Dysphagia Condensed

Question 1

cheek tension flattens the cheeks and keeps the bolus within the ‘dental vault’

Answer 1

Buccinator press

Question 2

with liquids tongue and palate contact seals the back of the oral cavity and prevents premature spillage into the pharynx

Answer 2

glossopalatal seal

Question 3

prevents nasal regurgitation by a sphincter like action involving velum, lateral and posterior pharyngeal wall that contributes to pressure system.

Answer 3

The velopharyngeal seal

Question 4

Base of tongue retracts and posterior pharyngeal wall moves forwards this applying positive pressure moving the bolus through the pharynx into oesophagus

Answer 4

BOT-PPW approximation

Question 5

Larynx is drawn upwards and forwards helping to create negative pressure in the hypopharynx. assists airway protection and stretches open the UES.

Answer 5

hyolaryngeal excursion

Question 6

As bolus enters the pharynx the pharyngeal constrictor muscles sequentially shorten and narrow the pharynx.

Answer 6

pharyngeal constriction.

Question 7

Epiglottis tilts backwards to deflect the bolus away from laryngeal vestibule

Answer 7

epiglottic deflection

Question 8

Valving of laryngeal vestibule involves

i. Closure/adduction of true vocal cords
ii. Closure of false vocal folds over true vocal folds

Answer 8

glottal closure

Question 9

what is the sensory role of the trigeminal nerve

Answer 9

Sensory: Carries info about sensations from anterior 2/3 of tongue, hard palate, cheeks

Question 10

what does the trigeminal nerve innervate

Answer 10

Innervates: Muscles of mastication, hyolaryngeal excursion tenses soft palate; assists velopharyngeal seal

Question 11

what happens if the trigeminal nerve is damaged

Answer 11

If damaged: Loss of sensation and Inability to move mandible (lower jaw)

Question 12

what is the sensory role of the facial nerve

Answer 12

Sensory: Delivers sensory taste info from anterior 2/3 of tongue Facial muscles are vital in the oral stage in ensuring food doesn’t spill out of mout

Question 13

what does the facial nerve innervate

Answer 13

­ Lip seal
­ Buccinator press
­ Hyolaryngeal excursion
­ Salivary glands

Question 14

what happens if the facial nerve is damaged

Answer 14

­	Paralysis of facial muscles
­	Poor lip strength
­	Dry mouth
­	Diminished jaw opening/closing
­	No taste in front 2/3 of tongue

Question 15

how do you test the facial nerve for UMN or LMN?

Answer 15

­ In LMN damage both the upper and lower facial muscles will be affected.
­ In UMN only lower facial muscles will be affected due to bilateral innervation

Question 16

what is the sensory role of the glossopharyngeal nerve

Answer 16

Sensory: Mediates taste sensation posterior 1/3 of tongue, General sensation posterior 1/3 of tongue, soft palate, faucial arches (triggering reflexive swallow) and the Gag reflex

Question 17

what does the glossopharyngeal nerve innervate

Answer 17

ii. Innervates
­ elevates pharynx and larynx
­  travels with X to help innervate pharyngeal constrictors
­  parotid salivary gland

Question 18

what happens if the glossopharyngeal nerve is damaged

Answer 18

iii. If damaged:
­ Decreased sense of taste and salivation
­ Diminished or inhibits gag reflex
­ Weak cough reflex

Question 19

what is the sensory role of the vagus nerve

Answer 19

i. Sensory: Carries sensory info from velum, larynx/vocal folds, pharynx, sinuses

Question 20

what does the vagusl nerve innervate

Answer 20

ii. Innervates:
­ velopharyngeal seal, glossopalatal seal
­ Pharyngeal constrictors
­ vocal fold adduction laryngeal constriction
­ UES relaxation

Question 21

what happens if the vagus nerve is damaged

Answer 21

­	Difficulty swallowing
­	Nasal regurgitation
­	- Reduced/lost gag reflex
­	- Hoarse, breathy, wet voice
­	- Inability to vary pitch

Question 22

what does the spinal accessory nerve innervate?

Answer 22

i. Innervates:
­ Muscles of head and neck
­ Lowers velum and narrowing of pharynx by innervating the palatopharyngeal muscle

Question 23

what does the hypoglossal nerve innervate

Answer 23

i.	Innervates:
­	all intrinsic and extrinsic tongue muscles which will help push bolus toward back of mouth 
­	glossopalatal seal
­	BOT-PPW approximation
­	ES opening

Question 24

what happens if the hypoglossal nerve is damaged

Answer 24

­ Inability to position food for chewing, resulting in food getting pocketed in cheeks

Question 25

what does the tongue do if the hypoglossal nerve is damaged UMNLMN or bilaterally

Answer 25

UMN deviation = opposite side to the lesion
­unilateral LMN = same side deviation
­bilateral LMN = no deviation + limited protrusion

Question 26

triggered by sensory stimulation of superficial mucosal receptors in the soft palate/pharynx and deep muscle receptors in the base of the tongue

Answer 26

the reflexive swallow