Anatomical Participantsstructures within respiratory, laryngeal, velopharyngeal‐ nasal, and pharyngeal‐oral systemsincludes chest wall, vocal folds, ventricular folds, epiglottis, pharynx, velum, tongue, mandible, lipsalso, esophagus and stomachPhases (stages) of a swallowOral preparatoryOral transportPharyngeal transportEsophageal transportOral Preparatory Phasevoluntaryhighly variable in durationbegins as soon as food enters mouthinvolves preparing bolus for swallowdifferent for liquids than solidsOral Transport Phase500 msechere, bolus propelled into oropharynxPharyngeal Transport Phasepreprogrammed (automatic) sequential event triggered when bolus passes anterior faucial pillarsseries of rapid coordinated movements that work to propel bolus into esophagustime from entrance of bolus into oropharynx to passage into esophagus is about 500‐800 msecEsophageal Transport Phaseinitiated shortly after bolus enters esophagusperistaltic contraction moves from striated muscle of upper 1/4 to smooth muscle of distal region at about 2‐4 cm/secresults in transit times of 8 ‐ 20 secPhase Overlapwhile describing the phases as a series of events, they can overlaporal prep phase may continue while part of bolus moves into pharynxBreathing and Swallowingmust coordinate breathing and swallowing to avoid aspirationusually occurs during expiratory phasetypical pattern is expiration‐ swallow‐expirationAbnormal Swallowingdifficulty swallowing referred to as dysphagiagenerally results from neuromuscular or structural changes in oral cavity, pharynx, or larynxe.g. stroke, neurologic disease, head and neck cancer surgery, radiation Rx for head and neck cancer, traumatic brain injuryOral Preparatory Phasefood spills into lateral oral sulci or base of tonguepoor control of bolusOral Transport Phasefood remains in mouthpoor control of bolus for propulsionSymptomsPharyngeal Transport PhaseresidueaspirationpenetrationUES stays closedEsophageal Transport Phasepoor persistalsisrefluxMeasuring Swallowing FunctionVideoflouroscopyEndoscopyVideoflouroscopysame approach used to look at velopharyngeal mechanismperson swallows substances mixed with barium sulphatecontrast material that allows bolus to be tracked visually as it travels through oral, pharyngeal, and esophageal regionsEndoscopyuses flexible endoscope inserted nasally and positioned in pharynxapproach commonly referred to as Flexible Endoscopic Evaluation of Swallowing (FEES)observe person swallowing food or liquid that may be colored to aid in visualization of bolusCsd 3112 1st Edition Lecture 36Outline of Last Lecture I. Measuring Articulatory Functiona. Aerodynamicsb. Lateral Still X-rayc. Videoflouroscopyd. Ultrasounde. Phototransductionf. Electromyographyg. Strain Gaugeh. Nasometryi. Endoscopyj. Velar Closure Forcek. Electromagnetic Articulometerl. ElectropalatographyOutline of Current Lecture II. SwallowingIII. Phases of a swallowa. Oral Preparatoryb. Oral Transportc. Pharyngeal Transportd. Esophageal TransportIV. Abnormal Swallowinga. SymptomsV. Measuring Swallowinga. Videoflouroscopyb. EndoscopyCurrent Lecture These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute. Anatomical Participants- structures within respiratory, laryngeal, velopharyngeal‐ nasal, and pharyngeal‐oral systems- includes chest wall, vocal folds, ventricular folds, epiglottis, pharynx, velum, tongue, mandible, lips- also, esophagus and stomach Phases (stages) of a swallow- Oral preparatory- Oral transport- Pharyngeal transport - Esophageal transport Oral Preparatory Phase- voluntary- highly variable in duration- begins as soon as food enters mouth- involves preparing bolus for swallow- different for liquids than solids Oral Transport Phase- 500 msec- here, bolus propelled into oropharynx Pharyngeal Transport Phase- preprogrammed (automatic) sequential event triggered when bolus passes anterior faucial pillars- series of rapid coordinated movements that work to propel bolus into esophagus- time from entrance of bolus into oropharynx to passage into esophagus is about 500‐800 msec Esophageal Transport Phase- initiated shortly after bolus enters esophagus- peristaltic contraction moves from striated muscle of upper 1/4 to smooth muscle of distal region at about 2‐4 cm/sec- results in transit times of 8 ‐ 20 sec Phase Overlap- while describing the phases as a series of events, they can overlap- oral prep phase may continue while part of bolus moves into pharynx Breathing and Swallowing- must coordinate breathing and swallowing to avoid aspiration- usually occurs during expiratory phase- typical pattern is expiration‐ swallow‐expiration Abnormal Swallowing- difficulty swallowing referred to as dysphagia- generally results from neuromuscular or structural changes in oral cavity, pharynx, or larynxo e.g. stroke, neurologic disease, head and neck cancer surgery,radiation Rx for head and neck cancer, traumatic brain injury- Oral Preparatory Phaseo food spills into lateral oral sulci or base of tongue o poor control of bolus- Oral Transport Phaseo food remains in moutho poor control of bolus for propulsion Symptoms- Pharyngeal Transport Phase o residueo aspirationo penetrationo UES stays closed- Esophageal Transport Phase o poor persistalsiso reflux Measuring Swallowing Function- Videoflouroscopy- Endoscopy Videoflouroscopy- same approach used to look at velopharyngeal mechanism- person swallows substances mixed with barium sulphateo contrast material that allows bolus to be tracked visually as it travels through oral, pharyngeal, and esophageal regions Endoscopy- uses flexible endoscope inserted nasally and positioned in pharynx- approach commonly referred to as Flexible Endoscopic Evaluation ofSwallowing (FEES)- observe person swallowing food or liquid that may be colored to aid in visualization of