyngeal & laryngeal elevation
Palatopharyngeus (CNX) Pharyngeal & laryngeal elevation
93
4 primary structures of pharynx movement
suprahyoid muscles, thyrohyoid muscles, long pharyngeal muscle, upper esophageal sphincter
94
PARTS for pharynx sensation
Mucosa in the nasopharynx
(cranial nerve IX)
Mucosa in the hypopharynx (cranial nerve X)
95
Pharynx sensory innervation
CN-IX and CN-X (pharyngeal plexus)- general sensory
96
5 main points: normal pharyngeal constriction
Main Points
1. duration: ~410msec
2. Pharynx elevates, shortens
3. Max constriction after UES at max open
4. Time to max constriction longer with age
5. Little age related pressure changes
97
Hyoid bone movement and innervation
```
Superior, anterior
CN V
mylohyoid, anterior belly dig.
CN XII
geniohyoid, hyoglossus
CN VII
stylohyoid, posterior belly dig.
Superior, posterior
Hyoid Bone Movement
Inferior
Ansa cervicalis C1-3
omohyoid, sternohyoid
```
98
Laryngeal movement and innervation
```
C1 of Ansa Cervicalis
coursing with CNXII
Thyrohyoid muscle
Superior
CN IX
stylopharyngeus
CN X
palatopharyngeus
Inferior
Ansa cervicalis C1-3 sternothyroid
```
99
Intrinsic laryngeal muscles: motor innervation
Motor Innervation
Cranial nerve X (recurrent laryngeal): all intrinsic laryngeal muscles, except cricothyroid
Cranial nerve X (superior laryngeal): cricothyroid
100
Laryngeal sensation and innervation
CN X superior laryngeal (SLN): Glottis and above
| CN X recurrent laryngeal (RLN): Mucosa below the glottis
101
Why is laryngeal vestibule closure necessary?
To prevent the bolus from entering the larynx
102
During laryngeal vestibule closure, the ____ contacts the ______.
Epiglottis, arytenoids
103
Which muscle is primarily involved in laryngeal vestibule closure?
Aryepiglottic muscle
104
Measurement of laryngeal vestibule closure
Measured between two time points: 1st frame closed - until - 1st frame re-open
105
Laryngeal Vestibule Closure Duration- Normal Range?
0.31-1.07 seconds
106
5 main points: laryngeal vestibular closure
1. LVC occurs from bottom to top
2. LVC events preceded UES events
3. LVC has both biomechanical and neuro- muscular parts
4. LVC varies in sequential swal.
5. LVC varies in sequential swal.
107
Hyoid anterior movement- normal range?
7.6mm-18mm
108
Larynx and hyoid superior movement- normal ranges?
Hyoid- 5.8mm-25mm
| Larynx- 21mm - 34 mm
109
Define UES (upper esophageal sphincter)
Pharyngeal esophageal segment Pharyngeal esophageal junction
110
Primary muscles of UES
Cricopharyngeus is the primary muscle of UES
| Also comprised of: •Lower Inferior Pharyngeal Constrictor •Superior cuff of Esophageal muscle
111
Motor and sensory innervation of UES
Cranial nerve X
112
UES opening and inhibition
Relax to open- superior view
| CN-X = inhibition
113
2 structures involved in opening the UES- stretch to open
cricoid cartilage- excursion, cricopharyngeous muscle
114
Define: Cricopharyngeal bar, near (bottom, top) of cricoid
bottom, appearance of a prominent cricopharyngeus muscle
115
Duration of UES opening
Measured between two time points: 1st frame open - until - 1st frame closed
116
Opening the UES- normal range
0.21 sec - 0.67 sec
117
3 main pointS: normal UES opening
1. UES pressures reduce as bolus moves through
2. UES opening associated with anterior laryngeal movement
3. Vocal fold closure precedes UES opening
118
Normal swallowing is _______, thus disorders of swallowing are often _________ (same as first).
multifactorial
