Biomechanical Analysis of Swallowing

incoordination of swallowing leads to

dysphagia

What is the purpose of biomechanical analysis?

to find the cause of certain aspects of swallowing (what caused aspiration? what caused residue?)

VFSS is a _______ and ________ procedure

diagnostic, interventional

structures that are active during the entire oropharyngeal swallow

-mandible

-soft palate

-tongue

-hyolaryngeal complex (hyoid and larynx married)

-UES

what are the anchoring attachments for the tongue?

-mandible (genioglossus)

-hyoid bone (hyoglossus)

-skull base (styloglossus)

the mandible anchors the _____ muscles responsible for HLE

anterior

what are the anterior muscles responsible for HLE?

geniohyoid, mylohyoid, ABD

what two steps help reduce volume for pressure generation?

tongue pumping, mandible elevation

while masticating a solid, a normal variation of swallowing is not having a __________ seal

linguavelar

after a linguavelar seal release, then _______ closure happens

velopharyngeal

the tongue base contacts the (medial/distal) epiglottis

distal

when epiglottic inversion happens, the hyoid moves ___________, suprahyoid muscles _______ which causes hyoid to move _______-_______ direction, and the laryngeal complex _________

anteriorly; contract; anterior-superior; follows

the base of the epiglottis is attached to ______

hyoid

for airway protection, the _______ shortens

thyrohyoid

what are the 3 levels of protection for the airway?

-epiglottic inversion

-closure of true vocal folds

-closure of false vocal folds (ventricular folds)

biomechanics of airway protection

-tongue base contacts distal epiglottis

-elevation and anterior movement of HLE

-epiglottis inverts (hyoid moves anteriorly, suprahyoid muscles contract, laryngeal complex follows)

-hyoid and tongue base push epiglottis

-intrabolus pressure

-thyrohyoid shortens

biomechanics of hyolaryngeal excursion

-hyoid moves, causes chain reaction

-net movement of suprahyoid muscles (contract)

-orients airway away from oncoming bolus

-thyrohyoid contraction

-bring larynx under inverting epiglottis

biomechanics of UES opening

-UES in tonic contraction- always closed

-hyoid bone moves anteriorly

-before food reaches, Vagus nerve sends signal to relax

-cricoid cartilage moves anterior due to HLE, UES opens

-increases volume, creates hypopharyngeal suction pump to suck food into esophagus

The posterior laryngeal wall, which is a part of the _____ cartilage, shares the _______ wall of the UES

cricoid; anterior

What are 3 contributions the HLE makes to the biomechanics of swallowing?

-opening of UES

-epiglottic inversion

-airway protection