Letcure 9: Swallowing Flashcards
What are the 3 phases of swallowing?
- oral phase
- pharyngeal phase
- oesophageal phase
What are the 2 stages of the oral phase during swallowing?
(Voluntary)
1. preparing the bolus
2. move bolus to oropharynx (part of pharynx that lies behind oral cavity): use tongue to do this, and as soon as the bolus touches the oropharynx a reflex kicks in to go to the pharyngeal phase
(tongue is elevated to the hard palette, stops food coming back out of mouth)
What happens in the pharyngeal stage of swallowing?
(Involuntary)
- takes roughly 0.2 seconds
- soft palette raises and seals off the nasopharynx to prevent reflux
- pharyngeal constrictors, push bolus down
- larynx elevates by contracting longitudinal muscles, this closes the epiglottis (prevents bolus entering the resp tract)
- vocal cords adduct to protect airways
- as the bolus moves down, the upper oesophageal sphincter relaxes and opens
What happens in the oesophageal phase?
(Involuntary)
- closing of the upper oesophageal sphincter to prevent air entering the GI tract
- rapid peristalsis down oesophagus towards stomach
What does dysphagia mean?
Difficulty in swallowing
What are some problems coordinating swallowing?
- ineffective swallow: dribbling
- material entering resp tract: coughing/choking
What disease processes affect the nerve/s supplying the upper GI tract?
-strokes
-parkinsons disease
-multiple sclerosis
(lead to dysphagia)
Are fluids/solids harder to swallow?
Fluids, they need tighter constriction to make sure they go down the right tract
When is dysphagia more difficult with solid food and what causes it?
Occurs when there is a blockage in the upper resp tract
-fluid can go round the blockage, whereas solids cannot
Causes
-fibrous ring (repeated scarring from reflux)
-oesophageal cancer
-achalasia (failure of lower oesophageal sphincter to relax)
What are some red flag signs involved with dysphagia?
Oesophageal cancer, is a type of progressive dysphagia
- weight loss
- above 55yo with dysphagia
