Palatine uvula

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Uvula
Tonsils diagram.jpg
Uvula's location in the human mouth
Details
Latin uvula palatina
Identifiers
MeSH A14.549.617.780.729
Dorlands
/Elsevier
Uvula
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TH {{#property:P1694}}
TE {{#property:P1693}}
FMA {{#property:P1402}}
Anatomical terminology
[[[d:Lua error in Module:Wikidata at line 863: attempt to index field 'wikibase' (a nil value).|edit on Wikidata]]]

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

File:Swollenuvula.jpg
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

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]

References in fiction

  • (1947) In the cartoon I Taw a Putty Tat, the uvula is depicted as a punching bag.
  • (1961) In the episode of The Andy Griffith Show called "Barney and the Choir", Deputy Barney Fife has learned this word while getting treatment for a sore throat, and recites a brief reference to the old Spiritual All God's Chillun Got Wings: "I got a uvula, you got a uvula, all God's chillun got a uvula!" In keeping with the reference, Andy responds, "Hallelujah!"
  • (1976) The uvula was featured in an early Saturday Night Live comedy skit starring Gilda Radner, Chevy Chase, and Laraine Newman. The skit, "Babs' Uvula" was a mock public service announcement about uvula care, featuring the tagline, "It'll behoove ya to care for your uvula."[14]
  • (April 24, 1987) It was featured in a "Far Side" cartoon by Gary Larson entitiled "Final page of the medical boards" where a person is depicted holding a question paper that reads "BONUS QUESTION: (50 points) What's the name of that thing that hangs down in the back of our throats?"
  • (1994) Bifid uvulas were featured as a part of Nickelodeon's animated series Aaahh!!! Real Monsters.
  • (1995) American pop punk band Green Day have a song entitled "Bab's Uvula Who?" on the album Insomniac, a reference to the aforementioned Saturday Night Live sketch.
  • (1997) In Cartoon Network's series Cow and Chicken the uvula is used along with the spleen to represent an unknown human organ. While the spleen is obviously mistaken for the spine, the uvula is most likely used because of its strange name.
  • (1997) "Weird Al" Yankovic used the word uvula frequently on the Weird Al Show.
  • (1998) In the Rugrats episode "Grandpa's Bad Bug", two of the kids, Tommy and Chucky, took a toy wrench and squeezed Grandpa's uvula while he was asleep, mistaking the vibrating uvula for a "bad bug" moving around inside of his throat. His uvula becomes inflamed, and Grandpa says "It feels like a lobster's been shakin' hands with my tonsils!".
  • (1998) In Full House episode It's Not My Job, Stephanie is afraid at the dentist and Joey tells her about the "courage hangy-ball" in the back of the throat. She admits she thought it was only there for decoration.
  • (2001) In Takashi Miikes Happiness of the Katakuris, a small monster runs away with a woman's uvula.
  • (2001) In "Osmosis Jones" Jones follows the deadly virus by flying out of the mouth from the uvula during a sneeze. He then returned there afterwards.
  • (2004) In the Friends episode The One Where the Stripper Cries, Joey Tribbiani appearing as a celebrity guest on the game show Pyramid (game show), gets the word "Addendum" to which he gives the clue "Okay, the little thing that hangs down at the back of your throat." His game partner shouts "Uvula", to which Joey responds "Oh, then pass."
  • (2006) The uvula is mistaken for a vulva as a gag in Monster House.
  • (2008) In Gears of War 2, after the Delta team is eaten by the Riftworm and the team makes it past the worm's teeth, the uvula can be seen, and is mistaken for the heart. If the player shoots it, the worm will gag causing the screen to shake for a few seconds, and in the following cutscene, Cole shoots it excessively, causing a large gag and the team to be chased by a large wall of debris, probably worm puke.
  • (2009) In a commercial for Dairy Queen, a talking pair of lips implores viewers to "look into my uvula" in an attempt to hypnotize them.
  • (2009) In Ice Age: Dawn of the Dinosaurs, Buck, the weasel that serves as a Virgil-like figure to Manny and his herd, avoids being eaten by Rudy (the Moby Dick-like white dinosaur) by using Rudy's uvula to propel himself out of Rudy's mouth.
  • (2010) In the episode 'Can You Dig It?' of the Disney channel spinoff, The Suite Life on Deck, Zack asks Cody what the thing vibrating at the back of his throat was when he shouted to which Cody answers in exasperation "It's called an uvula".

History

Etymology

In Latin, ūvula means 'little grape', the diminutive form of ūva 'grape' (of unknown origin). A swollen uvula was called "ūva."[15]

See also

References

  1. "eMedicine Definition".<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  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.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  5. Shu, M.D., Jennifer (April 12, 2010). "Will a bifid uvula cause any problems?". CNN. Retrieved 2010-08-07.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  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.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  7. "Loeys-Dietz Syndrom Foundation". Retrieved 25 March 2010.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  8. "Bifid Uvula and Aortic Aneurysm". Retrieved 12 November 2008.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  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.CS1 maint: multiple names: authors list (link)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  10. Lehnert, Paul (3 August 2005). "Uvulopalatopharyngoplasty for obstructive sleep apnea". Retrieved 26 October 2006.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  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.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  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.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  14. SNL Transcripts: Elliot Gould: 05/29/76: Babs' Uvula http://snltranscripts.jt.org/75/75vuvula.phtml
  15. The American Heritage Dictionary of the English Language (4th ed.). Boston: Houghton Mifflin. 2000. p. 1896. ISBN 0618082301.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>

External links

Additional Images

The bifid uvula of a 24 year old woman.