6th Swallowing PDF

SWALLOWING MASTICATION SPEECH Mohanad A. Al - Bayyati  Swallowing Swallowing is essential, not only for food ingestion, but also for Fluid contact on the protecting the...

SWALLOWING MASTICATION SPEECH Mohanad A. Al - Bayyati  Swallowing Swallowing is essential, not only for food ingestion, but also for Fluid contact on the protecting the airway, by clearing laryngeal mucosa is an away fluids such as saliva and effective stimulation as is nasal secretions, and preventing mechanical stimulation of them entering the larynx the tonsillar pillars and the posterior pharyngeal wall Swallowing is under voluntary control although it appears that some supportive sensations from the mucosa are needed  About 500 Day swallowing Time events Dryness of the oral cavity or local anesthesia may Swallowin make voluntary swallowing difficult g Incidence About 50 Night events during Time sleep  Swallowing Sequence B D Oral Phase Pharyngeal Phase Esophageal Phase  Oral Phase During the The This These oral phase, purpose of The To ensure the movement muscles bolus or fluid the tongue this circumoral is achieved directed does not enter forms a activity is muscles with the against the the nose, the soft lubricated to reduce contract, palate is lifted help of the palate by bolus and the oral helping to against the intrinsic the pushes it volume reduce the posterior and contraction upward and and oral volume pharyngeal wall, extrinsic of the jaw and the backward squeeze muscles of closing velopharyngeal toward the the food the tongue muscles sphincter is pharynx. backward closed  Pharyngeal Phase The response of the pharyngeal muscles is to begin a series of contractions starting at the velopharyngeal sphincter, which pass down in a ripple toward the esophagus. The elevation of the larynx helps the epiglottis to tip over to protect the airway. During this short period, breathing is stopped (apnea). The bolus enters the esophagus as the sphincter relaxes. The bolus is carried by peristalsis to the relaxed gastroesophageal sphincter and into the stomach The process is assisted by gravity. This sphincter is normally closed to prevent regurgitation from the stomach. Esophageal Phase  Summary of swallowing Cycle Bolus formed & Upper esophageal sphincter pushed toward relaxed allowing the bolus to pharynx enter esophagus Bolus continue moving downward to 01 03 05 stomach by peristalsis Soft palate moved 02 04 backward closing nasal passageway , larynx elevated & epiglottis flip down Up. Esophageal sphincter closing pharyngeal air contract again preventing way bolus from moving back toward throat  Tensor veli palatini (TVP) , Muscles Of Swallowing Levator veli palatini (LVP) ,Palatopharyngeous (PPh) Hyoglossus , Salpingopharyngeous Geniohyoid (SaPh), Stylopharyngeus (SPh) & Genioglossus Soft Intrinsic laryngeal Styloglossus Tongue palate & muscles (IL) Muscles Pharynx Upper Masticatory Neck Esophageal Muscles Muscles Sphinictor Extrinsic & Mylohyoid Intrinsic Masseter Muscles Anterior belly of digastric (ABD) Temporalis Posterior belly of digastric (PBD) Medial and lateral pterygoid muscles Neurological Control Of 6 cranial nerves Swallowing involved in voluntary & involuntary Facial Nerve CN VII movements Glossopharyn geal nerve CN Accessory IX nerve CN XI Trigeminal nerve ” CN V“ Vagus nerve Hypoglossal CN X nerve CN XII  Sound The development of normal speech in the Hearing child requires the adequate maturation of Deaf children need intensive the following factors : speech therapy. They have to be taught to copy their Muscle control teachers’ example as they Children who lack cannot correct and control muscle coordination their own sounds. may slur words and are unable to sing. Oral nasal seal The speech of children with an unrepaired cleft palate Emotional stability has a nasal sound as these Autistic children may be children are unable to build withdrawn and do not wish to up air pressure inside the communicate. A severe shock mouth. may leave you “speechless.”  As the cords are tightened, the vibrations have a higher Phonation is the production of frequency and the sound sounds by vibration of the air gets higher The vocal cords are passing through the vocal cords tightened by activity of the laryngeal muscles. Phonation and Articulation Articulation is the modification of the sound as it passes PHONATION & ARTICULATION from the larynx through the velopharyngeal valve and the oral cavity STRATEGY - The velopharyngeal valve is closed for most speech sounds except vowels and the nasal The velopharyngeal valve is closed for consonants “M, N, NG.” In individuals with an most speech sounds except vowels and unrepaired cleft palate, this valve is unable to close. the nasal consonants “M, N, NG.” In individuals with an unrepaired cleft palate, this valve is unable to close. - The velopharyngeal valve separates the nasal and oral cavities and is formed by the apposition of the soft palate against the posterior pharyngeal wall. It is usually open during vowels and some consonants like “M,” “N,” “NG” but closed during the remaining consonants.” P, B T,D K, G F S Th M  Speech Defects Lisp is caused by an inability to retract the tongue behind the Loss of the vocal cords may occur due to cancer front teeth when making an “S” surgery sound. The sound produced is “Th” such as “thixty thix.” Loss of mobility of the tongue. The loss of velopharyngeal This may be the result of surgery competence causes alteration of for tongue cancer, motor nerve plosive sounds which become nasal damage which occurs during a and breathless speech. This is usually stroke or too much alcohol or the result of a cleft palate which has drugs only been partially repaired  Mastication Normal The forces developed on a molar tooth during normal mastication - are between 5 and 10 kg Hard Masticatory Biting hard would generate from 20 to 200 kg - Forces Periodontium Loss of periodontal support and sensation decreases the ability to- bite hard  Masticatory Forces If this maldistribution of load is frequent and of long The biting force is duration, damage to the greatest at the molars periodontium may occur, and least on the and the tooth may become incisors abnormally mobile If the force is applied apically (toward the apex of the root), the entire periodontal Tooth support for the ligament and bone socket contribute to the forces generated by support. If the force is applied at an angle to the root, then the area of ligament providing chewing comes from support is reduced, and it is consequently under greater compression or tension the periodontium OCCLUSION The way the teeth meet during function is called occlusion When contouring the occlusal surfaces of a restoration, we try to ensure that forces on the tooth during mastication will be mostly apically directed JAW MOVEMENT Type of food A Jaw State of bolus Intra-individual movement variation B chewing side used Lorem Ipsum is simply dummy text of the printing and typesetting Inter-Individual.. Jaw Movement There is a wide Computer Impossible analysis of jaw range of jaw movements which to define a movements is occur during normal essential to filter normal mastication movement unusual movement  Opening 01 Each masticatory cycle phase lasts 0.5 to 1.2 seconds Masticatory Cycle Closing The closing phase is phase usually the fastest A typical cycle has been said to resemble a teardrop, the 03 Contact width depending on the phase texture of the food  Food-Dependent Chewing Chopping Stroke for Carrots Grinding for Tough Meat Hard food like raw carrots Tough meats require more requires a chopping stroke to lateral grinding of the teeth chew. during chewing.  Superior & Inferior heads Muscles of Mastication Act on Lateral movements of mandible Deep & Superficial Vertical & Horizontal heads fibers Act on elevation of Act on elevation of Mandible “ closing the mouth “ Lateral Mandible “ closing the mouth “ & Pterygoid Deep & Superficial parts retraction of Medial 4 Most powerful one mandible Act on elevation of Pterygoid Mandible “ closing 3 the mouth “ Temporalis 2 Masseter 1 Nerve All of them innervated by Mandibular Supply nerve ” branch of trigeminal nerve “ The muscles on the side on which food is being Ipsi chewed are called the ipsilateral muscles lateral Contra The muscles on the nonchewing side are lateral called the contralateral muscles. The timing of contractions of ipsilateral and contralateral muscles allows smooth and fast opening followed by powerful grinding movement through the area of maximum tooth contact The muscles which close When muscles fail to relax, coordination is the jaw, the adductors, disturbed, the muscles may even act stop closing after the againstYour eachTextother. Here For example, closing teeth have penetrated the musclesA wonderful may failserenity to relax at the right time has taken possession bolus. They then allow to allow opening muscles to be active. This lack of coordination causes muscle the opening muscles stiffness and fatigue (abductors) to open the jaw without resistance Your Text Here Mastication requires the accurate application of forces which bring the teeth together in crushing and grinding movements THANK YOU