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

Lecture 2

Muscles of Jaw 

• 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 

• 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) 

Extrinsic Muscles of Tongue 

Lecture 4

Muscles of 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