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Dysphagia > Quiz 1 > Flashcards

Quiz 1 Flashcards

(65 cards)

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1
Q

What are the two types of nervous systems

A

Central nervous system and peripheral nervous system

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2
Q

What are the two types of peripheral nervous systems

A

Autonomic nervous system and somatic nervous system

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3
Q

What are the two autonomic nervous system divisions

A

Sympathetic and parasympathetic

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4
Q

What are the two somatic nervous system divisions

A

Sensory and motor

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5
Q

Central nervous system

A

Integrates information received from the body and coordinates the activity

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6
Q

Peripheral nervous system

A

Connects the CNS to the limbs and organs; relay system between the brain and the extremities

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7
Q

Autonomic system

A

Involuntary responses that influence function of the internal organs

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8
Q

Somatic system

A

Communicates with sense organs and is primarily responsible for voluntary muscle movements

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9
Q

Parasympathetic nervous system

A

Responsible for the “rest and digest” action when the body is at rest

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10
Q

Sympathetic nervous system

A

Stimulate “flight or fight” response

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11
Q

Afferent/sensory

A

Impulses from peripheral tissues toward brainstem

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12
Q

Efferent/motor

A

Impulses from brainstem to muscles

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13
Q

Is swallowing voluntary or involuntary?

A

Both! Autonomic drive to eat and drink, sensory processing of bolus, reward component

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14
Q

What cranial nerves are involved in swallowing?

A

IV TRIGEMINAL, VII FACIAL, IX GLOSSOPHARYNGEAL, X VAGUS, XII HYPOGLOSSAL

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15
Q

Central pattern generator (CPG)

A

Houses the nucleus tractus solitarius (NTS) and nucleus ambiguus (NA)

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16
Q

Nucleus tractus solitarius (NTS)

A

Receives cranial nerve sensory input involved in swallowing

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17
Q

Nucleus ambiguus (NA)

A

Organizes motor components

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18
Q

Brainstem (CNS)

A

Houses the nuclei of the cranial nerves; also houses, respiratory centers and central pattern generators for chewing, respiration and pharyngeal swallow

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19
Q

Parts of brainstem

A

Medulla, pons and midbrain

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20
Q

Parts of the cortex

A

Limbic system, insula, thalamus, hypothalamus, basal, ganglia, cerebellum

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21
Q

Limbic system

A

Controls motions and drives

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22
Q

Insula

A

Monitors taste; modulate aspects of swallow

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23
Q

Thalamus

A

Relay station

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24
Q

Hypothalamus

A

Helps integrate the actions of the autonomic nervous system

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25
Basal ganglia
Nuclei deep within the brain; important for motor control and movement
26
Cerebellum
“Little brain”; coordinating movement
27
“Control circuits”
Basal ganglia and cerebellum
28
Cortex
Sensory, motor, limbic, cognitive
29
Main goals of swallowing
Bolus efficiency and airway protection
30
Normal swallow
Involves movement of 50+ muscles in the oral cavity, pharynx, larynx and esophagus; movements controlled by cranial nerves and peripheral (C1-C3 nerves)
31
Stages of swallow
1. Oral preparatory stage 2. Oral stage 3. Pharyngeal stage 4. Esophageal stage
32
Oral prep phase
Food manipulation and mastication; bolus mixes with saliva and divides for transport; almost entirely voluntary, can be interrupted anytime
33
Oral prep muscles
Zygomaticus major and minor; buccinator; masseter; orbicularis oris
34
Oral transport/oral phase
Propulsion/transit of the bolus; tongue contracts against hard palate; tongue serves as anchor during hyoid elevation and UES opening
35
Tongue
Muscular hydrostat (no skeletal support, used for food manipulation); all muscles innervated by hypoglossal nerve
36
Muscles of the tongue
4 intrinsic 4 extrinsic
37
Intrinsic tongue muscles
Superior longitudinal, inferior longitudinal, vertical, transverse
38
Extrinsic tongue muscles
Genioglossus, styloglossus, hyoglossus, palatoglossus
39
Anterior tongue
Formation, placement and manipulation of the bolus in the oral cavity
40
Posterior tongue
Containment of the bolus in the oral cavity and propulsion into the pharynx
41
Masseter
Elevates the mandible
42
Temporalis
Elevates and retract the mandible
43
Medial pterygoid
Closes the jaw by raising the mandible against the maxilla
44
Lateral pterygoid
Assists in opening the mouth by drawing the condyle and articular disc forward
45
Salvation
Motor response controlled by the salivary nucleus in the brainstem; activated by stimulation of taste receptors on anterior 2/3 of the tongue; contains enzymes for digesting starches and mucous for lubrication
46
Successful prep phase
1. Labial seal 2. Buffaloes and facial tone 3. Adequate and appropriate tongue movements 4. Lowering the velum 5. When necessary, mastication of the material, with lateral and rotary motion of the mandible.
47
Primary goal of the oral cavity for oropharyngeal swallowing
1. Processing food for safe swallowing 2. Posteriorly propelling the food into the pharynx to be swallowed (tongue)
48
Pharyngeal phase
Shortest, but most complex; reflexive/automatic, irreversible motor event; requires 1-1.5 seconds to complete;
49
Pharyngeal phase: affects the following automatic reactions
Velopharyngeal closure, closure of larynx, pharyngeal, peristalsis, elevation and anterior pull of the larynx, relaxation of UES/PES
50
Velopharyngeal closure
Contracts tensor veli palatini, lavatory veli palatini, musculus uvulus
51
Closure of larynx
True VFs adduct, 0.3-2.5 seconds of apnea occurs; epiglottis directs bolus toward UES/PES and protects airway; pharyngeal peristalsis begins before laryngeal elevation
52
Airway protection
Epiglottis inversion; aryepiglottic fold bunching; arytenoid anterior pivoting; arytenoid adduction
53
Larynx innervation
All muscles innervated by Vagus Superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN)
54
What is a cough?
A defensive respiratory event that begins with a brief inspiration, followed by expiration against a closed glottis, which produces large increases in intrapulmonary pressures
55
Bolus efficiency
Laryngeal elevation —> UES traction (stretching)
56
Muscles of the pharynx
Semicircular muscles (3 sets), paired muscles (2)
57
Semicircular muscles
Constriction Superior constrictor, middle constrictor, inferior constrictor
58
Paired muscles of the pharynx
Shortening and elevation Salpingopharyngeus, stylopharyngeus, palatopharyngues
59
Key muscles in pharyngeal phase
Palatopharyngeal, thyrohyoid, middle pharyngeal constrictor, inferior pharyngeal constrictor, stylopharyngeus, salpingopharyngeus, cricopharyngeus
60
Pharyngeal constriction and elevation
Via sequential contraction of superior, middle, then inferior constrictors Approximately 400 msec
61
Motor innervation
All muscles of the pharynx, except stylopharyngeus innervated by the pharyngeal plexus
62
Suprahyoids
Hyolaryngeal elevators; “sling muscles” Anterior digastric, posterior digastric, mylohyoid, geniohyoid, stylohyoid
63
Infrahyoids
Hyolaryngeal depressors; “strap muscles” Omohyoid, sternohyoid, sternothyroid, thyrohyoid
64
Pharyngeal phase
Bolus hits anterior faucial pillars; airway protection; pharyngeal muscles contract raising the pharynx; tongue base retracts to PPW; pharyngeal constrictors are activated in to steal-caudal direction causing pharyngeal peristalsis; suprahyoid muscles contract and hyoid moves superioly and anteriorly; thyroid contracts and larynx moves towards the hyoids creating negative pressure below bolus to “suck” it towards the esophagus; epiglottis inverts; laryngeal and pharyngeal elevation pull cricoid away from PPW opening the cricopharyngeus muscle; if labial and nasopharyngeal seal are intact the UES opening creates more “suction force” that combine with driving force of the tongue and pharyngeal stripping wave to enhance bolus efficiency
65
Esophageal phase
Starts after bolus passes through UES; relaxation of crisopharyngeus lasts 0.5-1.2 seconds; cricopharyngeus goes back to contracted state to avoid any retrograde flow; esophageal peristalsis is then activated and bolus is propelled towards the LES and stomach; peristaltic wave travels, inferiorly squeezing bolus through esophagus; after hypopharyngeal pressure peaks the LES is triggered to relax and bolus is squeezed into stomach; several secondary waves occur up to an hour after the swallow to clear any esophageal residue In healthy adults esophageal transit time is between 8 and 13 seconds

Dysphagia (2 decks)

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