WordNet

a small pendant fleshy lobe at the back of the soft palate
divided into two lobes; "a bifid petal"

PrepTutorEJDIC

口蓋(こうがい)垂,のどびこ

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/03 20:04:40」(JST)

wiki en

The palatine uvula, usually referred to as simply the uvula /ˈjuːvjʊlə/, is a conic projection from the posterior edge of the middle of the soft palate, composed of connective tissue containing a number of racemose glands, and some muscular fibers (musculus uvulae).^[1]^[2]

Structure

Muscle

Uvula hanging from the soft palate

The musculus uvulae, which lies entirely within the uvula, shortens and broadens the uvula. This changes the contour of the posterior part of the soft palate. This change in contour allows the soft palate to adapt closely to the posterior pharyngeal wall to help close the nasopharynx during swallowing.^[3]

It is innervated by the pharyngeal branch of the vagus nerve (cranial nerve X).

Variation

Uvula wiggling back and forth. This is caused by exhaling. This is also how the uvular R trill is done if it vibrates on the back of the tongue.

A bifid or cleft uvula.

A bifid or bifurcated uvula is a split or cleft uvula. Newborns with cleft palate often also have a split uvula. The bifid uvula results from incomplete fusion of the palatine shelves but it is considered only a slight form of clefting. Bifid uvulas have less muscle in them than a normal uvula, which may cause recurring problems with middle ear infections. While swallowing, the soft palate is pushed backwards, preventing food and drink from entering the nasal cavity. If the soft palate cannot touch the back of the throat while swallowing, food and drink can enter the nasal cavity.^[4] Splitting of the uvula occurs infrequently but is the most common form of mouth and nose area cleavage among newborns. Bifid uvula occurs in about 2% of the general population,^[5] although some populations may have a high incidence, such as Native Americans who have a 10% rate.^[6]

Bifid uvula is a common symptom of the rare genetic syndrome Loeys-Dietz syndrome,^[7] which is associated with an increased risk of aortic aneurysm.^[8]

Function

Speech

In many languages, the uvula is used to articulate a range of consonant sounds, known as uvular consonants. The voiced uvular trill, written [ʀ] in the International Phonetic Alphabet, is one example; it is used in French and Hebrew, among other languages.

However, the physiological and evolutionary role of the uvula remains unclear.^[9]

Clinical relevance

Emetic effect

Stimulation of the uvula causes the gag reflex to initiate. This is often an issue for people who plan to get uvula piercings.

Velopharyngeal insufficiency

In a small number of people, the uvula does not close properly against the back of the throat, causing a condition known as velopharyngeal insufficiency or VPI. This causes "nasal" (or more properly "hyper-nasal") speech, where a lot of extra air comes down the nose, and the speaker is unable to say certain consonants, for example producing the sound 'b' like 'm'.

Snoring and sleep apnea

The uvula can also contribute to snoring or heavy breathing during sleep; having an elongated uvula can cause vibrations which lead to snoring. In some cases this can lead to sleep apnea, which may be treated by removal of the uvula or part of it if necessary, an operation known as uvulopalatopharyngoplasty (commonly referred to as UPPP, or UP3). However, this operation can also cause sleep apnea if scar tissue forms and the airspace in the velopharynx is decreased. The success of UPPP as a treatment for sleep apnea is unknown, but some research has shown 40–60% effectiveness in reducing symptoms.^[10] Typically apnea subsides for the short term, but returns over the medium to long term, and sometimes is worse than it was before the UPPP.

Nasal regurgitation

During swallowing, the soft palate and the uvula move superiorly to close off the nasopharynx, preventing food from entering the nasal cavity. When this process fails, the result is called nasal regurgitation. It is common in people with VPI, the myositides, and neuromuscular disease.

Inflammation

A child's swollen uvula with tonsils

Long uvula

At times, the mucous membrane around the uvula may swell, causing the uvula to expand 3–5 times its normal size. This condition is known as uvulitis. When the uvula touches the throat or tongue, it can cause sensations like gagging or choking, even though there is no foreign matter present. This can cause problems with breathing, talking, and eating.

There are many theories about what causes the uvula to swell, including dehydration (e.g. from arid weather); excessive smoking or other inhaled irritants; snoring; allergic reaction; or a viral or bacterial infection. An aphthous ulcer which has formed on the uvula can also cause swelling and discomfort.^[11]

If the swelling is caused by dehydration, drinking fluids may improve the condition. If the cause is a bacterial infection, gargling salt water may help. However, it can also be a sign of other problems. Some people with a history of recurring uvulitis have to carry an EpiPen containing adrenaline (epinephrine) to inject themselves whenever the uvulitis begins. A swollen uvula is not normally life-threatening and subsides in a short time, typically within a day.

Society and culture

The bifid uvula of a 24-year-old woman.

In some parts of Africa, including Ethiopia and Eritrea, the uvula or a section of it is ritually removed by a traditional healer.^[12] In this case, the uvula may be noticeably shortened. It is not thought to contribute to velopharyngeal inadequacy, except in cases where the tonsils have also been removed.^[13]

History

Etymology

In Latin, ūvula means 'little grape', the diminutive form of ūva 'grape' (of unknown origin). A swollen uvula was called "ūva."^[14]

References

^ "eMedicine Definition".
^ Ten Cate's Oral Histology, Nanci, Elsevier, 2007, page 321
^ Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 108
^ "Split Uvula: Is It a Problem?". Retrieved 23 September 2007.
^ Shu, M.D., Jennifer (April 12, 2010). "Will a bifid uvula cause any problems?". CNN. Retrieved 2010-08-07.
^ McMillan, Julia A.; Feigin, Ralph D.; DeAngelis, Catherine; Jones, M. Douglas (2006). Oski's pediatrics: principles & practice (4th ed.). Lippincott Williams & Wilkins. p. 469. ISBN 0-7817-3894-6.
^ "Loeys-Dietz Syndrom Foundation". Retrieved 25 March 2010.
^ "Bifid Uvula and Aortic Aneurysm". Retrieved 12 November 2008.
^ Finkelstein Y, Meshorer A, Talmi Y, Zohar Y, Brenner J, Gal R (1992). "The riddle of the uvula.". Otolaryngol Head Neck Surg 107 (3): 444–50. doi:10.1177/019459989210700318. PMID 1408233.
^ Lehnert, Paul (3 August 2005). "Uvulopalatopharyngoplasty for obstructive sleep apnea". Retrieved 26 October 2006.
^ Biblo LA, Gilbert IA (May 1983). "Aphthous ulcer of the uvula and the painful burp". N. Engl. J. Med. 308 (19): 1168. doi:10.1056/NEJM198305123081922. PMID 6835348.
^ Ethiopian Refugees
^ Hartley B, Rowe-Jones J (1994). "Uvulectomy to prevent throat infections.". J Laryngol Otol 108 (1): 65–6. doi:10.1017/s0022215100125873. PMID 8133174.
^ The American Heritage Dictionary of the English Language (4th ed.). Boston: Houghton Mifflin. 2000. p. 1896. ISBN 0618082301.

External links

MedlinePlus Encyclopedia 001257 - Uvulitis

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 小児における身体的診察：HEENT the pediatric physical examination heent
2. エーラス・ダンロス症候群の臨床症状および診断 clinical manifestations and diagnosis of ehlers danlos syndromes
3. 口唇口蓋裂の病因、出生前診断、産科マネージメント、および再発 etiology prenatal diagnosis obstetrical management and recurrence of orofacial clefts
4. 小児における扁桃摘出およびアデノイド切除：適応および禁忌 tonsillectomy and adenoidectomy in children indications and contraindications
5. 幼児および小児における小頭症：病因および評価 microcephaly in infants and children etiology and evaluation

English Journal

Multiple phenotypes in phosphoglucomutase 1 deficiency.

Tegtmeyer LC1, Rust S, van Scherpenzeel M, Ng BG, Losfeld ME, Timal S, Raymond K, He P, Ichikawa M, Veltman J, Huijben K, Shin YS, Sharma V, Adamowicz M, Lammens M, Reunert J, Witten A, Schrapers E, Matthijs G, Jaeken J, Rymen D, Stojkovic T, Laforêt P, Petit F, Aumaître O, Czarnowska E, Piraud M, Podskarbi T, Stanley CA, Matalon R, Burda P, Seyyedi S, Debus V, Socha P, Sykut-Cegielska J, van Spronsen F, de Meirleir L, Vajro P, DeClue T, Ficicioglu C, Wada Y, Wevers RA, Vanderschaeghe D, Callewaert N, Fingerhut R, van Schaftingen E, Freeze HH, Morava E, Lefeber DJ, Marquardt T.Author information 1The authors' affiliations are listed in the Appendix.AbstractBACKGROUND: Congenital disorders of glycosylation are genetic syndromes that result in impaired glycoprotein production. We evaluated patients who had a novel recessive disorder of glycosylation, with a range of clinical manifestations that included hepatopathy, bifid uvula, malignant hyperthermia, hypogonadotropic hypogonadism, growth retardation, hypoglycemia, myopathy, dilated cardiomyopathy, and cardiac arrest.
The New England journal of medicine.N Engl J Med.2014 Feb 6;370(6):533-42. doi: 10.1056/NEJMoa1206605.
BACKGROUND: Congenital disorders of glycosylation are genetic syndromes that result in impaired glycoprotein production. We evaluated patients who had a novel recessive disorder of glycosylation, with a range of clinical manifestations that included hepatopathy, bifid uvula, malignant hyperthermia,
PMID 24499211

Hand and fibrillin-1 deposition abnormalities in Loeys-Dietz syndrome--expanding the clinical spectrum.

Chung BH1, Bradley T, Grosse-Wortmann L, Blaser S, Dirks P, Hinek A, Chitayat D.Author information 1Department of Paediatrics and Adolescent Medicine, Centre for Reproduction, Growth and Development, The University of Hong Kong, Hong Kong, Hong Kong.AbstractLoeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by hypertelorism, bifid uvula, cleft palate and arterial tortuosity. We report on a patient with LDS, bearing mutation in the TGFβR2 gene, whose prenatal examination demonstrated clenched fists and club feet, suggesting arthrogryposis multiplex congenita. Postnatal assessment showed digital abnormalities, including brachydactyly, camptodactyly, partial syndactyly and absent distal phalanges. With the lack of fibrillin-1 microfibril deposition as well as impaired and inadequate elastic fiber assembly in our patient's fibroblasts, we speculate that the skeletal abnormalities seen in this patient with LDS are the result of lack of these components in embryonal perichondrium and in blood vessels. We suggest that LDS should be included in the differential diagnosis of joint contractures seen pre and postnatally. Prenatal diagnosis of LDS would be important in parental counseling and early post natal diagnosis could prompt treatment before the development of detrimental vascular complications.
American journal of medical genetics. Part A.Am J Med Genet A.2014 Feb;164A(2):461-6. doi: 10.1002/ajmg.a.36246. Epub 2013 Nov 5.
Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by hypertelorism, bifid uvula, cleft palate and arterial tortuosity. We report on a patient with LDS, bearing mutation in the TGFβR2 gene, whose prenatal examination demonstrated clenched fists and club fee
PMID 24194458

Japanese Journal

Loeys-Dietz 症候群

森崎裕子,森崎隆幸
日本小児循環器学会雑誌 30(3), 232-238, 2014
Loeys-Dietz症候群（LDS）は，動脈瘤/解離，蛇行性血管などの血管症状，特徴的顔貌（眼間開離，二分口蓋垂/口蓋裂，頭蓋骨早期癒合），および種々の骨格症状（漏斗胸，鳩胸，側彎，関節過可動，クモ状指，内反足）を呈する常染色体優性遺伝性の全身性結合組織異常である．症例による症状の幅は広く，また必ずしも前記すべての症状を伴うとは限らないが，何らかの血管症状をほぼ全例で認める．Marfan症候群（ …
NAID 130004879018

Clinical features and genetic analysis of Korean patients with Loeys–Dietz syndrome

Yang Jeong Hoon,Ki Chang-Seok,Han Hyejin [他],SONG Bong Gun,JANG Shin Yi,CHUNG Tae-Young,SUNG Kiick,LEE Heung Jae,KIM Duk-Kyung
Journal of human genetics 57(1), 52-56, 2012-01-01
NAID 10030662407

Related Pictures

★リンクテーブル★

関連記事	「bifid」「uvula」

「bifid」

Uvula
	Uvula's location in the human mouth
Details
Latin	uvula palatina
Identifiers
MeSH	A14.549.617.780.729
Dorlands; /Elsevier	Uvula
TA	A05.2.01.004
FMA	55022
	Anatomical terminology [edit on Wikidata]

　　[★]

二分の

関: bipartite、bisect、bisection、dichotic、dichotomous

「uvula」

　　[★] 口蓋垂

同: 虫部垂

[1] "eMedicine Definition".

[2] Ten Cate's Oral Histology, Nanci, Elsevier, 2007, page 321

[3] Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 108

[4] "Split Uvula: Is It a Problem?". Retrieved 23 September 2007.

[5] Shu, M.D., Jennifer (April 12, 2010). "Will a bifid uvula cause any problems?". CNN. Retrieved 2010-08-07.

[6] McMillan, Julia A.; Feigin, Ralph D.; DeAngelis, Catherine; Jones, M. Douglas (2006). Oski's pediatrics: principles & practice (4th ed.). Lippincott Williams & Wilkins. p. 469. ISBN 0-7817-3894-6.

[7] "Loeys-Dietz Syndrom Foundation". Retrieved 25 March 2010.

[8] "Bifid Uvula and Aortic Aneurysm". Retrieved 12 November 2008.

[9] Finkelstein Y, Meshorer A, Talmi Y, Zohar Y, Brenner J, Gal R (1992). "The riddle of the uvula.". Otolaryngol Head Neck Surg 107 (3): 444–50. doi:10.1177/019459989210700318. PMID 1408233.

[upppstat-10] Lehnert, Paul (3 August 2005). "Uvulopalatopharyngoplasty for obstructive sleep apnea". Retrieved 26 October 2006.

[11] Biblo LA, Gilbert IA (May 1983). "Aphthous ulcer of the uvula and the painful burp". N. Engl. J. Med. 308 (19): 1168. doi:10.1056/NEJM198305123081922. PMID 6835348.

[12] Ethiopian Refugees

[13] Hartley B, Rowe-Jones J (1994). "Uvulectomy to prevent throat infections.". J Laryngol Otol 108 (1): 65–6. doi:10.1017/s0022215100125873. PMID 8133174.

[14] The American Heritage Dictionary of the English Language (4th ed.). Boston: Houghton Mifflin. 2000. p. 1896. ISBN 0618082301.

匿名

検索

案内

案内

bifid uvula