EX1; Swallowing, Emesis, Bruxism, and TMD Flashcards Preview

AU14 Physiology > EX1; Swallowing, Emesis, Bruxism, and TMD > Flashcards

Flashcards in EX1; Swallowing, Emesis, Bruxism, and TMD Deck (75):
1

Swallowing is a reflex after initial (can be voluntary) but is normally what

unconscious

2

How many times do we swallow a dat

1,000
1/min except when eating/sleeping

3

What are the four components of swallowing

large area of brain stem
six cranial nerves
receptors
muscles

4

What are the four phases of swallowing

preparatory
oral
pharyngeal
esophageal

5

In this stage of swallowing this is the forming of the bolus; same as the pre-swallowing phase at the end of mastication

preparatory phase

6

What are the four parts of the preparatory phase of swallowing

1. bolus is formed and positioned on dorsum of tongue
2. tip of tongue presses against maxillary incisors or anterior hard palate
3. region of tongue where the bolus is positioned rises lateral against posterior teeth and palatal mucosa
4. glossopalatal sphincter forms (temporarily) preventing the bolus from entering pharynx prematurely

7

This phase is the movement of the bolus from oral cavity to pharynx

Oral

8

This action of the oral phase; lips close, upper and lower incisors move close together has what consequence

formation of oral seal

9

This action of the oral phase; anterior 2/3 of tongue moves up against maxillary alveolar ridge and the anterior hard palate has this consequence

pushes the bolus toward the pharaynx

10

This action of the oral phase; base of tongue moves downward and forward has this consequence

expands hypopharynx and opens a chute to pharynx

11

This action of the oral phase; palate moves up has this consequence

opens the glossopalatal sphincter

12

This action of the oral phase; palate contacts posterior pharyngeal wall and the side walls of the nasopharynx are opposed has this consequence

this prevents the bolus from entering the nasal cavity

13

What mandibular and facial muscles are involved in preparatory and oral phases of swallowing

mandibular; masseter, medial pterygoid, temporalis
facial; labial and buccinator

14

The muscles involved with preparatory and oral phases of swallowing is a variable groups called the "facultative group" why is this

which muscles are involved at any time depends largely on the food consistency

15

contraction of these muscles contribute to the formation of the oral seal and stabilizes the mandible

labial and buccinator

16

True or False
The epiglottis is absolutely requires to prevent the aspiration of food

False; it is not required

17

This phase is the movement of the bolus from oropharynx to esophagus (~0.7 sec)

pharyngeal phase

18

This action of the pharyngeal phase; piston-like movement of posterior tongue has this consequence

propels the bolus through the oropharynx and into the hypopharynx

19

This action of the pharyngeal phase; pharyngal constrictors contract several times has this consequence

this moves the bolus through the pharynx

20

This action of the pharyngeal phase; upper esophageal sphincter opens has this consequence

allows bolus to enter the esophagus

21

This action of the pharyngeal phase; epiglottis movement cause by elevation of the hyoid bone and larynx and contraction of the thryohyoid muscle has this consequence

closes the opening to the larynx

22

What is the group of muscles involved with the pharyngeal phase called and why

"obligate group" and its because the leading complex of muscles contract fairly synchronously, followed by contractions that are more sequential

23

This phase is the movement of food along the entire esophagus (3 sec for liquids, 9 sec for solids)

esophageal

24

These waves of contraction (primarily smooth muscles) move the bolus through the open esophageal sphincter and into the stomach

peristaltic

25

Muscles of esophageal sphincters are what

tonically active; however basal activity stops before bolus enters the esophagus

26

This relaxes about when the tongue and upper pharynx contract and is open before the pressure wave passes through the pharynx

upper esophageal sphincter

27

The upper esophageal sphincter contracts when

after the food bolus enters the esophagus and its pressure rises well above resting level for several seconds

28

This sphincter relaxes for about 3 seconds before peristaltic wave reaches it and remains open until the last in a series of swallows in complete then the sphincter contracts for 1-2 seconds such that again the pressure developed is well above resting level

lower esophageal sphincter

29

These four mechanisms prevent aspiration of food during the pharyngeal phase

respiration is inhibited
larynx and upper esophageal sphincter elevate
intrinsic muscles of glottis move vocal cords toward each other
bolus moves through sinuses in pharynx

30

Which phases of swallowing are voluntary, subconscious or involuntary

preparatory and oral; voluntary, normally subconscious
pharyngeal and esophageal; involuntary

31

What are the three components of the brainstem swallowing center

sensory nuclei
motor nuclei
interneuronal network

32

What are the two components of the sensory nuclei in the brainstem swallowing center

nucleus tract solitarious (NTS)
trigeminal sensory nucleus

33

What are the two components of the motor nuclei in the brainstem swallowing center

nucleus ambiguous
facial, trigeminal, and hyopglossal nuclei

34

This mediates interactions between motor and sensory nuclei

interneuronal network

35

These interneurons are involved with initiation and programming (or timing) or swallowing

dorsal interneurons

36

These interneurons are involved with distributing the excitation to the swallowing motor nuclei

ventral interneurons

37

Which interneuron network can occur in the complete absence of sensory input but normally many afferent fibers send information to these interneurons through the NTS

dorsal interneurons

38

These interneurons are also involved in the control of swallowing; cell bodes are not in the brainstem; therefore not considered part of the brainstem swallowing center

cervical

39

Afferent information during swallowing originates where

in the pharynx, larynx, and esophagus

40

Where does the afferent information during swallowing go, and what does it result in

the info is sent to the NTS
results in modulation of swallow, depending on food consistency

41

The activation of afferent fibers can also lead to this

the inhibition of some motoneurons

42

Stimulation of the this can also initiate swallowing but it is not required for smooth, efficient swallowing

the cortex

43

Infantile swallowing involves the programming of these muscles when,

programming of obligate muscles beginning in utero; markedly different from the facultative muscles which have different patterns of activation before and after tooth eruption

44

Infantile swallowing is driven by this before tooth eruption

obicularis oris and buccinator; tongue thrust

45

True or False
jaw closer muscles do not have a prominent role in swallowing before eruption

True

46

When are jaw closer muscles involved in infantile swallowing

after tooth eruption; decreased contribution from labial and buccinator and from tongue thrust

47

What could be the result if infantile swallowing is maintained after tooth eruption

malocclusion; specifically an anterior open bite

48

True or False
infants can swallow without disruption of respiration

False

49

Is this infant suckling or adult sucking; infant suckling; lips seal around nipple, mandible lowered and negative pressure develops; elevation of jaw and tongue espresses the liquid; both jaw openers and closers involved

infant suckling

50

Is this infant suckling or adult sucking; lips form a seal but jaw opening mucles and now closing muscles do not have a prominent role; it is driven by inspiration mucles

adult sucking

51

True or False
respiration is maintained during suckling episodes

True

52

The purpose of this is to ride the stomach of its contents which often include toxic substances

Emesis (vomiting)

53

What are the two stimuli for vomiting

physiological
disease-related

54

This stimulus for vomiting includes pain, vestibular imbalance, distention or injury to stomach, intestine, bladder, or uterus, irritation of gut or peritoneum; substances in the blood can directly stimulate chemoreceptors in the medulla

physiological

55

This stimulus for vomiting includes increased intracranial pressure (often during a heart attack), stenosis of pyloric valve, radiation therapy, anesthesia, and psychological stress

diseases-related

56

What are the three stages of vomiting

pre-ejection
ejection
post-ejetion

57

The characteristics of this stage of vomiting include licking, salivation, tachycardia, and relaxation of the proximal part of the stomach

pre-ejection

58

What is the duration of the pre-ejection stage of vomiting

as short as a few minutes or as long as several days (pregnancy)

59

What are two ejection phases of vomiting

retching
expulsion

60

In the retching stage of ejection, the glottis is closed and the inspiratory muscles contract, causing this change in pressure

decrease in intra-thoracic pressure
increase in intra-abdomical pressure

61

True or False
Retches can occur repetitively; 1-2 seconds between each

True

62

This relaxes during each retch, but contracts again between each one

upper esophageal sphincter

63

During the expulsion stage of vomiting, these two things relax, and this contracts

antrum of stomach and upper esophageal sphincter relax
rectus abdominus and externam oblique contract

64

What becomes of the pressure differences during the expulsion stage

intra-thoracic and intra-abdominal pressures rise do ~100mmHg, compared to the 10mmHg pressure in the resting lower esophageal sphincter

65

This group of nuclei coordinates vomiting act; afferent information from the stimuli terminated in the sensory nucleus of this complex

in the medulla; medullary control

66

Direct stimulation near this in animals causes vomiting; this area is also connected to the area postrema which contains the "chemoreceptor trigger zone" which can be stimulated directly by emetic agents in the blood

solitary nucleus (NTS)

67

This is forceful tooth clenching and grinding during sleep; sometime rhythmic chewing and sometimes sustained contraction

bruxism

68

Interferences in occlusion were thought to cause bruxism, but this is unlikely, why?

the primary effect of tooth stimulation is inhibition, not excitation of jaw closers

69

Bruxism is associated with what

certain sleep phases; may have a CNS origin
appears to correlate with stress levels

70

In animal studies, the stimulation of certain brain areas, such as this, evoke stress-like responses and the same stimulation causes excitation of jaw-closer motoneurons

hypothalamus

71

What are some consequences of bruxism

pain, possible muscle damage
excessive tooth wear, fractures
inhibition of chewing
may can use TMD

72

What are some treatment options for bruxism

attempt to reduce stress
bite appliance therapy

73

What are the two major issues of TMD

pain
impaired chewing efficiency

74

TMDs are more common in which type of people

women
decreases with age

75

TMD may be one set of disorders which are collectively referred to as what, involving muscular pain, depression, treatments are similar

fibromyalgia