SHS 300 - Velopharyngeal-Nasal System

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parietal bone (lateral view)

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frontal bone (lateral view)

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temporal bone (lateral view)

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occipital bone (lateral view)

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zygomatic process (lateral view)

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mastoid process (lateral view)

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styloid process (lateral view)

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sphenoid bone (lateral view)

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ethmoid bone (lateral view)

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frontal bone (anterior view)

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parietal bone (anterior view)

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temporal bone (anterior view)

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maxilla/maxillary bone (anterior view)

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mandible (anterior view)

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nasal bone (anterior view)

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ethmoid bone (anterior view)

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inferior nasal concha (anterior view)

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vomer bone (anterior view)

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lacrimal bone (anterior view)

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sphenoid bone (anterior view)

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zygomatic bone (anterior view)

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zygomatic process of the temporal bone

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styloid process of the temporal bone

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mastoid process of the temporal bone

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tympanic process of the temporal bone

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corpus/body of the mandible (lateral view)

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ramus of the mandible (lateral view)

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angle of the mandible (lateral view)

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mental symphysis of the mandible (lateral view)

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coronoid process of the mandible (lateral view)

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condylar process of the mandible (lateral view)

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ramus of the mandible (anterior view)

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corpus/body of the mandible (anterior view)

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mental symphysis of the mandible (anterior view)

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angle of the mandible (anterior view)

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coronoid process of the mandible (anterior view)

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condylar process of the mandible (anterior view)

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frontal process of the zygomatic bone

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maxillary process of the zygomatic bone

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temporal process of the zygomatic bone

bones that form the hard palate

palatine process of the maxillary bone and horizontal plate of the palatine bone

label yellow

palatine process of the maxillary bone (sagittal plane)

label pink

horizontal plate of the palatine bone (sagittal plane)

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palatine process of the maxillary bone (transverse plane)

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horizontal plate of the palatine bone (transverse plane)

label black circle

alveolar ridge (transverse plane)

bones that form the nasal skeleton (5 in total)

nasal bone

inferior nasal conchae

middle and superior nasal conchae of the ethmoid bone

lacrimal bone

maxillary bone

bones that form the nasal septum

vomer bone

perpendicular plates of the ethmoid bone

label blue (and its 4 boundaries)

nasopharynx

anterior boundary - nasal choanae

posterior boundary - posterior pharyngeal wall

superior boundary - cranium

inferior boundary - velum

label green (and its 4 boundaries)

oropharynx

anterior boundary - oral cavity

posterior boundary - posterior pharyngeal wall

superior boundary - velum

inferior boundary - hyoid bone and anterior epiglottis

label yellow (and its 4 boundaries)

hypopharynx (laryngopharynx)

anterior boundary - base of tongue and laryngeal aditus 

posterior boundary - posterior pharyngeal wall

superior boundary - hyoid bone and anterior epiglottis

inferior boundary - cricoid cartilage (esophagus)

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posterior pharyngeal wall

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palatine tonsils

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anterior faucial pillar

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posterior faucial pillar

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soft palate

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uvula

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nares (nostril)

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nasal vestibule

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inferior conchae (turbinates)

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middle conchae (turbinates)

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superior conchae (turbinates)

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frontal and sphenoid sinuses

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meatuses

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choana

4 paranasal sinuses and their functions

maxillary, frontal, ethmoid, and sphenoid sinuses

function: contain cells that produce muscus; also warm up and humidify incoming air

structures forming the velum

soft palate and the uvula

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palatopharyngeus (figure 1)

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salpingopharyngeus

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superior pharyngeal constrictor

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inferior pharyngeal constrictor

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middle pharyngeal constrictor

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stylopharyngeus

cricopharyngeus - motor innervation and function

motor innervation: CNX

function: allows food/liquid to pass into the esophagus by relaxing and opening when swallowing (otherwise, it is contracted and closed)

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tensor veli palatini

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levator veli palatini

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palatoglossus

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palatopharyngeus (figure 2)

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musculus uvulae

muscles of the outer nose - motor innervation and functions

motor innervation: CNVII

functions: dilate (open) or compress (constrict) the nares

superior pharyngeal constrictor - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function:

• uppermost fibers - assist with velopharyngeal closure (close the communication point between the pharynx and the nasal cavity)

• other fibers - move the posterior wall of the larynx forward and narrow the diameter of the pharynx (constrict the pharynx)

middle pharyngeal constrictor - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: move the posterior wall of the pharynx forward and narrow the diameter of the pharynx (constrict the pharynx)

for learn: middle PE

inferior pharyngeal constrictor - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: move the posterior wall of the pharynx forward and narrow the diameter of the pharynx (constrict the pharynx)

for learn: inferior PE

salpingopharyngeus - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: move the lateral walls of the pharynx upward and inward (shorten and elevate the pharynx)

• secondary: equalizes ear pressure in the middle ear due to its connections with the eustachian tubes

palatopharyngeus - motor innervation and PHARYNGEAL function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: move the lateral walls of the pharynx upward and inward (shorten and elevate the pharynx)

stylopharyngeus - motor innervation and function

motor innervation: CN IX

function: elevates the pharynx and (indirectly) the larynx; dilates (widens) the pharynx

levator veli palatini - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: elevate and retract the velum to close the velopharyngeal sphincter/port

tensor veli palatini - motor innervation and function

motor innervation: CNV

function: dilates the eustachian tubes to allow aeration of the middle ear

• secondary: may assist with tensing the soft palate and closing the velopharyngeal port/sphincter

musculus uvulae - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: shorten and elevate the velum

palatoglossus - motor innervation and function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: lowers the soft palate and elevates the back of the tongue to create a posterior seal in the oral cavity

• important to note: forms the anterior faucial pillar

palatopharyngeus - motor innervation and VELAR function

motor innervation: pharyngeal plexus (CNIX, CNX)

function: lowers the velum (upper fibers) and narrows the upper pharynx (lower fibers)

• important to note: forms the posterior faucial pillar

3 main functions of the velopharyngeal-nasal apparatus

ventilation:

• nasal cavity - humidifies and warms air; filters incoming air

• pharynx - connects the upper airways to the lower airways

speech production:

• manages airstream to produce certain types of oral sounds

• manages the flow of acoustic energy into the oral and nasal cavities

swallowing:

• VP opened for nasal breathing during oral phase of swallowing

• VP closed during the pharyngeal phase of swallowing

possible movement of the pharynx

• lengthening or shortening (vertical)

• inward/outward movements of the LATERAL pharyngeal walls (horizontal)

• forward/backward movements of the POSTERIOR pharyngeal wall (horizontal)

possible movements of the velum

• upward and backward —> closes VP (touches posterior pharyngeal wall)

  • prevents air from circulating to and through the nasal cavity (used during swallowing)

• downward and forward —> opens VP (touches posterior tongue)

  • referred to as posterior containment/back-seal (used during chewing)

ways that the velopharyngeal closure can be achieved

1. elevate and retract the velum (most cases; accomplished by the levator veli palatini) = speech***

2. move the lateral pharyngeal walls inward (added: tensor veli palatini and superior pharyngeal constrictor)

3. 1 + 2

4. 1 + 2 + move the posterior pharyngeal wall forward = swallowing

***activation of pharyngeal walls for sound requiring higher pressure

difference in velopharyngeal movement when producing oral vs nasal sounds

oral - VP will be closed (tightly closed for high-pressure sounds)

nasal - VP will be open

3 velopharyngeal-nasal control variables

• airway resistance - opposition to airflow through the velopharyngeal-nasal airway

  • open VP = low resistance (air in nasal AND oral cavities)

  • closed VP = high resistance (air ONLY in oral cavity)

• sphincter compression - muscular force

  • low compression force = gentle closure

  • high compression force = forceful closure

• acoustic impedance - opposition to the flow of sound offered by the velopharyngeal-nasal apparatus

  • open VP = sound energy is distributed in the nasal AND oral cavities

  • closed VP = sound energy is directed ONLY to the oral cavity