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uvula
Tonsils diagram.jpg
Uvula's location in the human mouth
Latin uvula palatina
Gray's subject #241 1112
MeSH Uvula
Dorlands/Elsevier Palatine uvula

The uvula (pronounced /ˈjuːvjələ/) is the 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]

Contents

[edit] Function in voice

The uvula plays a key role in the articulation of the sound of the human voice to form the sounds of speech.[2] Anita O'Day, a popular big band singer, had her uvula accidentally removed during a childhood surgery when only her tonsils were intended to be removed. This affected her voice by eliminating vibrato, she said, in an interview with Terry Gross of NPR's "Fresh Air" radio show, although the uvula is not responsible for vibrato (the vocal cords make this happen).[citation needed]

[edit] Function in languages

The uvula functions in tandem with the back of the throat, the palate, and air coming up from the lungs to create a number of guttural and other sounds. Uvular consonants are not found in most dialects of English, though they are found in many Semitic, Caucasian, and Turkic languages, as well as several languages of Western Europe such as German, French and many Celtic languages. Certain African languages[which?] use the uvula to produce click consonants as well, though other than that, uvular consonants are fairly uncommon in Sub-Saharan Africa.

[edit] Pathology

[edit] Emetic Effect

Massaging the uvula causes the gag reflex to initiate and expel stomach contents. This is often an issue for people who plan to get uvula piercings.

[edit] 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/.

[edit] 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 U3P). However, this operation can also cause sleep apnea if scar tissue forms and the airspace in the velopharnyx 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.[3] 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.

[edit] 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 disorders.

[edit] Uvulitis

A child's swollen uvula with tonsils
An adult's swollen uvula

At times, the mucous membrane around the uvula may swell, causing the uvula to expand 3–5 times its normal size. 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 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.[4]

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 normally not life threatening and subsides in a short time, typically within a day.[5]

[edit] Bifid uvula

A bifid or cleft uvula.
The bifid uvula of a 24 year old woman.

A bifid uvula is a split or cleft uvula. Newborns with cleft palate also have a split uvula. The bifid uvula results from failure of complete fusion of the medial nasal and maxillary processes. Bifid uvulas have less muscle in them than a normal uvula, this may cause recurring problems with middle ear infections. While swallowing, the soft palate is pushed backwards. This prevents 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.[6] Splitting of the uvula occurs infrequently but is the most common form of mouth and nose area cleavage among newborns (roughly 2% of infants have this bifid or split uvula). Bifid uvula occurs in about 1% of Caucasians and 10% of Native Americans.

Statistics have been presented in the New England Journal of Medicine suggesting a correlation between bifid uvula and aortic aneurysm.[7]

[edit] Traditional removal of the uvula

In some parts of Africa, including Ethiopia and Eritrea, the uvula or a section of it may be removed by a traditional healer to allegedly prevent throat infections.[8] In this case, the uvula may be noticeably shortened. It is not thought to contribute to VPI, except in cases where the tonsils have also been removed.[9]

[edit] References in pop culture

  • (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!"
  • (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?"
  • (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.
  • (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!".
  • (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.
  • (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[2], 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.

[edit] Additional images

[edit] See also

[edit] References

  1. ^ "eMedicine Definition". http://www.emedicine.com/asp/dictionary.asp?exact=Y&keyword=palatine+uvula. 
  2. ^ 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. PMID 1408233. 
  3. ^ Lehnert, Paul (3 August 2005). "Uvulopalatopharyngoplasty for obstructive sleep apnea". http://www.webmd.com/hw/sleep_disorders/hw48958.asp#ug3207. Retrieved 26 October 2006. 
  4. ^ [1]
  5. ^ Swollen Uvula
  6. ^ "Split Uvula: Is It a Problem?". http://health.ivillage.com/dental/0,,6hlv,00.html. Retrieved 23 September 2007. 
  7. ^ "Bifid Uvula and Aortic Aneurysm". http://content.nejm.org/cgi/content/full/359/2/e2. Retrieved 12 November 2008. 
  8. ^ Ethiopian Refugees
  9. ^ Hartley B, Rowe-Jones J (1994). "Uvulectomy to prevent throat infections.". J Laryngol Otol 108 (1): 65–6. PMID 8133174. 
  10. ^ SNL Transcripts: Elliot Gould: 05/29/76: Babs' Uvula http://snltranscripts.jt.org/75/75vuvula.phtml

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