Anatomy is torture 3rd quiz

Articulation
How do we measure it

How do we measure it?
• Cineradiography
• Electopalatography
• Electromyography

Lips
Obicularis Oris

Labial Seal: Obicularis Oris
Other muscles insert here and
create pull and force in multiple
directions to create lip shapes

Upper Lip moves slower than bottom lip

Lower Lip Does most of the work in lip
closure Faster and stronger than the
upper lip due to position of the
mandible and the mentalis muscle

Highly Adaptable The lips are highly adaptable to
structural interference: teeth,
appliances, holding something in the
mouth. Governed by proprioception

Mandible

-Assists lips and tongue Carries lips and tongue to the target position brings structures closer to the teeth when
needed

-Changes position to support lip movement

—Opens Digastricus Muscle
Mylohyoid Muscle
Geniohyoid Muscle
Lateral Pterygoid Muscle

—Tightly Closes Temporalis Muscle
Masseter Muscle Medial Pterygoid Muscle

Tongue

-Super Strong Only 20% of tongue strength is typically used in articulation

-Sensory Make Up Muscle spindles are sensory stretch receptors Golgi tendon organs for proprioception Tactile Sensors

-Extremely sensitive tongue can differentiate points of contact
only 1.5mm apart
Aids in proprioception and monitoring of
articulation placement

Extrinsic Muscle: Take the tongue to the general area where it is needed

Intrinsic Muscles: Create fine motor movements for the creation of unique speech sounds.

Velum

-The velum must open and close at high
rate of speech to accommodate for nasal
and non nasal speech sound production in
quick succession.

-Closed-Contraction of levator veli palatini
Non- nasal speech
Creates intraoral pressure for fricative
and plosive production

-Open-Relaxation of levator veli palatini
Allows for voice to resonate in the
nasal cavities

-Nasal assimilation-The resulting sound of nasal resonance
when not appropriate

Speech Sound Development

2-h p n d b w m

3- t f y ng k g

4- Ch l s z v dz sh

5- th voicless zh r

6- th voiced

Development
needed to articulate

Reflexes
Vestibular Development

Motor Development
Extension

trunk/neck stability
• CV structures

How the Oral Cavity Grows

Nasopharynx gets bigger and is more sharply angled relative to the
oropharynx
The oral cavity grows and gets bigger
The tongue descends
The oropharyngeal space increases
Growth of structures changes the relationship of the articulators
Adult oral cavity size is reached between 7 and 18 years of age

Anatomical
Growth of the
Vocal Tract

Nasopharynx gets bigger and is more sharply angled relative to the
oropharynx
The oral cavity grows and gets bigger
The tongue descends
The oropharyngeal space increases
Growth of structures changes the relationship of the articulators
Adult oral cavity size is reached between 7 and 18 years of age

Theories on how articulation happens

Associated Chain Theory—-Articulation is a series of motor sequences that are learned
• The overlapping impact of one speech sound on another—-Coarticulation
• Master control mechanism dictates the muscle movements based
on the linguistic goal—-Central Control Theory
• Sensory feedback from the articulators influence accurate speech
sound production—-Feedback Theories
• The end product of muscle activity is goal driven—-Dynamic or Action Theory
• A feedback driven model—-DIVA Model

Dentition

Impacts on:
• Articulation
• Mastication
• Deglutition

Lips and
Palate

Impact on:
• Articulation
• Mastication
• Deglutition

Tongue

Impact on:
• Articulation
• Mastication
• Deglutition

Mastication

The process of the oral motor
preparation of food for swallowing

Deglutition

The process of swallowing

Bolus

A ball of food or liquid to be
swallowed

Evaluation Procedures

Videofluoroscopic Swallow Study, VFSS

Fiberoptic Evaluation of Swallowing FEES

0-6 mos

Rooting Reflex
• Sucking Reflex
• suckling pattern

6 mos+

Sucking Action

10+
months

Teeth erupt and the Sucking Action
changes again

Primitive Reflexes

Essential for survival
• Disappear as the brain develops
• The action changes from
involuntary to voluntary
• A reflex is composed of sensory input
• The signal travels to the brainstem motor output

How is infant anatomy different for swallowing?

Fat pads in the cheeks narrow the oral cavity
laterally
The tongue fills the oral cavity
Hyoid and larynx are
much higher in the neck
Provides natural airway
protection
Velum hangs lower
Uvula rests inside epiglottis forming a
pocket in valleculae

How is infant physiology different for swallowing?

Oral Phase Reflexive sucking
No foods yet
Pharyngeal
Phase
Less laryngeal elevation
More pharyngeal wall
movement

Review: Changes in anatomy from infancy to adulthood

The jaw grows down and forward
The tongue descends and oral cavity enlarges
The pharynx enlarges
The larynx and hyoid drop
Most enlargement occurs during puberty

The Infant Swallow

Suck – Swallow – Breathe
• A reflexive activity
• Begins in utero
• Apneic period

Typical Advancement
of textures

Birth   suck-swallow reflex
• Begin puree   4-6 mos
• Begin finger foods    8 mos
• Chopped food, small bites   12 mos
• Adult food, cut up  2-3 years

4 phases of swallowing

Oral Stage I: Oral preparation

Voluntary
• Chewing food into a soft ball ready for transport

Oral Stage II: Oral Transit
• Voluntary or involuntary
• The bolus is moved to the oropharynx to initiate a swallow
Stage III: Pharyngeal Stage
• Reflexive
• Begins at faucial pillars
• Squeezing of the bolus through the pharynx
Stage IV: Esophageal Stage
• Reflexive
• Peristalsis moves the bolus from the cricopharyngeus through to
the stomach

Oral Stage II:
Oral Transit

voluntary or involuntary
begins when the bolus is formed and is
propelled toward the faucial pillars
tongue elevates, forms a ramp and pulls
posteriorly
mastication and breathing stops
Next stage begins when bolus reaches
faucial pillars and is squeezed into pharynx

Predicting Changes

Anatomy
• Teeth: loss, decay
• Muscle deterioration
• Muscle deterioration, mucosa
deterioration

Physiology
• Oral: More/longer chewing,
dentures
• : Pharyngeal: Larynx/hyoid don’t elevate well to protect airway
• Esophageal: Delayed emptying of
esophagus, feeling of fullness/food
stuck