SLHS 303 Exam 5 Study Guide 

Lecture 1

Producing Speech

  • Complicated and rapid task

  • Approximately 175 words per minute

  • Initiating eating

  • Require coordination of 100s of neural signals and muscle contractions

  • Careful examination of underlying structures 


Vocal Tract

  • Oral cavity: lips to anterior faucial pillars (arch in back of mouth)

  • Nasal cavity: nose to nasopharynx

    • 2 chambers separated by septum

    • Nasal passages: superior, middle, inferior conchae, meatus

  • Pharyngeal cavity: nasopharynx,  oropharynx,  and laryngopharynx .

    • Boarders: velopharyngeal port, base of tongue, epiglottis 

  • Articulators

    • Mobile: lips, velum, tongue, jaw/mandible, pharynx 

    • Immobile: teeth, alveolar ridge, hard palate 


Teeth

  • Housed in mandible and maxilla

  • Biological function: chewing

  • Non Biological factor: speech

  • Primary teeth: 20 teeth

  • Permanent teeth: 32 teeth

  • Types: 

    • Incisors: front 8

    • Canines: next 4; sharpest

    • Premolars: next 4; only in permanent teeth 

    • Molars: last 12; 8 in primary, 4 more (wisdom teeth) 

  • Occlusions: alignment if upper and lower jaw 

    • Class I, II, or III (Edward H Angle classification) 












Muscles of Face

Name 

Origin 

Insertion 

Innervation 

Function 

Orbicular oris 

Maxilla; mandible

Mucosa of upper and lower lip

CN VII (facial)

Puckering lips

Tight lip closure

Buccinator 

Maxilla; mandible

Angle of mouth

CN VII

Pulls lips laterally

Tenses cheeks and pulls them to teeth

Levator labii superioris 

Frontal process of maxilla; infraorbital region; zygomatic bone 

Skin of upper lips and side cartilage of nose 

CN VII

Elevate upper lip

Raise angle of mouth 

Zygomaticus major

Zygomatic bone 

Angle of mouth 

CN VII

Pulls lip upward and laterally (smiling) 

Depressor labii inferiorus 

Mandible 

Lower lip

CN VII

Pulls lips down and laterally (frowning) 

Platysma 

Neck, shoulder, chest 

Mandible, cheek, angle of mouth 

CN VII

Tenses lower face

Pulls corner of mouth

Mandible depression 























Lecture 2

Muscles of Jaw 

Name 

Origin 

Insertion 

Innervation 

Function 

Masseter 

Zygomatic arch 

Angle and lateral side of mandible 

CN V

(trigeminal)

Elevates mandible (close jaw); Protrudes jaw

Temporalis 

Temporal bone

Top and part of ramus of mandible 

CN V

(trigeminal)

Elevates mandible

Retracts jaw

Medial pterygoid 

Lateral pterygoid plate; maxilla

Ramus and angle of mandible 

CN V

(trigeminal)

Elevates mandible

Protrudes mandible 

Lateral pterygoid 

Greater wing of sphenoid; lateral pterygoid plate 

Condyle of mandible; temporomandibular joint 

CN V

(trigeminal)

Depressed mandible (open); Protrudes mandible; Moves mandible laterally 

  • Anterior belly of digastric; mylohyoid; geniohyoid

  • Function: depresses jaw; GH shortens floor of mouth

  • Innervation: D+M - CN V; GH - cervical nerve 1 and cervical plexus 


Muscles of Soft Palate and Velopharynx 

Name 

Origin 

Insertion 

Innervation 

Function 

Tensor veli palatini 

Sphenoid bone; eustachian tube 

Palatine aponeurosis 

CN V (trigeminal) 

Tenses soft palate 

Dilates eustachian tube 

Levator veli palatini 

Temporal bone; eustachian tube 

Palatine aponeurosis 

CN X; CN XI (pharyngeal plexus)

Elevates soft palate

Muscular uvulae 

Posterior nasal spine 

Palatine aponeurosis; mucosa of uvula 

CN X; CN XI (pharyngeal plexus)

Shortens uvula

Helps for complete VF closure 

Palatoglossus 

CN X; CN XI (pharyngeal plexus)

Depresses side of the soft palate 

Palatopharyngeus 

Hard palate; palatine aponeurosis 

Lateral wall of pharynx 

CN X; CN XI (pharyngeal plexus)

Depresses and tenses soft palate

Narrows pharynx  

  • Faucial arches

    • Posterior faucial arch: Palatopharyngeus muscles

    • Anterior faucial arch: Palatoglossus

  • VP closure patterns

    • Coronal: anterior-posterior

    • Sagittal: lateral wall movement

    • Circumferential: both together 

Lecture 3

Tongue

  • Superior surface: median sulcus and septum

  • Inferior surface: lingual frenulum and ducts for salivary gland 

  • Tip: apex of tongue; most anterior part

  • Blade: under the alveolar ridge 

  • Dorsum: main mass; in front of root

  • Root: most dorsal part 

  • Tongue is a muscular hydrostat

    • Maintains constant volumes as muscle contracts

    • Minimal bing support (by hyoid and mandible)

    • Acts like a fluid filled structure (incompressible)


Intrinsic Muscles of Tongue  (origin and insertion in tongue) 

Name 

Origin

Insertion

Innervation

Function

Superior longitudinal 

Epiglottis; hyoid; median septum

Lateral margins of tongue and apex

CN XII

Elevates tip

Assists retraction

Inferior longitudinal

Root of tongue; corpus of hyoid 

Apex of tongue 

CN XII

Pulls tip down

Tongue retraction 

Transverse longitudinal

Median fibrous septum 

Sides of tongue 

CN XII

Narrows tongue 

Vertical lingual muscle

Base of tongue 

Membranous cover of tongue 

CN XII

Flattens and broadens tongue 






Extrinsic Muscles of Tongue 

Name 

Origin

Insertion

Innervation

Function

Genioglossus 

Midline of mandible 

Lip and dorsum of tongue; hyoid bone

CN XII (hypoglossal) 

Protrudes tongue

Retracts tongue

Tongue cupping

Hyoglossus 

Hyoid bone 

Sides of posterior portion of tongue 

CN XII (hypoglossal) 

Depresses sides of tongue 

Palatoglossus 

Midline of soft palate 

Side of tongue 

CN X; CN XI

Elevates posterior sides of tongue 

Styloglossus 

Styloid process of temporal bone 

Side of tongue 

CN XII (hypoglossal) 

Reatracts and pulls tongue superiorly 

Lecture 4

Muscles of Pharynx 

Name 

Origin

Insertion

Innervation

Function

Superior constrictor muscle 

Complex bones of skulls and mandible 

Dorsal pharyngeal midline raphe 

CN X; CN XI

Narrows upper pharynx 

Middle constrictor muscle 

Hyoid bone 

Dorsal pharyngeal midline raphe 

CN X; CN XI

Narrows upper pharynx 

Inferior constrictor muscle 

Sides of thyroid and cricoid cartilage 

Dorsal pharyngeal midline raphe 

CN X; CN XI

Narrows lower  pharynx 

Stylopharyngeus 

Styloid process of temporal bone 

Thyroid cartilage; lateral pharyngeal walls 

CN IX

Elevates/widens pharynx 

Elevates larynx 

Palatopharyngeus 

Hard palate; palatine aponeurosis 

Lateral wall of pharynx 

CN X; CN XI (pharyngeal plexus)

Narrows pharynx 

  • Pharynx as an articulator 

    • Changes in diameter and length to change resonance 

      • Superior: size VP port

      • Middle: pharyngeal diameter changes 

      • Inferior: narrows hypopharynx 

        • Ex: during whispering 





















Lecture 1 

Swallowing

  • Swallow 600-1000 times per day

  • Swallow saliva every 1-2 minutes 

  • Swallow in our sleep and in utero

  • Do it almost automatically

  • A series of neurogenic sensorimotor events

    • Initiated by touch, taste, temperature, or texture of food/fluid 

    • Followed by preparation of correct consistency

    • Finalized by transportation thru oral, pharyngeal, esophageal structures to the stomach 

  • Bolus: mass of food that is ready to be swallowed

  • Penetration: food into larynx but not past true VFs

  • Aspiration: food/liquid past treu VFs (in airway)

  • Backflow: food moving backwards in system 


Pharyngeal Spaces

  • Valleculae: space between base of tongue and epiglottis

    • Subdivided by hyoepiglottic ligament 

  • Pyriform sinuses: channels in the laryngopharynx

    • End at cricopharyngeus muscle 


Swallowing Neurophysiology

  • 35 pairs of muscles

  • Controlled by 6 CNs

  • Controlled by brain and brainstem




















Lecture 2 

Physiology of Swallowing

  1. Oral - oral prep and oral transport

  2. Pharyngeal

  3. Esophageal

  • Oral Prep

    • Sensory awareness of food in mouth

    • Manipulations of food to form bolus; liquids - tongue cups

    • Duration depends on viscosity and chewing required 

    • Bolus propulsion: tongue forms a grove and pushes bolus superiorly and posteriorly 

    • Lasts about 1-1.5 seconds 

  • Pharyngeal Swallow Triggering

    • Triggered when bolus reaches region between the anterior faucial pillars

    • Not triggered → “delayed” swallowing 

      • Not all delayed swallowing is abnormal 

  • Pharyngeal Phase

    • Starts with triggering 

    • Bolus pushed thru pharynx to esophagus; larynx closed

    • Takes about 800 ms

    • Respiration stops

    • 5 important events

  1. Velopharyngeal closure (build pressure)

  2. Anterior and superior movement of hyoid bone and larynx

  3. Airway closure 

  4. Upper esophageal sphincter (UES) opening

  5. Base of tongue to pharyngeal walls movement 

  • Esophageal Phase

    • Esophagus 

      • 23-25 cm tube 

      • 2 sphincter

        • UES: upper esophageal sphincter

        • LES: lower esophageal sphincter

      • Front of esophagus attached to back of trachea

      • Peristalsis: sequence of squeezing that carries bolus to stomach  

      • Esophageal transit time: normally about 8-20 seconds

        • Time for bolus to go from UES to LES and intro stomach