Bailey And Johnson - Chapter 48

Front 1

What are the six valves that operate during a swallow?

Back 1

1. Lips 2. Tongue 3. Velum to back of tongue (glossopalatal valve) 4. Velopharynx (velum to posterior pharyngeal wall 5. Larynx 6. Upper esophageal sphincter (cricopharyngeus)

Front 2

What prevents food from falling in the the lateral sulci during chewing?

Back 2

Facial tone

Front 3

What is the relationship between food viscosity and bolus size?

Back 3

Thicker the food viscostiy, the smaller the bolus

Front 4

At what point does the pharygeal swallow get triggered?

Back 4

When the bolus passes the faucial arches, back of tongue (the point where the ramus of the mandible crosses the base of tongue)

Front 5

What brainstem nuclei trigger the pharyngeal swallow?

Back 5

Afferent input to the cortex and brainstem swallowing centers (nucleus solitarius and nucleus ambiguus)

Front 6

What muscle pulls the soft palate down to contact the tonuge during food manipulation before the swallow?

Back 6

Palatoglossus

Front 7

What structures contribute to velopharyngeal closure during pharygeal swallow?

Back 7

Velar elevation from the levator veli palatini, Velar retraction from palatopharyngeal muscle ; Anterior movement of the posterior pharyngeal wall (superior pharyngeal constrictor (passavant pad); Medial movment of the lateral pharyngeal walls (superior constrictor), Adenoid pad can contribute

Front 8

At what three levels does the larynx close during a swallow?

Back 8

1. True vocal folds close first 2. False vocal folds then close and the arytenoids tilt anteriorly to contact the base of the epiglottis. 3. Epiglottis folds over the top of the airway

Front 9

What suspends the larynx?

Back 9

Thyrohyoid and ligaments attached to the hyoid bone

Front 10

What suspends the hyoid?

Back 10

Anteriorly by the anterior digastric, mylohyoid, and geniohyoid. Posteriorly by the stylohyoid, posterior belly of the digastric

Front 11

Describe the events of the pharyngeal swallow

Back 11

Hyoid and larynx elevate and move anteriorly - Epiglottis is folded into a horizontal position. Tongue base retraction pushes the tip of the epiglottis in contact with the posterior pharyngeal wall. As the bolus passes the tongue base moves anteriorly, epiglottis elevates and when the tip of the epiglotis is no longer in contact with posterior wall it springs back

Front 12

What is the state of the cricopharyngeal muscle during sleep?

Back 12

relaxed

Front 13

What are the steps in opening of the Upper Esophageal Sphincter?

Back 13

1. Cricopharyngeal muscle relaxes (does not open the sphinter!) 2. Larynx and hyoid move anteriorly and cricoid lamina is jerked anteriorly away from the posterior pharyngeal wall.

Front 14

What are the pressure generators during a swallow?

Back 14

1. Oral tongue 2. Base of tongue 3. Pharyngeal constrictrors

Front 15

What muscle attaches to the eustacian tube and imporant in swallowing?

Back 15

Salpingopharyngeus

Front 16

What muscle attaches to the styloid process and important in swallowing?

Back 16

Sylopharyngeus

Front 17

How does the mandible move during mastication?

Back 17

Lateral rotary motion in coordination with the lateral rolling tongue movements

Front 18

What is the status of the velopharynx and larynx during chewing?

Back 18

Open

Front 19

What does a chin tuck do to the pharynx?

Back 19

Anterior wall of the pharynx (tongue base and epiglottis) is pushed posteriorly

Front 20

What changes in swallowing occur in adults older than 60

Back 20

0.4 increase in the time required to trigger the pharyngeal swallow.