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Anatomy of Neck and Blood Supply of Brain
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
These include the digastric (Figure 2.27), stylohyoid, geniohyoid and mylohyoid muscles. They are pharyngeal muscles and play a vital role in the process of swallowing. They have the general action of elevating the hyoid bone and widening the esophageal opening along with their individual different functions.
Head and Neck Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Warrenkevin Henderson, Hannah Jacobson, Noelle Purcell, Kylar Wiltz
Palatopharyngeus is also in close proximity to several rare accessory pharyngeal muscles, including petropharyngeus (see the entry for this muscle), occipitopharyngeus, mastoidopharyngeus, sphenopharyngeus, pterygopharyngeus externus, azygospharyngeus, and tympanopharyngeus (Bergman et al. 1988; Knott 1883a; Sakamoto 2016a). Some of these muscles may be considered variants of the same accessory muscle, cephalo-pharyngeus (Macalister 1875; Knott 1883a).
Special considerations: Parkinson’s disease
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Aspiration pneumonia is the leading cause of death in patients with PD (12). It is related to the impairment of pharyngeal muscles and swallowing. Reduced swallowing causes secondary sialorrhea. Drugs used to treat parkinsonism have little effect on dysphagia. These patients are also known to have decreased gastric emptying, another factor that can contribute to increase aspiration risk in the perioperative period (13). Difficulty with swallowing also contributes to a poor nutritional status preoperatively, and higher risk of postoperative complications. Patients may also have gastrointestinal side effects like nausea and vomiting from antiparkinsonian medications.
A review of surgical management of progressive myogenic ptosis
Published in Orbit, 2023
Royce B. Park, Sruti S. Akella, Vinay K. Aakalu
Oculopharyngeal muscular dystrophy (OPMD) is a slowly progressive disease involving symmetric blepharoptosis, dysphagia, and proximal muscle weakness.3 It is inherited in an autosomal dominant pattern and its onset is insidious, typically manifesting during the fifth or sixth decade of life.3 French Canadians (Quebec), Hispanic New Mexicans, and Israeli Bukhara Jewish populations are most prevalently affected by OPMD.13 The condition is diagnosed through molecular genetic testing and manifests as a myopathy affecting skeletal muscle cells.38 The levator palpebrae superioris and pharyngeal muscles are often most severely impaired, but the disease can also involve other extraocular muscles and limb muscle groups.38 Patients will compensate for progression of ptosis with contraction of the frontalis muscle and “backward head tilt.”38 Meanwhile, the orbicularis oculi muscle and Bell’s phenomenon are fairly well-preserved in OPMD patients.3 Surgical techniques described include blepharoplasty, levator advancement, frontalis sling, and combined aponeurosis-Muller muscle advancement.12
Botulinum toxin A injection using ultrasound combined with balloon guidance for the treatment of cricopharyngeal dysphagia: analysis of 21 cases
Published in Scandinavian Journal of Gastroenterology, 2022
Lielie Zhu, Jiajun Chen, Xiangzhi Shao, Xinyu Pu, Jinyihui Zheng, Jiacheng Zhang, Xinming Wu, Dengchong Wu
As part of the upper oesophageal sphincter (UES), normally, the cricopharyngeal muscle maintains tension and contraction during breathing, preventing air from entering the oesophagus and protecting the airway from retrograde reflux from the stomach [1–3]. During swallowing, food is pushed from the mouth to the pharynx under the contraction of masticatory muscles, tongue muscles and pharyngeal muscles; then, the hyoid–laryngeal complex moves upwards and forwards, and the cricopharyngeal muscle relaxes physiologically to allow food to pass through [38]. This swallowing motor sequence is regulated by the medulla oblongata swallowing central pattern generator (CPG) [39]. Brain lesions of many causes, especially brainstem stroke, could damage this regulatory mechanism, which then cannot distribute the swallowing impulse to the relevant motor nucleus, resulting in cricopharyngeal muscle achalasia [38,39]. Therefore, patients with stroke were selected as the participants in this study, which has important clinical significance because of its high incidence and the high incidence of cricopharyngeal muscle achalasia after stroke [5–7,23]. In addition, with good administration, stroke can reach a relatively stable clinical state compared with other progressive neurogenic or neuromuscular diseases, which might hinder patients from gaining permanent therapeutic effects.
Prehospital Manual Ventilation: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
John W. Lyng, Francis X. Guyette, Michael Levy, Nichole Bosson
Airway obstruction frequently occurs in the unconscious or obtunded patient due to decreased muscular tone in pharyngeal muscles and consequent obstruction at the level of the soft palate, posterior oropharynx, epiglottitis, and tongue (44, 45). Therefore, BVM technique also involves simultaneous positioning of the head and neck to open the airway structures. The basic maneuvers to establish an airway include putting the patient in the “sniffing position” to align the three important airway axes (mouth, laryngeal, and pharyngeal). Safar found that neck flexion obstructed the airway in 80 anesthetized, spontaneously breathing patients; and neck extension (chin up) position achieved patency in 50% of this group, while the other 50% required either anterior displacement of the mandible, insertion of an oral airway, or both to achieve airway patency (46). Boidin showed that epiglottic obstruction was common and could be overcome by anterior displacement of the hyoid with elevation of the occiput in a range from 4 cm to 8 cm above horizontal, with head tilt contributing less relief of obstruction than elevation of the occiput (45) .