HNS 3

Question 1

The 5 phases of swallowing

Answer 1

-oral (prepartory + transit) phase
-pharyngeal (I + II) phase
-oesophageal phase

Question 2

what sort of function is needed for the oral preparatoryphase

Answer 2

lip, jaw, tongue and palate sensory and motor function + dentition

Question 3

oral preparatory phase

Answer 3

voluntary task where the air way is open and food/liquid chewed and formed into a bolus

Question 4

what nerves take part in the oral preparatory phase

Answer 4

cranial nerves
-V, VII, IX, X, XII
-trigeminal nerve, facial nerve, glossopharyngeal, vagus and hypoglossal

Question 5

oral transit phase

Answer 5

voluntary control where airway is open and bolus propelled to back of mouth and the soft palate seals entrance to nasal cavity

Question 6

what are the functions needed for oral transit phase

Answer 6

lip, jaw tongue and palate sensory and motor function needed

Question 7

what nerves supply the oral transit phase?

Answer 7

V, VII, IX, X, XII

Question 8

pharyngeal phase I

Answer 8

-reflex control when the airway is closed and bolus reaches faucial arch (back of mouth) while the palate stays elevated
-tongue retracts, pushing bolus to pharynx

Question 9

what nerves supply the pharyngeal phase I?

Answer 9

pharynx: IX, X
tongue: XII

Question 10

what are the functions needed for phayngeal phase I

Answer 10

tongue, palate and laryngeal sensory and motor function needed

Question 11

pharyngeal phase II

Answer 11

Reflex control where airway is closed by epiglottis, vocal cords and arytenoid action
+ bolus propelled through pharaynx

Question 12

what nerves supply the pharyngeal phase II?

Answer 12

IX, X, XII

Question 13

what are the functions needed for phayngeal phase II

Answer 13

tongue, palate and laryngeal sensory and motor function needed

Question 14

what are the functions needed for phayngeal phase II

Answer 14

tongue, palate and laryngeal sensory and motor needed

Question 15

oesophageal phase

Answer 15

reflex control where oesophagus opensm airways closed tf breath held
-bolus propelled through oesophagus
-respiration then resumes with an exhalation to clear any food particles from airway entrance

Question 16

what nerves supply the oesophageal phase?

Answer 16

IX, X

Question 17

what type of imaging can we use to examine swallowing?

Answer 17

videofluoroscopy

Question 18

what is an ataxic swallow

Answer 18

-uncoordinated tongue retraction to propel food causing delayed airway closure

Question 19

what can cause ataxic swallow?

Answer 19

cerebellar haematoma

Question 20

fix for ataxic swallow

Answer 20

flexed neck during swallow prevents aspiration

Question 21

how may a lower motor neurone lesion cause impaired swallowing?

Answer 21

ipsilateral paresis of phaynx, layrnx and tongue causing weak bolus propulsion tf failed airway closure->aspiration

Question 22

fix for failed airway closure due to lower motor neurone lesion (excised acoustic neuroma-tumour removal from brain)

Answer 22

head rotation to direct bolus down strong side of pharynx and airway closure

Question 23

describe the impaired swallowing in parkinsons disease

Answer 23

-typical repetitive tongue movement linked with muscle rigidity -> unable to lower the back of tongue + struggle with swallowing

Question 24

fix for impaired swallowing in Parkinsons disease

Answer 24

active range of motion exercises of lips and tonue

Question 25

what makes up normal swallowing?

Answer 25

-vocal cords adduct to produce voice and to close airway -saliva is cleared in asingle swallow and does not accumulate -water swallowed <1 second -no residue in pharynx or in trachea

Question 25

how are the muscles of facial expression grouped?

Answer 25

orbital, nasal and oral

Question 26

what are the muscles of facial expression innervated by?

Answer 26

Facial nerve VII

Question 27

What muscles make up orbital group?

Answer 27

corrugator supercilli and the orbicularis oculi (orbital and palpebral)

Question 28

what muscles make up the nasal group?

Answer 28

procerus and nasalis (transverse and alar part) and depressor septi nasi

Question 29

what muscles make up the oral group?

Answer 29

a lot

Question 30

what muscles move the ear?

Answer 30

superior, anterior and posterior auricular

Question 31

what muscle contract to close eyelid?

Answer 31

(orbital) orbicularis oculi

Question 32

describe how facial nerve is distributed across the face

Answer 32

divides in the parotid gland and innervates the temporal, zygomatic, buccal, mandibular and cervical (neck) muscles

Question 33

what is the temporomandiibular joint?

Answer 33

sinovial joint between temporal bone and mandible that allow the opening and closing of mouth (mastication)

Question 34

what are the muscles of mastication (moving mandible) innervated by?

Answer 34

mandibular division of trigeminal nerve

Question 34

describe what action predominates when i) jaws slightly opened ii) jaws widely open

Answer 34

i) hinge action predominates ii) hinge and gliding action combined

Question 35

what are the superficial muscles of mastication?

Answer 35

masseter and temporalis

Question 36

what are the deep muscles of mastication?

Answer 36

lateral ptyeryoid and medial pterygoid

Question 37

origin and insertion of masseter

Answer 37

zygomatic arch to lateral surface of ramus and angle of mandible

Question 38

function of masseter

Answer 38

elevation of mandible (forced closure of mouth)

Question 39

origin and insertion of temporalis

Answer 39

temporal fossato coronoid process of mandible

Question 40

function of temporalis

Answer 40

elevation and retraction of mandible

Question 41

function of temporalis

Answer 41

elevates and retracts mandible

Question 42

origin and insertion of lateral pterygoid

Answer 42

lateral pterygoid plate (sphenoid bone) to neck of mandible

Question 43

function of lateral pterygoid

Answer 43

open mouth by depressing and protracting mandible

Question 44

origin and insertion of medial prterygoid

Answer 44

lateral pterygoid plate + maxilla + palate to angle of mandible

Question 45

function of medial pterygoid

Answer 45

elevates, protracts and lateral movement of mandible for chewing

Question 46

how do we know when vagus nerve is fine?

Answer 46

if uvula goes up

Question 47

what are the 3 muscles of the pharynx?

Answer 47

superior, middle and inferior constrictors

Question 48

what nerves innervate the sensory function of the muscles of the phaynx?

Answer 48

pharyngeal plexus: glossopharyngeal (IX) and vagus (X)

Question 49

what nerves innervate the motor function of the muscles of the phaynx?

Answer 49

Vagus (X) and sometimes accessory nerve (IX)

Question 50

function of muscles of the pharynx

Answer 50

aid swallowing via their coordinated sequential contraction

Question 51

what are the three salivary glands?

Answer 51

mainly serous: parotid and submandibular mainly mucous: suplingual

Question 52

what innervates the parotid gland?

Answer 52

Glossopharyngeal (IX)

Question 53

what innervates the submandibular gland?

Answer 53

Facial (VII)

Question 54

what innervates the sublingual gland?

Answer 54

Facial (VII)

Question 55

what innervates the anterior 2/3 of tongue and their function?

Answer 55

s: mandibular branch of trigeminal (V3) nerve- (lingual nerve) t: facial (VII) nerve (chorda tympani-> also innervates sublingual)

Question 56

what innervates the posterior 1/3 of tongue and their function?

Answer 56

s and t: glossopharyngeal (IX) nerve

Question 57

what nerve allows movement of tongue?

Answer 57

hypoglossal (XII) nerve

Question 58

what innervates the base of tongue and the epiglottis?

Answer 58

vagus (X) nerve

Question 59

unami flavour area on tongue

Answer 59

all over

Question 60

sour flavour area on tongue

Answer 60

sides of tongue

Question 61

sweet flavour area on tongue

Answer 61

tip of tongue

Question 62

bitter flavour area on tongue

Answer 62

base of tongue

Question 63

fix for impaired swallowing in Parkinsons disease

Answer 63

active range of motion exercises of lips and tonue

Question 63

salty flavour area on tongue

Answer 63

border, tip of tongue

Question 64

What are the structures involved in tongue musculature?

Answer 64

muscles: tongue, extrinsic (palatoglossus, styloglossus, genioglossus) nerves: lingual nerve with submadibular ganglion bone: mandible and hyoid (bottom)