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108 Cards in this Set
- Front
- Back
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What do eating and drinking require?
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Coordination of many structures
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What is deglutition?
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1. Placing food or liquid in the oral cavity
2. Moving it backward to the pharynx 3. Propelling it into the esophagus 4. Letting it travel down to the stomach |
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What is the esophagus?
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- 20cm flexible tube of striated and smooth muscle
- Posterior to the trachea - Upper esophageal sphincter (Cricopharyngeus muscle) - Flat - Lower esophageal sphincter (above the stomach) |
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Describe the stomach.
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- Smooth muscle and mucosa
- Holds about 1L food and liquid after a meal - The large intestine absorbs salt and water not absorbed with the nutrients in the small intestine |
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What is the pressure of the oral cavity at rest?
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0 atmospheric
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What is that pressure of the esophagus at rest?
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About 5 cm H2O
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What is the pressure of the stomach at rest?
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5 cm H2O
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What is the air pressure of the esophageal sphincter at rest?
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40 to 80 cm H2O
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What are the passive forces of swallowing?
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Natural recoil
surface tension gravity Aeromechanical factors |
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What are the active forces of swallowing?
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Contraction of muscles of:
Respiration Larynx Pharynx Oral cavity |
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What are the four phases of swallowing?
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1. Oral prep
2. Oral transport 3. Pharyngeal transport 4. Esophageal transport |
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What happens in the oral preparation phase for liquid?
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1. Liquid is placed an oral cavity.
2. Mandible elevates and lips close. 3. Anterior tongue forms of cup for the bolus 4. Back of the tongue contacts the velum 5. Velopharyngeal port is OPEN |
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What happens during the oral preparation phase for food?
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-Mastication - Mandible, teeth, lips, tongue, cheeks grind and manipulate substance into a bolus. (3-20 sec)
-Bolus is positioned on the anterior surface of the tongue -Velum contacts the tongue. -Velopharyngeal port is OPEN |
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What happens during oral transport phase?
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- Bolus moves back towards the pharynx
- Tongue tip elevates and squeezes the bolus - Lips and cheeks compress - Velum elevates (Less than five seconds) |
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What happens during the pharyngeal transport phase?
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- Instinct is triggered when the bolus passes the anterior facial pillars. All under automatic control. (.5 sec)
- Velum elevates until it contacts the pharyngeal walls - Pharyngeal wall constricts - Hyoid bone/larynx move upward and forward - Vocal folds close/epiglottis folds over - Tongue propels bolus into pharynx - Cricopharyngeus relaxes |
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What happens during the esophageal transport face?
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Air pressure lowers below the bolus
Peristaltic action of the esophagus propels bolus Peristalsis = contracted and relaxed (1-2 secs) |
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What are the characteristics of breathing and swallowing?
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Swallowing usually occurs during expiration.
Reduces the risk of aspiration. Larynx closes during swallowing |
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What is the suspension of breathing during swallowing called?
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Apneic intervals (last one second)
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How does neural control differ for speech and swallowing and how is it the same?
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Different – Parts of the central nervous system
Same – peripheral nervous system |
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What role does the cortex play and swallowing?
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Participates in the voluntary phases
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What parts of the cortex participate in swallowing?
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The primary motor cortex
premotor cortex primary sensory cortex |
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What subcortical structures are involved in swallowing?
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Basal ganglia, thalamus, cerebellum
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What does the cerebellum do?
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Coordination
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What does the thalamus do?
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Inner chamber – motor sequencing
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What structures are involved in peripheral innervation for swallowing?
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The larynx
Velopharyngeal port Articulators Upper esophagus Lower esophagus |
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Which cranial nerves innervate the larynx for swallowing?
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CN V, CN VII
CN X, CN XI, CN XII |
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Which cranial nerves innervate the velopharyngeal port for swallowing?
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CN V, CN VII
Plexus CN IX, CN X, CN XI |
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What cranial nerves innervate the articulators for swallowing?
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Jaw, CN V
Lips, cheeks, CN VII Tongue, CN XII |
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What cranial nerves innervate for the upper esophagus, striated muscle?
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CN X
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What cranial nerves innervate for the lower esophagus, smooth muscle?
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Autonomic nervous system
Fibers that travel along with CN X |
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What is somatic mean?
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Voluntary
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What does autonomic mean?
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Automatic
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What are the spinal innervations for swallowing?
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The spinal nerves for breathing and the sensation of apnea during swallowing
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What is the spinal innervation for swallowing?
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C1 - C8
T1 - T12 L1 - L 2 |
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What is the action of swallowing and breathing together?
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Swallow, expired, swallow
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What provides sensory input to the cranial nerves?
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Muscle length, muscle tension
Joint position Surface and deep pressures Surface Deformation Temperature Taste Noxious stimuli |
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What is the term for a brain freeze?
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Sphenopalatineganglioneuralgia
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In the development of swallowing, what anatomical changes occur?
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Tongue size in the oral cavity
Deciduous teeth Descent and growth of the larynx |
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Does swallowing begin before or after birth?
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Before
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What is the suckling pattern for newborns and babies?
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Newborns have a suckling pattern that changes at six months from the mandible to the tongue
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How is swallowing affected by aging?
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Swallowing duration increases
More tongue movement Longer time to open esophageal sphincter Apneic intervals |
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What is the primary result of aging on swallowing?
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More frequent laryngeal penetration
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Are there any sex differences in swallowing?
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No
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What measurements are available to measure swallowing?
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Video fluoroscopy
Endoscopy Ultrasound |
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What elements are involved in a video fluoroscopy?
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Modified barium swallow
With a video x-ray |
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What elements are involved in an endoscopy?
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Flexible endoscope
Can be performed by an SLP No radiation |
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What are the elements of ultrasound and manometry?
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Measures pressure within the pharynx and upper esophageal sphincter
Goes into the nose down through the esophagus to the stomach to measure pressure |
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What are swallowing disorders?
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Dysphasia –
Structural - causes like tumors Neuromuscular diseases - like Parkinson's |
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List the parts of the ear.
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Outer ear, canal, pina, tympanic membrane, malleus, incus, stapes, nerves, cochlea, eustachian tube.
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What is the main function of the external auditory canal?
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Protects the tympanic membrane
Amplifies some sound frequencies Assists in sound localization (Receives disturbances in the air) Sound localization |
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What do the External auditory canal and concha act as?
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A Resonator
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Amplification by the outer ear_______.
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Perceives sounds from 20 to 20,000 Hz
Resonates sound |
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What is the best amount of Hz for the outer ear sensitivity?
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Best sensitivity from 1500 to 7000 Hz
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What is sound localization?
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Determining the direction from which sound comes
Intensity or loudness The time or distance away |
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What types of hearing loss are related to outer your disorders?
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Conductive hearing loss
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What is conductive hearing loss?
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Sounds not transmitted through outer ear to inner ear.
Could be from blockage of the outer or middle ear |
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What are some external ear disorders?
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Atresia (Closure of the opening)
Microtia ( I dwarfed ear or the opening is covered) Anotia (No ear) Cilva (The hairs can be damaged causing ringing in ears) |
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What is the tympanic membrane?
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Coan shaped
Three layers of tissue Eardrum Vibrates back-and-forth at the frequency of soundwaves |
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What are the auditory Eustachian tubes?
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35 to 38 mm
They equalize pressure between the middle ear and extern atmosphere Drainage of normal and disease secretions of the middle ear |
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What are the obstacles?
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The three bones that respond to movement of the tympanic membrane
Deliver sound vibrations to be delivered to fluid 5mm |
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What does the tensor tympani muscle do?
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Draws the malleus medically and anteriorly
Increases tension of the tympanic membrane |
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What is that stapedius muscle?
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Runs in the bony canal in the posterior wall of the middle ear cavity
Draws the head of the stapes back from the oval window |
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How does the stapes attach to the stapedius muscle?
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The stapes tendon
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What cranial nerve innervates that tensor tympani muscle?
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CN V
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What is the function of the middle ear?
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Transforms soundwaves into mechanical vibrations
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What is the process in which sound waves become mechanical vibrations?
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1.Tympanic membrane vibrates
2. Malleus vibrates then incus then stapes 3. Stapes moves in and out of the oval window of the inner ear 4. Fluid at the inner ear vibrates |
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What is the acoustic reflex?
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Limits exposure to high-intensity or low intensity frequency
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What happens when the ear is excited by a loud sound, more than 80 dB?
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The stapedius muscle increases pull on the ossicles Making sound transmissions for the middle year more difficult
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What are some middle your disorders?
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Otis media/middle ear infection
Inflammation Tympanic membrane perforation |
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What is otosclerosis?
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Abnormal growth of the bone on the stapes in the middle ear which prevents ossicles from functioning normally
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What is stapedectomy?
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Prothetic stapes bone
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What are the parts of the inner ear?
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Organs of equilibrium/balance
The organ of hearing |
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What are the organs of equilibrium?
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Vestibular origins
- Semicircular canals - Utricle and saccule |
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What is the organ of hearing?
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Cochlea
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What is the cochlea?
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A bony cavity 35 mm long
Spirals around modiolus |
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What are the three parts of the cochlea?
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Scala vestbuli- Move sound Inward
Scala tympani - Moves fluid outward Scala media/Cochlear duct |
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What does the scala vestbuli do?
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Moves sound inward
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What does the scala tympani do?
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Moves fluid outward
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What kind of fluid is in the cochlear duct/Scala media?
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Endolymph fluid made up of potassium
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What kind of fluid is in the scala vestbuli and the scala tympani?
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Perilymph fluid
Made up of sodium |
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What is the Scala media?
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Spiral tube about 35 mm long filled with endolymph
Separated from SV and ST by membranes |
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What are the two membranes that separate the Scala media from SV and ST?
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Vestibular (Reissor) membrane above
Basilar membrane below |
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Where is the basilar membrane located?
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On top of the Scala tympani
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Where is the Organ of Corti located?
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Inside the scala media
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What are the three elements that make up the Organ Of Corti?
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Tectorial membrane – sounds – nerve impulses
Basilar membrane Hair cells |
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How does movement at the cochlear fluid effect the basilar membrane?
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Movement of the stapes footplate in the oval window causes fluids of the inner ear to move.
Movement of the cochlear fluid causes vibrations on the Basliar membrane |
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The basilar membrane is stiffer and narrower at which end?
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The basal end
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At which end is the Cochlea and the basilar membrane more flexible?
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At the apex
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What is tonotopic organization?
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Locations code for frequencies.
High-frequency are encoded at the base low-frequency's are encoded at the apex |
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At which end are high frequencies encoded?
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At the base
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At which end I low-frequency encode it?
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At the apex.
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What are the two kinds of hair cells in the organ of Corti?
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Inner hair cells arranged in one row - 3500 in each ear
Outer hair cells arranged in 3 to 5 rows - 13,500 in each ear |
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What caps the sensory hairs of the Organ of Corti?
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Stereocilia
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What is the function of the outer hair cells of the organ of Corti?
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Create the active mechanism
Electromotility Amplifies sounds at particular locations along the basliar membrane Improve frequency resolution |
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What are the functions of the inner hair cells of the Organ of Corti?
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Send sound information to the brain
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What are the steps of nerve impulse transmission?
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1. Movement of the cochlear fluid causes the basliar membrane to move
2. Stereocilia of hair cells bend 3. Bending of stereocilia causes nerve impulses to be sent |
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What are the results of hair cell stimulation?
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The inner hair cells send sensory information to the brain
Via the auditory nerve CN VIII (vestibular cochlear nerve) |
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What is the primary auditory cortex?
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Broadman's areas 41 and 42
Wernick's area - Brodmann area 22 |
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Where does the auditory nerve branch out?
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This scala media and this vestibular
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What is the result of damage to the outer hair cells?
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50 to 60 dB hearing loss
Poor frequency resolution poor speech discrimination Hearing aids can be used amplify sound |
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How many decibels is a conversation?
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60 to 65 dB
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How many decibels is a whisper?
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20
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What is the result of damage to the inner hair cells?
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Complete hearing loss.
Can't amplify sounds with hearing. Can use a cochlear implant to stimulate auditory nerve fibers |
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How many individual sounds can be processed per second in the human ear?
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25 to 30.
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What are the challenges of understanding speech?
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Lack of segmentation – connected speech often has very few silences between words
Speech sounds are affected by surrounding sounds like vowels. |
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What are the variations between speakers?
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Vocal tract length and size determined acoustic characteristics
Speakers accents change acoustic characteristics Acoustic characteristics of speech sounds are often affected by the speaking rate and style |
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How is speech information communicated?
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Through acoustics Speech
Visual cues Situational |
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What are two kinds of speech perception experiments?
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McKurk effect
Categorical perception |
