Stages of Swallowing

Question 1

what are the two binary goals of the swallowing process?

Answer 1

1. to protect/seal the airway

2. to move the bolus down tot he esophagus

Question 2

true or false: the oral seal during the oral preparatory phase is not constant.

Answer 2

true

Question 3

since an oral seal is not always necessary during mastication of a solid bolus, often the bolus will collect in…

Answer 3

the vallecula during continued oral prep

Question 4

list two healthy normal swallowing patterns

Answer 4

exhale > swallow (apnea) > exhale (80%)
or…
inhale > swallow (apnea) > exhale (20%)

Question 5

swallowing requires a ___________ ___________ of the pharynx from a. breathing configuration to a swallowing configuration

Answer 5

complete reorganization

Question 6

swallowing has to be _____ and ________ because apnea can only be a short duration

Answer 6

fast & efficient

Question 7

swallowing involves both ___________ & ______________ actions as it involves both activation and inhibition of muscles in a timely and coordinated fashion

Answer 7

excitatory & inhibitory

Question 8

swallowing is _______________; once it is initiated it is irreversible

Answer 8

involuntary

Question 9

what starts the pharyngeal phase?

Answer 9

sensory input is what triggers the pharyngeal swallow

Question 10

the sensory trigger for the pharyngeal phase is thought to be when the bolus passes the ______ ______ but healthy adults can imitate swallow when the bolus is lower in the pharynx

Answer 10

faucial pillars

Question 11

will verbal cuing improve or decrease swallowing function?

Answer 11

improve

Question 12

what are three ways that the airway is protected in the pharyngeal stage?

Answer 12

a. hyolaryngeal excursion (hyoid & larynx are pulled up to get out of the way)
b. epiglottis folds down over arytenoids to make a seal
c. true and false VF close from bottom to top

Question 13

how is the bolus moved down in the pharyngeal phase?

Answer 13

a. hyolaryngeal excursion (pulling up hyoid open sup the UES)
b. tongue propels the bolus through pharyngeal cavity
c. pharyngeal constriction achieves by constrictors wraps and squeezes the bolus
d. pharynx gets shorter thought he longitudinal muscles and allows the bolus to travel a shorter distance for more efficient swallow
e. gravity
f. cricopharyngeal relaxation (muscles controlling the UES)
h. negative suction in the esophagus

Question 14

what is a safe swallow?

Answer 14

when the airway is protected and nothing has gone the wrong way

Question 15

what is an efficient swallow?

Answer 15

when the bolus has cleared through the pharynx that allows for nothing to be left behind

Question 16

which is the longest phase of swallowing?

Answer 16

esophageal (8-20 seconds)

Question 17

how long of a distance is the bolus propelled through the esophagus?

Answer 17

25cm

Question 18

why is the esophageal phase not really able to be targeted in therapy?

Answer 18

it is not under volitional control

Question 19

what is the oral prep stage & the major events taking place?

Answer 19

This where the bolus is prepared in the mouth.

• the oral cavity is sealed off (lips & velum)
• mastication of bolus with saliva
• divide bolus into pieces for transport to pharynx

Question 20

what is the oral phase & what are the major events?

Answer 20

this is when the bolus is pushed posteriorly.

• bolus is propelled from oral cavity to pharynx
• velum elevation prevent nasal regurgitation
• voluntary opening of the pharynx– while velum lifts posterior tongue depresses
• early hyoid elevation – anticipation of pharyngeal phase

Question 21

what is the pharyngeal phase & what are the major events?

Answer 21

this when we swallow the bolus through the pharynx

• jaw stabilization
• bolus transfer to the pharynx
• hyolaryngeal elevation
• laryngeal vestibule closure; T|F VF closure
• pharyngeal shortening and constriction
• upper esophageal sphincter (UES) opening