Muscles of the Upper Airway and Accessory Respiratory Muscles
Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop in Neural Control of the Respiratory Muscles, 2019
The third major respiratory role of the upper airway muscles is to regulate the route of airflow. During quiet breathing and with mild levels of exertion airflow traverses the nasal route, which has the advantage of allowing better humidification, warming, and filtering of inspired air than when inspiration occurs through the mouth. However, with increased ventilatory demands posed especially by exercise but also by respiratory diseases, the nose imposes a level of resistance which is too high for the thoracic muscles to overcome, and breathing occurs through both the nose and mouth or only the mouth. This requires opening of the mouth by relaxing jaw elevator musculature (e.g., the masseter) and contracting muscles which pull the jaw caudally (e.g., the geniohyoid muscle), depressing the tongue and, in order for flow to avoid the nasal route, moving the soft palate posteriorly.
Introductory Aspects of Head and Neck Cancers
Loredana G. Marcu, Iuliana Toma-Dasu, Alexandru Dasu, Claes Mercke in Radiotherapy and Clinical Radiobiology of Head and Neck Cancer, 2018
Floor of mouth: The floor of mouth is a space extending from the lower alveolar ridge to the undersurface of the tongue. It overlies the mylohyoid and hyoglossus muscles. The mylohyoid muscles extend from linea mylohyoidea on the inside of the mandible and meet in the midline in a fibrous band, covering a distance from the inside of the chin to the hyoid bone. The floor of mouth is reinforced by two other muscles, posteriorly by the geniohyoid muscle and ventrally by the anterior part of the digastric muscle. The muscular part of the floor of mouth is not complete since mylohyoid muscle does not reach the posterior ramus of the jaw.
Head and Neck
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
There are four true extrinsic tongue muscles (which are all hypobranchial muscles): Three of these muscles directly attach to the tongue and thus have “glossus” in their names (genioglossus, styloglossus, and hyoglossus); one of them does not (geniohyoid) (Plate 3.41). As noted previously, the other muscle that attaches onto the tongue and thus also has “glossus” in its name—the palatoglossus—is not a true tongue muscle but instead a pharyngeal (and thus branchial) muscle innervated by the vagus nerve. This muscle is another example of a structure whose anatomy and function in the adult differs from its developmental and evolutionary history. The geniohyoid muscle is deep (superior) to the mylohyoid, runs from the inferior mental spine of the mandible to the body of the hyoid bone, pulls the hyoid bone anteriorly, and is innervated by the Cl nerve that “hitchhikes” with the hypoglossal nerve (CN XII), as explained above. The genioglossus is deep (superior) to the geniohyoid, runs from the superior mental spine of the mandible to the hyoid bone and tongue, protrudes (sticks out) the tongue, and is innervated by the hypoglossal nerve, as are the styloglossus and the hyoglossus. As its name indicates, the styloglossus muscle runs from the styloid process to the lateral side of the tongue and thus retrudes (pulls in) and elevates the tongue. Lastly, the hyoglossus runs vertically from the body and greater horn of the hyoid bone to the side of the tongue and functions to depress and retrude the tongue. In addition to these four extrinsic muscles, the tongue includes four intrinsic muscles: vertical tongue muscles, transverse tongue muscles, superior longitudinal muscles, and inferior longitudinal muscles. Logically, all these intrinsic tongue muscles are also innervated by the hypoglossal nerve.
Swallowing and ageing
Published in Speech, Language and Hearing, 2019
Margaret Walshe
Within the oral phase, there is a general consensus that tongue strength decreases with age (Crow & Ship, 1996; Fei et al., 2013; Robbins et al., 1995; Robbins, Humpal, Banaszynski, Hind, & Rogus-Pulia, 2016; Vanderwegen et al., 2013; Youmans, Youmans, & Stierwalt, 2009) and that this change is gradual over time (Vanderwegen et al., 2013). Sakai et al. (2018) suggest that in older people suspected as having sarcopenia, lip force and tongue strength may be useful independent indices for diagnosing sarcopenic dysphagia. Butler, Stuart, Leng, et al. (2011) found that reduced posterior and anterior tongue strength for swallowing was significantly associated with aspiration in otherwise healthy adults. Atrophy of geniohyoid muscle was also found to be associated with aspiration in healthy older adults (Feng et al., 2013). There is an argument that tongue pressure measures on non-swallowing tasks will differ from swallowing tasks and there are variations even between saliva and water swallows. Fei et al. (2013) found that while maximum isometric tongue pressures were reduced in a cohort of older adults (>60 years) saliva and water swallowing pressures were not influenced by age. It is further suggested that biomechanical aspects of swallowing are influenced by bolus type rather than age (Fei et al., 2013; van den Engel-Hoek et al., 2012).
Utilization of submandibular ultrasound to measure oral cavity changes with interventions in routine airway management
Published in Baylor University Medical Center Proceedings, 2022
Alexandra Helbing, Esther Lee, Raymond Pla, Eric Heinz
Ultrasound scanning was performed by two attending anesthesiologists with previous experience and training in airway POCUS. Airway sonography was performed using a SonoSite X-porte Ultrasound system (FujiFilm, Philips Healthcare, Bothell, WA) equipped with a 3 to 8 MHz curvilinear transducer. For the preoperative measurements of TT and OCH, the patient was placed in a supine position with the head in a relaxed position. The ultrasound was placed in a sagittal orientation. TT was measured between the geniohyoid muscle and the dorsum of the tongue, and OCH was measured as the geniohyoid muscle to the hard palate. For the postinduction measurements, the patient was placed in a similar position and imaging was performed in a similar manner with the airway device placed by the anesthesiologist (Figure 1).
Concept of diverse sleep treatments in physiotherapy
Published in European Journal of Physiotherapy, 2019
Cristina Staub
An alternative to all these devices is exercise training, not only because of resulting weight loss [83]. Different studies show the effects especially of oropharyngeal exercises activating muscles opening the airway (e.g. the genioglossus and the geniohyoid muscle) [84,85]. One of the most famous studies is the one with Didgeridoo playing [86]. This training method with circular breathing was also developed by a Swiss patient suffering from sleep apnoea. The study wants to prove that the sleepiness of the Didgeridoo playing group decreases more than that of the control group. However, it illustrates that the results of randomised studies can be senseless: One of the 11 patients of the control group could not improve at all, because he was not sleepy at the beginning. Also the second patient of the control group was not sleepy enough. The mean sleepiness of the two groups at the beginning was about the same, but the standard deviation of the controls was too big. Conducting a randomised study, researchers should be aware of such facts, but this mistake is seen in many randomised ‘controlled’ trials, published in different journals. Statistics are really useless, if researchers do not consider the context.
Related Knowledge Centers
- Hyoid Bone
- Hypoglossal Nerve
- Lingual Artery
- Muscle
- Mylohyoid Muscle
- Suprahyoid Muscles
- Chin
- Mental Spine
- Mandibular Symphysis
- Cervical Spinal Nerve 1