Swallowing pathophysiology

Question 1

What is the first stage of swallowing

Answer 1

Oral preparatory phase (chewing), break downs food to a consistency appropriate for swallowing and mixes it enzyme rich saliva, this phase is under voluntary control

Question 2

What seals are formed during the oral prepatory phase

Answer 2

An anterior seal may be formed with the lips, if there is a large bolus the posterior oral cavity
The soft palate lowers to contact the pharyngeal aspect of the posterior tongue, containing the bolus in the anterior oral cavity and preventing premature entry to the pharynx. Airway is open

Question 3

What is the second phase of swallowing

Answer 3

Oral phase, tongue transports food bolus posteriorly towards the pharynx, constricts the passage anterior to the bolus while opening passage posterior to it, largely voluntary

Question 4

What does the tongue do during the oral phase of swallowing

Answer 4

Posterior part of the tongue depresses while anterior tongue elevates and rolls posteriorly squeezing the bolus in a posterior direction toward the faucial pillars, at point of contact between tongue and palate moves posteriorly, base of tongue moves forwards and flattens converting it into a chute down which the bolus slides.

Question 5

What happens as the bolus enters the pharynx to the soft palate and why

Answer 5

Soft palate elevates and retracts which seals off the nasopharynx from regurgitation,

Question 6

What is the third phase of swallow

Answer 6

Early pharyngeal phase, an involuntary phase of preprogrammed rapid coordinated events that controls bolus propulsion and airway protection

Question 7

What phase of swallowing is respiration interrupted

Answer 7

early pharyngeal phase,

Question 8

why does the soft palate elevate and retract against the posterior pharyngeal wall during a swallow

Answer 8

Allows bolus to leave the mouth and seals off the nasopharynx from regurgitation

Question 9

Function of superior laryngeal nerve relevant to swallowing

Answer 9

Sensory innervation for penetration, if in tack should produce a cough when penetration occurs.

Question 10

What nerve detects aspiration

Answer 10

recurrent laryngeal nerve

Question 11

what nerve detects penetration

Answer 11

superior laryngeal nerve

Question 12

Where does the superior laryngeal nerve innervate

Answer 12

True vocal folds and above

Question 13

Where does the recurrent laryngeal nerve innervate

Answer 13

Motor fibres of all muscles in the larynx (except cricothyroid) including the posterior cricoarytenoid, lateral cricoarytenoid, interarytenoids and thyroarytenoids.
Sensory innervation below the level of the vocal folds, i.e aspiration