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Adult Dysphagia > Week 2 > Flashcards

Week 2 Flashcards

(68 cards)

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1
Q

What is swallowing

A

highly integrated process of moving food, liquid, saliva through the upper aero digestive tract (500 milliseconds to swallow)

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2
Q

Oral preparatory stage

A

containment and mastication (containing bolus)

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3
Q

Oral Transit stage

A

transit from mouth to oropharynx (back of mouth)

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4
Q

Oral/Pharyngeal (oropharyngeal) stage

A

transit from oropharynx to esophagus
-most complex stage
-pass food from airway to esophagus
-velopharyngeal sphincter needs to be closed and airway

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5
Q

Esophageal stage

A

transit through the esophagus to the stomach

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6
Q

additional stage that has been proposed

A

visual appreciation stimulates saliva production (some ASD or dementia patients don’t appreciate food)

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7
Q

premature spillage

A

when bolus passes through the oropharynx and you are still chewing

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8
Q

what happens to the muscles when elevating mandible

A

muscles are agonists and depressing muscles are antagonists

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9
Q

what happens to the muscles when depressing the mandible

A

muscles are agonists and the elevating muscles are antagonists

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10
Q

muscles included in the oral preparatory stage

A

orbicularis oris, masseter, temporalis, medial pterygoid, lateral pterygoid, buccinator

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11
Q

orbicularis oris

A

innervation: facial
action: closes and opens lips

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12
Q

masseter

A

innervation: trigeminal
action: elevates mandible and retracts the mandible

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13
Q

temporalis

A

innervation: trigeminal
action: elevates mandible (closing mouth)

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14
Q

medial pterygoid

A

innervation: trigeminal
action: elevates mandible

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15
Q

lateral pterygoid

A

innervation: trigeminal
action: depressor of mandible (open mouth); protrudes mandible; permits side to side movement of mandible

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16
Q

buccinator

A

innervation: facial
action: flattens cheek; holds food in contact with teeth; retracts angles of the mouth

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17
Q

muscles of oral/pharyngeal stage

A

levator veli palatini, tensor veli palatini, palatoglossus, palatopharyngeus, uvulae, mylohyoid, digastric (anterior belly), geniohyoid, stylohyoid, hyoglossus, genioglossus, styloglossus, palatoglossus

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18
Q

levator veli palatini

A

innervation: vagus and accessory (two slings below soft palate)
action: raises soft palate

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19
Q

tensor veli palatini

A

innervation: trigeminal (making balance between pressure inside middle air and outside atmosphere)
action: stretches soft palate and not highly involved in swallowing

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20
Q

palatoglossus

A

innervation: vagus and accessory
action: raises back of the tongue during the first stage of swallowing
-soft palate depressor and this is important to raise the posterior tongue to keep food in oral cavity

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21
Q

palatopharyngeus

A

innervation: vagus and accessory
action: shuts off nasopharynx during second part of swallowing (shortening pharynx and squeezing it)

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22
Q

uvulae

A

innervation: vagus and accessory
action: shortens and raises uvula

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23
Q

mylohyoid

A

innervation: trigeminal
action: elevates tongue and floor of mouth; depresses jaw when hyoid bone is fixed

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24
Q

digastric anterior belly

A

innervation: trigeminal
action: raises hyoid bone if jaw is in fixed position; depresses jaw when hyoid bone is fixed

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25
geniohyoid
innervation: C1 and C2 via hyoglossus action: draws hyoid bone forward; depresses mandible when hyoid bone is in fixed position
26
stylohyoid
innervation: facial action: elevates hyoid and tongue base during swallowing
27
hyoglossus
innervation: hypoglossal (facilitates bolus transfer) action: gibers inserted into mandible and depresses the tongue
28
genioglossus
innervation: hypoglossal action: protrusion and depression of the tongue
29
styloglossus
innervation: hypoglossal action: elevates up and back of tongue
30
palatoglossus
innervation: glossopharyngeal, vagus, and accessory action: narrows faces and elevates posterior tongue
31
intrinsic lingual muscles
insertion/origin: inside tongue -change the shape of the tongue -superior, inferior, longitudinal, transverse, vertical
32
superior and inferior longitudinal muscles
superior: in tongue and elevates the tip inferior: muscle for tongue top depressor
33
transverse muscle
narrows tongue
34
vertical muscles
flattens tongue
35
extrinsic lingual muscles
move the body of the tongue origin: somewhere outside the lingual muscles
36
pharyngeal muscles
pharyngeal constrictors (intrinsic) palatopharyngeus, stylopharyngeus, salpingopharyngeus, cricopharyngeus (extrinsic)
37
pharyngeal constrictors
innervation: vagus and accessory action: constrict the pharynx
38
palatopharyngeus
shortens the pharynx action: draws the pharynx up and draws the velum down
39
stylopharyngeus
innervation: glossopharyngeus action: elevates the pharynx
40
salpingopharyngeus
innervation: accessory nerve and pharyngeal plexus action: draws the lateral walls of the pharynx up, balance air pressure of Eustachian tube and relaxes the pharynx
41
cricopharyngeus
innervation: vagus action: acts as a sphincter, relaxing during passage of the bolus from the pharynx into the esophagus -constriction is causing the upper part of the esophagus to be closed and relaxes during swallowing -if open all the time, it could cause the food from the stoma to come up and cause acid reflux
42
ventral surface of the tongue
underneath part
43
what is the only part of the pharynx that is visible during an oral mech
oropharynx
44
hyoid and laryngeal elevation is supported by what
FOM muscles (flow of mouth) and attached to the hyoid
45
hyoid and laryngeal depressors after the swallow are likely
passive
46
hyoid and laryngeal depressors more likely act as what to the muscles used in elevation
antagonists (sternohyoid, sternothryoid, omohyoid)
47
during swallowing, what happens to the esophageal lumen
it is collapsed
48
proximal esophageal muscle
upper 4th 1/3 striated and innervated by RLN and sympathetic plexus (autonomic input)
49
distal esophageal muscle
smooth and enervated by autonomic input -inner (circular fibers) -outer (longitudinal fibers)
50
course of the esophagus
-esophagus runs lateral +posterior to left ventricle of the heart -after esophagus passes the diaphragmatic hiatus, it connects to the body of the stomach at the level of the LAS
51
why is the bend important in the esophagus
if a person is dealing with enlarged heart muscles, the heart may press the esophagus and make it harder for food to pass
52
epiglottis
flexible cartilage covering airway during swallowing
53
what triggers the swallow reflex
the food accumulates in the the vallecula area and then when it gets large enough the reflex is triggered
54
what happens when the material passes the epiglottis level
aspiration
55
what happens when the material enters the airway through the vocal cords
penetration
56
swallowing is controlled by
peripheral and central nervous system
57
what are the layers of protection during swallowing action
-epiglottis bends over airway -vocal cords must be abducted during swallowing -coughing mechanism
58
what is medullary control known as
swallowing pattern generator
59
multimodal sensory impulses are sent to what
nucleus tractus solitarius (NTS) to initiate the pharyngeal swallow
60
what is the motor function mediated by during medullary control
nucleus ambiguous (NA) via multiple cranial nerves
61
dysphagia in the brainstem lesion area is characterized by
incoordination between stages and between swallowing and respiration- damage to swallowing center -muscular weakness- damage to corticobulbar system -results in an incomplete swallow (significant residue)
62
supra nuclear controls
higher control centers involved in continuing, modifying, and monitoring swallowing and responding to input variability
63
examples of higher control centers
feedback loops continuing the repetitive chewing behavior -volitional modification (taking pills, feeding rate, expectorating unwanted bolus) -responding to different sensory stimuli
64
which muscle lowers the mandible
lateral pterygoid
65
contraction of which muscle elevates the hyoid
mylohyoid
66
the cricopharynxgeus muscle contracts during pharyngeal stage
false
67
this muscle holds food in contact with molars during chewing
buccinator
68
nucleus tractus solitaries receives sensory information in medulla
false

Adult Dysphagia (4 decks)

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