Swallowing

Question 1

Why does the swallow work in the way that it does?

Answer 1

1.) Bolus efficiency
2.) Airway protection

Question 2

What is the goal of bolus efficiency?

Answer 2

Transport nutrition and hydration material into the body

Question 3

What is the goal of airway protection?

Answer 3

Keep material out of the lungs/airway

Question 4

What is the anticipatory phase?

Answer 4

Preparing your body to accept food

Question 5

In what phase does salivary production happen?

Answer 5

Anticipatory phase

Question 6

In what phase does does deciding how far to open mouth or how to bite happen?

Answer 6

Anticipatory phase

Question 7

What do the lips do in the oral phase?

Answer 7

1.) Seal around spoon or straw
2.) Keep food in the mouth

Question 8

What does the jaw do in the oral phase?

Answer 8

1.) Open and close mouth to accept food
2.) Bite into food
3.) Chew bolus while in the oral cavity

Question 9

What does the tongue do in the oral phase?

Answer 9

1.) Create oral suction
2.) Control/form food/liquids while in oral cavity
3.) Push to the back of mouth to swallow

Question 10

What do the cheeks do in the oral phase?

Answer 10

Keep food in the middle of the mouth

Question 11

What does sensation do in the oral phase?

Answer 11

1.) Awareness of where food/drink is in (and out) of the oral cavity
2.) Taste

Question 12

What are the 4 anatomical parts used in the pharyngeal phase?

Answer 12

1.) Tongue base
2.) Pharynx
3.) Hyoid/Larynx
4.) Upper esophageal sphincter

Question 13

What does the tongue base do in the pharyngeal phase?

Answer 13

Moves backward to meet posterior pharyngeal wall to push food down

Question 14

What does the pharynx do in the pharyngeal phase?

Answer 14

Constricts to push bolus through the pharynx

Question 15

What does the hyoid/larynx do in the pharyngeal phase?

Answer 15

1.) Open at rest
2.) Elevates and moves forward to close airway to keep food out and open esophagus to let food in

Question 16

What does the upper esophageal sphincter do in the pharyngeal phase?

Answer 16

1.) Closed at rest
2.) Keeps esophagus closed to keep air out then opens to let food in

Question 17

What is the esophageal phase?

Answer 17

Peristaltic wave of mucosa moves food bolus down esophagus to the lower esophageal sphincter and then into the stomach

Question 18

Swallowing is both…

Answer 18

Voluntary and automatic

Question 19

When is swallowing a voluntary act?

Answer 19

During the oral phase

Question 20

When is swallowing an automatic act?

Answer 20

During the pharyngeal/esophageal phases

Question 21

What does the central nervous system consist of?

Answer 21

Brain and spinal cord

Question 22

What does the peripheral nervous consist of?

Answer 22

1.) Sensory nerves
2.) Motor nerves

Question 23

What do sensory nerves consist of?

Answer 23

1.) Afferent/ascending info to CNS
2.) Sensory nuclei

Question 24

What do motor nerves consist of?

Answer 24

1.) Efferent/descending info from CNS
2.) Motor nuclei

Question 25

How do nerve connections pass from the brain to the the body?

Answer 25

Through the brainstem

Question 26

What 3 things does the brainstem consist of?

Answer 26

1.) Midbrain 2.) Pons 3.) Medulla oblongata

Question 27

What is the function of the brainstem?

Answer 27

Regulates heart rate, breathing, sleeping and swallowing

Question 28

Where does the spinal cord extend from?

Answer 28

Medulla oblongata

Question 29

What does the spinal cord do?

Answer 29

Transmits information to and from head to toes via cranial, spinal, and peripheral nerves

Question 30

What are central pattern generators?

Answer 30

Biological neural networks that produce rhythmic outputs in the absence of rhythmic input

Question 31

What do central pattern generators do?

Answer 31

Source of neural activity that drive rhythmic motions like walking, breathing, swallowing, and chewing

Question 32

Where is oral phase pattern-generating neural circuitry found?

Answer 32

1.) Trigeminal nucleus 2.) Reticular formation

Question 33

What does the nucleus tractus solitarius (NTS) do?

Answer 33

Incorporates sensory input from CN V, VII, and XII for the pattern-generating circuitry of both the pharyngeal and esophageal phases of swallowing

Question 34

What is the role of the ventromedial NTS?

Answer 34

Coupling of the pharyngeal phase to the esophageal phase of swallowing

Question 35

What is the role of the nucleus ambiguus and dorsal motor nucleus?

Answer 35

Motor output to CN IX, X, and XI for the pharyngeal and esophageal phases of swallowing

Question 36

Is the trigeminal nerve V a motor or sensory nerve?

Answer 36

Motor

Question 37

What are 6 muscles that the trigeminal nerve innervates?

Answer 37

1.) Masseter 2.) Temporalis 3.) Medial/Lateral Pterygoids 4.) Tensor veli palitini 5.) Mylohyoid 6.) Anterior belly of digastrics

Question 38

Which 3 muscles work together to masticate a bolus, move the mandible from side to side, and elevate/protrude the jaw?

Answer 38

1.) Masseter 2.) Temporalis 3.) Medial/Lateral Pterygoids

Question 39

What do the masseter, temporalis, and medial/lateral pterygoids do? (3)

Answer 39

Work together to... 1.) Masticate a bolud 2.) Move the mandible from side to side 3.) Elevate and protrude the jaw

Question 40

What does the tensor veli palitini do?

Answer 40

Tenses the soft palate prior to its elevation

Question 41

What does the mylohyoid do?

Answer 41

Elevates the hyoid bone, floor of the mouth and tongue

Question 42

What does the anterior belly of digastrics do/

Answer 42

Depresses the mandible, raises and stabilizes the hyoid bone

Question 43

What is the only muscle of the jaw that the trigeminal nerve does not innervate?

Answer 43

Geniohyoid

Question 44

What are 4 things to do during an oral motor exam when examining the motor function of the trigeminal nerve?

Answer 44

1.) Open mouth 2.) Move jaw side to side 3.) Clench teeth 4.) Feel for temporalis and masseter

Question 45

What is done during the oral motor exam when testing for the function of the sensory portion of the trigeminal nerve? (3)

Answer 45

Light touch to face... 1.) Upper and lower face 2.) One side at a time 3.) Both sides at once

Question 46

What 5 anatomical parts make up the facial nerve VII for swallowing?

Answer 46

1.) Muscles of facial expression 2.) Buccinator 3.) Posterior belly of digastrics 4.) Platysma 5.) Stylohyoid

Question 47

What do muscles of facial expression do?

Answer 47

Muscles surrounding the mouth are most important to maintain an adequate labial seal and keep food/liquid in the mouth

Question 48

What does the buccinator do?

Answer 48

Aids mastication by pressing the bolus laterally into the molar teeth

Question 49

What does the posterior belly of digastric do?

Answer 49

Raises and stabilizes the hyoid bone

Question 50

What does platysma do?

Answer 50

Depresses the mandible

Question 51

What does the stylohyoid do?

Answer 51

Elevates the hyoid and retracts the hyoid distally

Question 52

What do you test when doing the facial motor portion of the oral motor exam? (5)

Answer 52

1.) Raise eyebrows 2.) Close eyes tight 3.) Scrunch nose 4.) Smile 5.) Pucker

Question 53

What do you test when doing the facial sensory portion of the oral motor exam?

Answer 53

Trial different taste stimuli

Question 54

What muscle is involved in the glossopharyngeal nerve IX?

Answer 54

Stylopharyngeus

Question 55

What does the stylopharyngeus muscle do?

Answer 55

Elevates the pharynx and larynx

Question 56

What 3 muscles does the Vagus nerve X innervate?

Answer 56

1.) Intrinsic muscles of the larynx 2.) Cricothyroid 3.) Cricopharyngeus

Question 57

What do intrinsic muscles of the larynx do?

Answer 57

Oppose the vocal cords to protect the airway during swallowing

Question 58

What does the cricothyroid do?

Answer 58

Tips the thyroid cartilage anteriorly, helping to protect the airway during swallowing

Question 59

What does the cricopharyngeus do?

Answer 59

Inhibits the reflux of gastric contents

Question 60

What cranial nerves make up the pharyngeal plexus?

Answer 60

Brain CN IX and X

Question 61

What 6 muscles does the pharyngeal plexus innervate?

Answer 61

1.) Levator veli palatini 2.) Palatoglossus 3.) Palatopharyngeus 4.) Musculus uvulae 5.) Superior/Middle/Inferior constrictors 6.) Salpingopharyngeus

Question 62

What does the levator veli palatini do?

Answer 62

Elevates the soft palate

Question 63

What does the palatoglossus do?

Answer 63

Elevates the posterior part of the tongue and draws the soft palate onto the tongue

Question 64

What does the palatopharyngeus do?

Answer 64

Tenses soft palate and pulls pharyngeal walls up

Question 65

What does the musculus uvulae do?

Answer 65

Shortens the uvula, pulling it up superiorly

Question 66

What do the superior/middle/inferior constrictors do?

Answer 66

Constrict the walls of the pharynx

Question 67

What does the salpingopharyngeus do?

Answer 67

Elevates the pharynx and larynx

Question 68

Where does sensation come from in the pharyngeal plexus?

Answer 68

1.) Oropharynx 2.) Laryngopharynx

Question 69

Which 2 CN are usually tested together during the oral motor exam?

Answer 69

Glossopharyngeal Vagus

Question 70

What 3 things are tested during the CN IX and X oral motor exam?

Answer 70

1.) Palatal elevation 2.) Vocal quality 3.) Cough

Question 71

What 5 muscles does the hypoglossal nerve XII innervate?

Answer 71

1.) Intrinsic muscles of the tongue 2.) Genioglossus 3.) Hyoglossus 4.) Styloglossus 5.) Geniohyoid?

Question 72

What do intrinsic muscles of the tongue do?

Answer 72

Change the shape of the tongue to allow bolus movement

Question 73

What does the genioglossus do?

Answer 73

Depresses the tongue and allows protrusion

Question 74

What does the hyoglossus do?

Answer 74

Depresses and retracts the tongue

Question 75

What does the styloglossus do?

Answer 75

Retracts the tongue and also draws up the lateral borders to generate a chute

Question 76

What 3 anatomical features make up the general sensation of the sensory portion of the hyptoglossal nerve?

Answer 76

1.) Nasopharynx 2.) Posterior 1/3 of tongue 3.) Faucial arches

Question 77

What anatomical feature makes up the special sensation of the sensory portion of the hyptoglossal nerve?

Answer 77

Taste; posterior 1/3 of tongue

Question 78

What do you test when doing the hypoglossal sensory portion of the oral motor exam?

Answer 78

1.) Taste to posterior 1/3 of tongue 2.) Touch to faucial arches

Question 79

What do you test when doing the hypoglossal motor portion of the oral motor exam? (5)

Answer 79

1.) Stick tongue straight out 2.) Move tongue side to side 3.) Lick lips 4.) Put tongue in cheek on either side 5.) Subjective/objective strength testing

Question 80

What are the four infrahyoids?

Answer 80

1.) Thyrohyoid 2.) Sternohyoid 3.) Sternothyroid 4.) Omohyoid

Question 81

What do the infrahyoids do?

Answer 81

1.) Depress the hyoid bone after swallowing 2.) May also stabilize the hyoid and elevate the larynx

Question 82

Where is the geniohyoid?

Answer 82

Either CN XII or C1

Question 83

What does the geniohyoid do?

Answer 83

Pulls hyoid anterior and superior, widening pharynx and pulling larynx out of bolus path

Question 84

Where is sensation for the cervical plexus?

Answer 84

To the anterior neck