oral functions 4 - aerodigestive tract reflexes and speech Flashcards Preview

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Flashcards in oral functions 4 - aerodigestive tract reflexes and speech Deck (44)
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what are the 3 stages in swallowing

- buccal phase = voluntary
- pharyngeal phase = involuntary
- oesophageal = involuntary


what is swallowing

- process by which the accumulated food bolus is transported through the lower pharynx and oesophagus to the stomach (feeding function)
- prevents ingested material from entering the lower airway (protective function)


how is bolus formed

- the water in saliva allows the bolus to stick together to be swallowed


why is swallowing potentially dangerous

- because the 'food-way' crosses the airway


how are liquids swallowed

- liquids are gathered on the tongue, anterior to the pillars of the fauces
- the mouth is separated from the pharynx by a posterior oral seal = this doesn't happen with solid bolus
- the liquid bolus is then propelled through the oropharynx and hypo pharynx and then into the oesophagus


how is solid bolus swallowed

- chewed food material accumulates on the pharyngeal part of the tongue and vallecula (oropharynx)
- there is no true posterior oral seal
- the bolus is then propelled from the tongue through the hypo pharynx and then into the oesophagus


what are some key points of swallowing

- liquids are swallowed from the mouth = oral seal
- solids are swallowed from the oropharynx = no oral seal
- both are mixed rapidly through the hypo pharynx past the laryngeal inlet


what do tongue movements do in swallowing

- the forward movement of the tongue during the occlusal and initial opening phases creates a contact between the tongue and hard palate
- the contact zone moves progressively backwards, squeezing the processed food through the fauces
- tongue breaks up the bolus to be swallowed in smaller amounts


what are the swallowing events

- propulsion of food
- prevention of reflux
- protecting the airway


what is the duration of the masticatory sequence

- the duration varies with the different extents of food consistency


how strong are swallowing forces

- these are strong enough to move bolus up hill or down hill


how is reflux prevented

- elevation of the soft palate
- tongue (sides) contacts pillars of fauces
- tongue (dorsal) contacts posterior pharyngeal wall
- upper oesophageal sphincter stops reflux from oesophagus into pharynx
- lower oesophageal sphincter stops reflux from stomach into oesophagus


how can erosion occur

- stomach acid can erode teeth by reflux, vomitting, regurgitation and rumination
- when palatal surface erosion is present, 2/3 of the time stomach acid is responsible = causes cupping on the palatal surface - is intrinsic erosion


how can you prevent fizzy drinks causing erosion

- patients will not stop drinking these even if asked
- instead need to suggest that they drink them with a straw or only at mealtimes to lessen damage


what are other types of tooth surface loss than erosion

- attrition
- abrasion
- abfractions


what is attrition

- is tooth wear occlusally caused by contact between occluding teeth
- the teeth inter-digitate indication that attrition is occurring
- there are equal amounts between upper and lower


what is abrasion

- occurring on its own is unusual = might be caused by biting or chewing objects between the teeth
- the most common presentation of tooth wear it the result of a combined lesion involving erosion and abrasion
- acids weaken the outer 3-5 microns of mineralised tissue and increase the susceptibility of the enamel and dentine to abrasion from tooth brushing with or without toothpaste


what is abfraction

- stress lesion s
- wedge-shaped notch caused by the flexure and ultimate material fatigue of susceptible teeth at locations away from the point of loading
- the breakdown is dependant on the magnitude, duration, frequency and location of occlusal forces
- premolars are specifically at risk due to high occlusal load here


how is the airway protected during swallowing

- upward and forward movement of larynx
- closure of laryngeal inlet = aryepiglottic muscles, epiglottis
- adduction of vocal folds = movement of them towards midline of body, or towards other part
- stop breathing = apnoea


what is dysphasia

- sometime called aphasia
- a specific language disorder
- involving damage to particular parts of the brain = Broca's area and Wernick's area


what is dysphagia

- difficulty/inability to swallow


what is odynophobia

- pain on swallowing
- a pathological condition in which the affected person experiences extreme pain when swallowing be it foods, liquids, drugs


what is dysarthria

- difficulty speaking that is caused by problems with the muscle used in speech
- due to neuro-muscular defects = important to notice these in a patient as can affect treatment - e.g. dentures


what are some oral causes of language and speech defects

- malocclusions
- loss of teeth and denture
- cleft lip/palate
- tongue related issues
- dry mouth


what is malocclusions

- e.g. anterior open bite
- caused by digit sucking as a baby
- tongue thrust
- skeletal origin


what can cleft lip/palate do to speech

- oral and nasal cavities are not separated
- speech as a 'nasal' quality
- palatal defect has to be repaired or filled with an obturator


what are some tongue related issues with speech

- tongue tie = easy fix
- partial atrophy = tongue not completed
- tongue stud


what does dry mouth do

- xerostomia
- one of the serious repercussions of dry mouth if impeded speech
- wit inadequate saliva production, pronouncing words becomes difficult
- people who have dry mouth and difficulty speaking cannot simply swallow and start talking normally


what is torus mandibularis/tori

- does not affect speech of languor but can affect RPD's
- have to change design to accommodate if patient doesn't want them removed
- they are just lumps in the mouth - benign
- also get it on the palate (torus platinus) = need to deist a horseshoe denture to accommodate it


what are some denture related issues for speech

- problems mainly arise from restricted tongue space
- denture base can be too thick
- artificial teeth may not be set properly