physiology

Question 1

what are the four phases of normal deglutition?

Answer 1

oral preparatory phase
oral phase
pharyngeal phase
esophageal phase

Question 2

what are the components of OPP

Answer 2

lip closure
facial tone
rotary jaw motion
rotary/lateral tongue movement
anterior bulging of soft palate

Question 3

at the end of the OPP, the bolus is held in two positions…

Answer 3

1. 80% of people: held on top of the tongue against the alveolar ridge and hard palate (tippers)
2. 20% of people: held on the floor of the mouth in front and under the tongue (dipper)

Question 4

what is the initiation of the oral phase?

Answer 4

tongue posterior movement of the bolus

Question 5

how long is the oral phase?

Answer 5

1 to 1.5 seconds

Question 6

xx have increased oral transit times

Answer 6

elderly

Question 7

what are the components of the oral phase?

Answer 7

intact:
labial closure
lingual movement
buccal musculature
palatal muscles
nasal breathing

Question 8

what is the sensory center of swallowing?

Answer 8

nucleus tractus

Question 9

what is the motor center of swallowing?

Answer 9

nucleus ambiguous

Question 10

what is the trigger point of the pharyngeal swallow?

Answer 10

when the bolus head passes the anterior faucial arches (in young normal people)

Question 11

how long is the pharyngeal phase?

Answer 11

one second or less

Question 12

what are steps one and two of the pharyngeal phase

Answer 12

1. Elevation and retraction of soft palate to close velopharyngeal port
2. Elevation and anterior movement of hyoid and larynx

Question 13

what are steps three and four of the pharyngeal phase?

Answer 13

3. Closure of the larynx at all three sphincters
4. Opening of cricopharyngeal sphincter

Question 14

what are steps five and six of the pharyngeal phase?

Answer 14

5. Contact of base of tongue to posterior pharyngeal wall
6. Progressive contraction of pharyngeal constrictors

Question 15

what are the steps for closing the airway?

Answer 15

1. begins at vocal folds and moves upwards towards the laryngeal vestibule
2. true vocal folds close via arytenoid rotations
3. arytenoids tilt forward to base of epiglottis and false vocal fold close
4. epiglottis folds down and over

Question 16

what is the process of the cricopharyngeal opening?

Answer 16

relaxation of the cricopharyngeal muscle

upward and anterior movement of the larynx

pressure within bolus widens the opening

Question 17

airway closure and cricopharyngeal opening occur…

Answer 17

simultaneously

Question 18

what are two of the pressure generators?

Answer 18

oral tongue pushes on tail of bolus

Base of tongue to posterior pharyngeal wall acts like a piston in pharyngeal chamber

Question 19

what are the two other pressure generators?

Answer 19

Pharyngeal contraction as a clearance force

Laryngeal elevation and shortening of pharynx

Question 20

why is it important that the valves function correctly and in a timely manner?

Answer 20

because they direct the food through the right tubes

Question 21

what is the purpose of the velopharyngeal port?

Answer 21

prevent nasal regurgitation

Question 22

what is the purpose of the larynx?

Answer 22

protect airway

Question 23

what is the purpose of the UES?

Answer 23

direct food into the esophagus

Question 24

esophageal transit time is between the xx and the xx

Answer 24

UES and LES

Question 25

how long is the esophageal phase?

Answer 25

8 to 20 seconds

Question 26

esophageal phase cannot be changed by xx

Answer 26

therapeutic exercises

Question 27

what are the swallowing anatomy changes in infants

Answer 27

tongue fills oral cavity fat pads in cheek narrow oral cavity hyoid bone and larynx are higher, soft palate is lower, uvula rests inside the epiglottis which forms pockets in the valleculae differences in laryngeal cartilages

Question 28

what are the swallowing physiology changes in infants?

Answer 28

tongue pumping: collecting liquid in the facial arches and valleculae (around 2-7 pumps) when adequate bolus is collected then pharyngeal swallow triggers laryngeal evaluation is smaller and posterior pharyngeal wall moves further anteriorly

Question 29

what are the anatomical changes for the elderly?

Answer 29

ossification in the thyroid and cricoid cartilages and hyoid bone increases over 70: larynx lowered in the neck reduction of strength of pharyngeal contraction

Question 30

if an elderly person has arthritis in their cervical vertebrae..

Answer 30

it may impinge on the pharyngeal wall

Question 31

what are the physiological changes in the elderly?

Answer 31

more dipper longer oral stage small increase in freq + extent of pharyngeal residue increased incidence of penetration Reduced maximal laryngeal and hyoid anterior and vertical movement Reduced cricopharyngeal flexibility Slower esophageal transit and clearance

Question 32

with increased volume, the oral and pharyngeal phase..

Answer 32

become simultaneous activity Base of tongue to posterior pharyngeal wall contact occur late Prolonged cricopharyngeal opening, laryngeal closure, and elevation

Question 33

what are some variations for normal swallowing viscosity?

Answer 33

Pressure generated by oral tongue, tongue base and pharyngeal walls increase prolonged: velopharyngeal/laryngeal closure cricopharyngeal opening

Question 34

what are some variations for normal swallowing with cup drinking?

Answer 34

Early airway closure and some pre-elevation of the larynx as the cup is approaching The UES opens repeatedly as each bolus approaches

Question 35

cup drinking: during xx the velopharyngeal area is closed, the lips maintained seal, the tongue repeated propels, and the tongue base and pharyngeal walls make contact at the tail of each sequential bolus

Answer 35

sequential swallows

Question 36

what happens during straw drinking?

Answer 36

To create suction: The soft palate is lower against the back of tongue and suction created in mouth + the muscles of the cheek and face contract When material reach the mouth, the suction is discontinued Soft palate elevates and the oral phase swallow initiates

Question 37

what happens when we "chug"?

Answer 37

Pull larynx forward to open UES Close the airway at larynx Dump material through the oral cavity and pharynx by gravity into the esophagus and stomach

Question 38

what happens when a pharyngeal swallow only occurs?

Answer 38

premature spillage during chewing The person will stop chewing, produce a pharyngeal swallow and resume chewing

Question 39

Swallow interrupts the xx of the respiratory cycle, then the person returns to xx after the swallow

Answer 39

exhalatory phase; exhalation