Podcast
Questions and Answers
All cranial nerves that contribute to swallowing exit through the ______ ______.
All cranial nerves that contribute to swallowing exit through the ______ ______.
nucleus ambiguus
All sensory information that contributes to swallowing goes through ______ ______ ______ (NTS).
All sensory information that contributes to swallowing goes through ______ ______ ______ (NTS).
nucleus tractus solitarius
The construct involving the nucleus ambiguus and nucleus tractus solitarius working together to produce a swallow is called a ______ ______ ______.
The construct involving the nucleus ambiguus and nucleus tractus solitarius working together to produce a swallow is called a ______ ______ ______.
central pattern generator
When a bolus is presented, the sensory information from seeing and smelling the bolus enters through the receptors and transfers to the ______ ______.
When a bolus is presented, the sensory information from seeing and smelling the bolus enters through the receptors and transfers to the ______ ______.
From the association cortices, information about the bolus travels to the ______ ______, which processes emotional responses, linking to the hippocampus to form perceived flavor.
From the association cortices, information about the bolus travels to the ______ ______, which processes emotional responses, linking to the hippocampus to form perceived flavor.
After swirling through the limbic system, bolus information proceeds to the ______ ______, enabling a conscious decision about whether to consume something or not.
After swirling through the limbic system, bolus information proceeds to the ______ ______, enabling a conscious decision about whether to consume something or not.
The primitive response of swallowing spit is adapted to meet an oncoming bolus through information sent to ______, where a motor plan is formulated.
The primitive response of swallowing spit is adapted to meet an oncoming bolus through information sent to ______, where a motor plan is formulated.
Activation of cranial nerves 1 and 2 occurs as food gets closer. These cranial nerves are the ______ and ______ nerves.
Activation of cranial nerves 1 and 2 occurs as food gets closer. These cranial nerves are the ______ and ______ nerves.
As food sits in front of us, two physiological responses occur: increased ______ ______ and ______ ______ closure occur.
As food sits in front of us, two physiological responses occur: increased ______ ______ and ______ ______ closure occur.
Salivary flow is facilitated by three glands: the sublingual, submandibular, and ______ glands.
Salivary flow is facilitated by three glands: the sublingual, submandibular, and ______ glands.
Vocal fold adduction, which protects the airway during swallowing, is primarily controlled by the ______ nerve, specifically CN 10.
Vocal fold adduction, which protects the airway during swallowing, is primarily controlled by the ______ nerve, specifically CN 10.
To allow food into the oral cavity, tone needs to decrease in the jaw closers and what muscle?
To allow food into the oral cavity, tone needs to decrease in the jaw closers and what muscle?
Three muscles that open the jaw are the geniohyoid, innervated by ansa cervicalis, and the anterior belly of the digastric and ______, both innervated by the trigeminal nerve.
Three muscles that open the jaw are the geniohyoid, innervated by ansa cervicalis, and the anterior belly of the digastric and ______, both innervated by the trigeminal nerve.
The first airway protection technique as food approaches in ______ ______ approximation, which is mainly facilitated by the palatoglossus muscle.
The first airway protection technique as food approaches in ______ ______ approximation, which is mainly facilitated by the palatoglossus muscle.
The palatoglossus is assisted by the stylohyoid and posterior belly of the digastric, both innervated by the ______ nerve, to pull the tongue up and back.
The palatoglossus is assisted by the stylohyoid and posterior belly of the digastric, both innervated by the ______ nerve, to pull the tongue up and back.
Once the bolus is in the oral cavity, if it’s solid, chewing involves an organized response between the jaw closers like temporalis, masseter, and pterygoids and the jaw openers anterior belly, ______, and geniohyoid.
Once the bolus is in the oral cavity, if it’s solid, chewing involves an organized response between the jaw closers like temporalis, masseter, and pterygoids and the jaw openers anterior belly, ______, and geniohyoid.
The jaw closing muscles (temporalis, masseter, and pterygoids) are innervated by the ______ nerve (CN 5).
The jaw closing muscles (temporalis, masseter, and pterygoids) are innervated by the ______ nerve (CN 5).
The top of the mouth is innervated for touch and taste by what branch of the trigeminal nerve?
The top of the mouth is innervated for touch and taste by what branch of the trigeminal nerve?
During chewing, the base of the tongue is typically ______ than the tongue tip to keep the bolus positioned anteriorly.
During chewing, the base of the tongue is typically ______ than the tongue tip to keep the bolus positioned anteriorly.
The muscles that actively contract to pull the back of the tongue down and forward, facilitating bolus transfer, are the hyoglossus and ______, both innervated by the hypoglossal nerve.
The muscles that actively contract to pull the back of the tongue down and forward, facilitating bolus transfer, are the hyoglossus and ______, both innervated by the hypoglossal nerve.
The very first movement that happens when the pharyngeal response is elicited is what?
The very first movement that happens when the pharyngeal response is elicited is what?
Superior hyoid movement during initiation of the pharyngeal phase of swallowing is due to the stylohyoid and the posterior belly, those two little buddies that ate CN ______.
Superior hyoid movement during initiation of the pharyngeal phase of swallowing is due to the stylohyoid and the posterior belly, those two little buddies that ate CN ______.
The anterior movement of the hyoid provides traction to the ______, which in turn pulls the UES open.
The anterior movement of the hyoid provides traction to the ______, which in turn pulls the UES open.
Two muscles that shorten, are good mates and innervated by the facial nerve during swallowing are ______ and ______
Two muscles that shorten, are good mates and innervated by the facial nerve during swallowing are ______ and ______
Sequential contraction of the superior, middle, and inferior ______ ______, all innervated by the pharyngeal plexus, helps squeeze the bolus from top to bottom.
Sequential contraction of the superior, middle, and inferior ______ ______, all innervated by the pharyngeal plexus, helps squeeze the bolus from top to bottom.
The ______ nerve innervates the stylopharyngeus.
The ______ nerve innervates the stylopharyngeus.
The sensory perception, the top of the mouth is innervated for touch and taste by what? The ______ branch of the trigeminal nerve.
The sensory perception, the top of the mouth is innervated for touch and taste by what? The ______ branch of the trigeminal nerve.
Now the tongue tip, with the intrinsic tongue muscles goes up to the alveolar ridge and compresses against the ______.
Now the tongue tip, with the intrinsic tongue muscles goes up to the alveolar ridge and compresses against the ______.
The ______ ______ movement causes the epiglottis to tilt
The ______ ______ movement causes the epiglottis to tilt
When swallowing, we need to ______ the pharyngeal lumen and squeeze the bolus from top to bottom.
When swallowing, we need to ______ the pharyngeal lumen and squeeze the bolus from top to bottom.
During swallowing, the ______ then, as it goes up and forward, pulls the UES open.
During swallowing, the ______ then, as it goes up and forward, pulls the UES open.
If we want the tongue to go up, what is above the togue? ______ and that is innervated by the pharyngeal plexus.
If we want the tongue to go up, what is above the togue? ______ and that is innervated by the pharyngeal plexus.
If we want the tongue to move forward we contract the ______.
If we want the tongue to move forward we contract the ______.
We also need the vocal folds to ______
We also need the vocal folds to ______
At rest we have tone in the ______ and the jaw closers.
At rest we have tone in the ______ and the jaw closers.
Flashcards
Nucleus Ambiguus
Nucleus Ambiguus
Motor nuclei for swallowing; all cranial nerves contribute to swallowing.
Nucleus Tractus Solitarius (NTS)
Nucleus Tractus Solitarius (NTS)
Sensory nucleus; all sensory swallowing info goes through it.
Central Pattern Generator
Central Pattern Generator
NTS and Nucleus Ambiguus work together to produce a swallow.
CN 1 & 2 Activation
CN 1 & 2 Activation
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Association Cortices Role
Association Cortices Role
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Limbic System Role
Limbic System Role
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Frontal Lobe Role
Frontal Lobe Role
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NTS Motor Plan
NTS Motor Plan
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NTS Sends Info
NTS Sends Info
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Two things when food is presented
Two things when food is presented
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Salivary Glands
Salivary Glands
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Salivary Gland Innervation
Salivary Gland Innervation
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Vocal Fold Adduction Nerve
Vocal Fold Adduction Nerve
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Jaw Closer Muscles
Jaw Closer Muscles
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Jaw Closer Innervation
Jaw Closer Innervation
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Lip Closure Muscle
Lip Closure Muscle
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Orbicularis Oris Innervation
Orbicularis Oris Innervation
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Jaw Opening Muscles
Jaw Opening Muscles
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Glossopalatal Approximation
Glossopalatal Approximation
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Helper Muscles for Glossopalatal Approximation
Helper Muscles for Glossopalatal Approximation
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Intrinsic Tongue Muscle Innervation
Intrinsic Tongue Muscle Innervation
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Chewing
Chewing
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Bolus Manipulation
Bolus Manipulation
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Tongue Forward Movement
Tongue Forward Movement
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Tongue Depression
Tongue Depression
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Tongue Elevation
Tongue Elevation
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Tongue Up & Back
Tongue Up & Back
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Tongue Straight-Back
Tongue Straight-Back
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Sensory Perception- Top of Mouth
Sensory Perception- Top of Mouth
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Tongue Sensory Nerves
Tongue Sensory Nerves
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Tongue Position While Chewing
Tongue Position While Chewing
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Transfer bolus to pharynx
Transfer bolus to pharynx
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Muscles that pull back down forward
Muscles that pull back down forward
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Hyolaryngeal Excursion
Hyolaryngeal Excursion
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Superior hyoid movement
Superior hyoid movement
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Study Notes
- The nucleus ambiguus serves as the motor nuclei for swallowing, with all cranial nerves involved in swallowing exiting through it.
- The nucleus tractus solitarius (NTS) is the sensory nucleus, receiving all sensory information related to swallowing.
- Sensory information passes through the NTS and then transfers to the nucleus ambiguus for motor output, forming a central pattern generator.
- This central pattern generator, comprised of these nuclei, produces swallows unconsciously or consciously.
- When a bolus is presented, cranial nerves 1 (olfactory) and 2 (optic) are activated.
- Sensory information from seeing and smelling the bolus goes to the cell bodies in the eyeball and cribriform plate, then transfers to the association cortices.
- The association cortices process the sensory information and pass it to the limbic system for an emotive response, linking with the hippocampus to process smell and flavor.
- The limbic system sends information to the frontal lobe for a conscious response.
- The NTS receives this information and develops a motor plan, adapting the swallow response to the bolus.
- When the sensory information reaches a threshold, an action potential is triggered, eliciting a swallowing response.
- As food approaches, cranial nerves 1 and 2 are activated
- Salivary flow and vocal fold closure occur as food gets closer
Salivary Flow
- Salivary flow involves the sublingual, submandibular (CN 7), and parotid glands (CN 9).
- Submandibular and sublingual glands are innervated by the facial nerve (CN 7).
- The parotid gland is innervated by the glossopharyngeal nerve (CN 9).
Vocal Fold Closure
- Vocal fold adduction occurs via the vagus nerve (CN 10).
Oral Cavity Preparation
- At rest, the lips and jaw closers have tone that must decrease
- Jaw closers (temporalis, masseter, pterygoids - CN 5) reduce tone.
- Orbicularis oris (CN 7) also decreases tone.
- Jaw openers include geniohyoid (ansa cervicalis), anterior belly of digastric and mylohyoid (CN 5).
- As food approaches, glossopalatal approximation occurs via the palatoglossus muscle (pharyngeal plexus).
- The stylohyoid and posterior belly of the digastric (CN 7) assist in pulling the tongue up and back.
- Intrinsic tongue muscles (CN 12) groove the tongue to create a cup for the bolus.
- The jaw closes via the temporalis and masseter muscles (CN 5).
- Orbicularis oris (CN 7) contracts to keep food in the mouth.
Chewing
- Chewing involves coordinated action of jaw closers (temporalis, masseter, pterygoids - CN 5) and jaw openers (anterior belly of digastric, mylohyoid - CN 5; geniohyoid - ansa cervicalis).
- Intrinsic and extrinsic tongue muscles move the bolus around the oral cavity.
- Genioglossus (CN 12) moves the tongue forward.
- Hyoglossus (CN 12) drops the back of the tongue down.
- Palatoglossus (pharyngeal plexus) elevates the tongue.
- Styloglossus (CN 12) moves the base of the tongue up and back.
- The tongue moves straight back via Glossopharyngeus (pharyngeal plexus).
- Sensory perception on the top of the mouth for touch and taste is innervated by the maxillary branch of trigeminal nerve (CN 5).
- Sensory input from the tongue, working back is innervated, for touch, by CN 5, 7, 9 For taste the tongue is innervated by CN 7 and 9
- During chewing, the base of the tongue remains higher than the tip to keep the bolus anteriorly.
Bolus Transfer to Pharynx
- To transfer the bolus, the palatoglossus, stylohyoid, and posterior belly muscles relax so the tongue can drop.
- The hyoglossus and genioglossus (CN 12) actively contract to pull the back of the tongue down and forward.
- The tongue tip elevates to the alveolar ridge, compressing against the palate, squeezing the bolus past the lowered base of the tongue.
- Sensory information floods the NTS until an action potential is triggered, ideally near the faucial arches.
Pharyngeal Response
- The first movement is hyolaryngeal excursion.
- Superior movement results form the stylohyoid and the posterior belly (CN 7).
- The middle pharyngeal constrictor grabs the hyoid and pulls it up and back.
- The thyrohyoid pulls the thyroid cartilage upward for airway protection.
- Anterior movement results form anterior belly of digastric, mylohyoid (CN 5) and geniohyoid (AC).
Biomechanical Consequences of Hyoid Excursion
- As the bolus descends to the vallecula, hyoid elevation and anterior movement cause epiglottic tilt and fold.
- The bolus splits and travels down lateral channels between the pharyngeal wall and aryepiglottic folds, avoiding the laryngeal vestibule.
- Anterior hyoid movement provides traction to the thyroid, pulling the cricoid and opening the UES.
Shortening the Pharynx
- During swallowing, the pharyngeal lumen decreases and squeezes the bolus.
- The pharynx shortens via the stylohyoid and posterior belly (CN 7), stylopharyngeus (CN 9), styloglossus (CN 12,) and glossopharyngeus (pharyngeal plexus).
- Sequential contraction of the superior, middle, and inferior pharyngeal constrictors (pharyngeal plexus) occurs.
- The constrictors are big muscles and will pull up but also will pull back.
- Additional muscles that facilitate shortening of the pharynx include the palatopharyngeus and salpingopharyngeus which embed in the pharyngeal wall and pull it up.
- Muscles ending in "pharyngeus" embed in the pharyngeal wall.
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