Oropharyngeal & Swallowing System

Prognathic jaw

underbite

Retrognathic jaw

overbite

Maxilla

upper jaw

temporomandibular joint (TMJ)

the joint between the temporal bone and the mandible

TMJ movements

Upward and downward

Forward and backward

Side to side

Orbicularis oris muscle

Muscle around the mouth that closes the lips

Buccinator

compresses cheek

Risorius

Draws corner of mouth laterally (laughter)

Levator anguli oris

elevates corner of mouth

Depressor anguli oris

depresses corner of mouth

Levator labii superioris

elevates upper lip

Levator labii superioris alaeque nasi

elevates upper lip

Zygomatic minor

elevates upper lip

Zygomatic major

Elevates upper lip

depressor labii inferioris

depresses lower lip

Platysma

Depresses the lower lip and mandible; tenses neck skin

Mentalis

protrudes lower lip

Mandibular depressors

digastricus, mylohyoid, geniohyoid, platysma, Lateral Pterygoid

Mandibular elevators

masseter, temporalis, medial pterygoid

superior longitudinal

elevates tongue tip

Inferior longitudinal

depresses tongue tip

Transverse muscle of tongue

narrows tongue

Vertical muscle of tongue

flattens tongue

Genioglossus

depresses and protrudes tongue

Styloglossus

retracts and elevates tongue

Palatoglossus

elevates posterior part of tongue

Hyoglossus

depresses and retracts tongue

Central Control Theory

There is a master control mechanism that dictates the muscle movements which are produced in a timely and accurate way

Dynamic/action theory models

Coordinative structures (muscles which work together to achieve a goal) enable system to adapt to changes. Many possible solutions exist to achieving a certain trajectory

Forward coarticulation

An articulatory feature of a phoneme is apparent during the production of a later occurring phoneme

backward coarticulation

upcoming sound can influence the preceding sound

Phonological disorder

impaired comprehension of the sound system of a language and the rules that govern the sound combinations

Articulation disorder

Difficulty producing speech sounds and speech sound sequences

deglutition

process of swallowing

Feeding

placement of food in the mouth; manipulation of food in the oral cavity prior to the swallow

Cricopharyngeal muscle

Relax and opens the UES when food approaches the esophagus

Oral preparatory stage

the stage in which food is prepared for swallow

Oral transport stage

the stage of swallow in which the bolus is transmitted to the pharynx

Pharyngeal stage

involuntary passage of bolus through pharynx into esophagus

esophageal stage

the stage of swallow in which food is transported from the upper esophageal region to the stomach

Dysphagia complications

-Aspiration pneumonia

-Dehydration

-Weight loss

Videofluoroscopic Swallow Study (VFSS)

-radiological procedure

-assesses oral, pharyngeal, and upper esophageal anatomy and stages of swallowing

-detects problems related to head/neck positioning

-helps identify compensatory techniques to minimize risk of aspiration