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7026915
Dysphagia: Normal Swallow
Descrição
Dysphagia Mapa Mental sobre Dysphagia: Normal Swallow, criado por Heather Snaith em 17-11-2016.
Sem etiquetas
dysphagia
Mapa Mental por
Heather Snaith
, atualizado more than 1 year ago
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Criado por
Heather Snaith
mais de 7 anos atrás
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Resumo de Recurso
Dysphagia: Normal Swallow
Many studies which look at swallow breakdown haven't included controls w no dysphagia (Huckabee 2012)
Two types of swallow
Controlled by cortex
Voluntary swallow
Controlled by brainstem
Reflex phases of swallow
Dynamic process requiring intact anatomy and neurology (25 pairs muscles)
Also affected by
Appetite
Food on offer
Sight
Smell
Saliva
Has to be co-ordianted with respiration
Has three, or some say four stages (if you include pre-oral phase) (Huckabee 2008)
1. Oral preparatory
Under volutary control.
Respiration continues
Lips sealed (CNVII): Orbicularis Oris
Food held between tongue and hard palate
Bolus pulled into cohesive formation
LATERAL ROTARY MOVEMENT of mandible (jaw) and tongue muscles of mastication
Velum down approximates with post tongue (Palatoglossus CNX)
Buccal muscles tense, buccinator (CNVII)
MUSC. MASTICATION (CNV)
Masseter
Temporalis
Medial and lat. pterygoids
TONGUE MUSCLES (CNXII) except p'glossus.
Intrinsic - shape and tone
Extrinsic - tongue position
SENSORY FEEDBACK
Anterior Tongue (CNV)
TASTE CNVII ant. 2/3
Posterior Tongue (CNVII)
Part post* (CNIX)
2. Oral phase (Oral cavity to pharynx)
Tongue makes a central groove
Initiates a 'Stripping' action along hard palate
Intra oral pressure increases
Orbicularis Oris & Buccinator remain contracteu
Velum (sof palate) elevates opening pharynx (CNX - levator palatini)
Posterior tongue lowers (CNXII)
Contraction of posterior pharyngeal wall (PPW) (CNX)
Finally, hyoid begins to elevate (Mylohyoid CNV)
3. Pharyngeal stage (Involuntary)
Lasts 1 second - apnoeic period while resp ceases
Swallow OCCURS ON EXPIRATION (mostly)
Respiratory disease may occur on insp.
ELEVATION & RETRACTION of Velum - closes VP port
Tongue BASE RETRACTION to contact PPW
Oropharynx = closed creating pressure to drive bolus
LARYNX RAISES with hyoid bone as attached by THYROHYOID membrane and muslces
ANTERIOR MOVEMENT (see below)
CNXII
CNV
Anterior belly of... (CNV)
ELEVATION
CNVII
Posterior belly of diagastirc (CNVII)
Larynx closes on 3 levels:
1. True VF's (Lat. cricoaryteniod CNX)
2. False VF's
3. Epiglottis
Tongue stabilised by mandibular musc. Mandible CLOSED
Crycoid lamina away ph. wall - opens UES
Spincter most relaxed at point of highest laryn. elevation
Bolus into PE segment
Pharyngeal contractions move bolus from height of glottic opening
4. Oesophageal (8-20 secs)
Gravity & sequential peristaltic wave
Blous down oes. canal to LOWER oes. sphincter
Upper 1/3 Striated, lower 1/3 smooth
We swallow 1-1.5L SALIVA/ day
Anexos de mídia
c1d491e1-8992-4315-a24d-92191da2cbfa (image/jpg)
b6ef2003-58c6-4b60-9dac-930c66868c7c (image/jpg)
addbacdd-5a6f-4736-9a98-ae8567358858 (image/png)
c5fad341-6f07-4bfb-9835-44fdbb7a691b (image/jpg)
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