swallowing anatomy and physiology

Question 1

purposes of swallowing

Answer 1

• take in food and liquid and move to stomach

- protect airway

Question 2

swallowing is a three stage event

Answer 2

• oral
• pharyngeal
• esophageal

Question 3

oral preparatory stage

Answer 3

• retrieve food
• requires lips to protrude, press together with some force to form a seal
• keep airway open
• protect airway maintain adequate gas exchange
• tongue controls bolus
• keep food off floor
• side to side for mastication
• against soft palate to harden
• propels into pharynx to initiate swallow

Question 4

oral preparatory stage

-tongue muscles

Answer 4

• intrinsic control tongue shape
• longitudinal, transverse, vertical
• extrinsic control position in oral cavity
• genioglossus
• hyoglossus
• styloglossus

Question 5

oral preparatory stage

-mastication muscles

Answer 5

mandibular elevators
-temporalis
-masseter
-medial pterygoid
mandibular depressors
-lateral pterygoid
-ABD
-geniohyoid
-mylohyoid

Question 6

oral preparatory stage

-salivary glands

Answer 6

• parotid
• sublingual
• submandibular
• dysfunction can lead to
• hypersalivation or hyposalivation

Question 7

oral transport stage

Answer 7

• begin elevating velum
• tongue drives bolus posteriorly
• forms anteroposterior groove to guide
• verticalis, genioglossues
• elevates from anterior to posterior squeezing bolus back against palate
• posterior tongue must initially depress
• **bolus does not fall passively from mouth to throat. is driven and controlled

Question 8

what happens to mandible?

Answer 8

• open mouth wide then swallow

- floor of mouth also raises via mylohyoid contraction

Question 9

pharyngeal stage

Answer 9

-velum raise
-hyoid bone up and forward
-larynx closes
true vocal folds adduct
false vocal folds adduct
epiglottis inverts
-larynx up and forward
-pharyngeal constrictors contract sequentially
-pharynx shortens and widens
-UES opens

Question 10

airway closure from bottom up

Answer 10

• true vocal fold adduciton
• lateral cricoarytenoid, transverse and oblique arytenoids
• false vocal fold adduction
• epiglottic inversion
• movement of hyolaryngeal complex and tongue

Question 11

hyolaryngeal complex movement

Answer 11

• epiglottic inversion
• means hyoid, larynx, and associated muscles
• epiglottis attached to posterior aspect of larynx
• if larynx moves epiglottis moves
• floor of suprahyoid muscles (mylohyoid,geniohyoid,genioglossus,ABD) contract
• hyoid moves anteriosuperiorly
• larynx attach and pulled along

Question 12

pharyngeal stage

-constrictors

Answer 12

• top to bottom:
• superior, middle, inferior
• serve to clear our material rather than primary driving force
• base of tongue is primary driving force
• UES

Question 13

esophageal phase

Answer 13

• esophagus has both longitudinal and circular fibers

- lower esophageal sphincter relaxes to permit bolus to pass through to stomach

Question 14

one anatomy, two functions

Answer 14

• during swallow, airway is shut
• not breathing - ~0.5-1 sec
• respiration and swallowing tightly coordinated by brainstem centers
• exhale-swallow-exhale