Swallowing physiology Flashcards
Name and Describe phase one of swallowing?
Oral Preparatory phase:
1- food and liquid chewed and formed into a bolus
2-Bolus held on the centre of the tongue
Lip, Jaw, tongue and palate sensory and motor function needed and dentition(teeth)
Voluntary task
Cranial nerves V, VII, IX, X, XII
involved
Name and describe phase 2 of swallowing?
Oral Transit Phase
1-Bolus propelled tot he back of the mouth
2-Palate seals entrance tot he nasal cavity
Lip, jaw, tongue, palate sensory and motor function needed
Voluntary control
involves cranial nerves V, VII, IX, X, XII
Name and describe stage 3 of Swallowing ?
Pharyngeal Phase 1
1- triggered when the bolus reaches the faucial arches at the back of the mouth
2- the palate stays elevated
3- tongue retracts to push bolus to pharynx
tongue, palate and laryngeal sensory and motor function needed
Reflex control(non-voluntary)
Cranial nerves IX, X, XII involved (9 and 10 in pharynx, 12 in the tongue)
Name and describe stage 4 of swallowing?
Pharyngeal phase II
1-Bolus propelled through pharynx
Tongue, palate and laryngeal sensory and motor function needed
Reflex control
CN IX, X, XII
Airway closed by the epiglottis (retroflex over the laryngeal inlet to stop and food going into the upper airway), vocal cords and arytenoid action
Name and describe phase 5 of swallowing?
Oesophageal phase
1-Oesophagus opens up, airway closed, breath is held
2-Bolus of food propelled through the oesophagus
3- respiration the resumes with an exhalation to clear any food particles from the airway entrance
Under reflex control
CN IX, X
Describe a normal swallow?
Pharyngeal transit 1-2 seconds
No residue in mouth or pharynx
No spillage from lips or into the airway
How does a cerebellum haematoma impair swallowing?
bleed in the cerbellum result in ATAXIC SWALLOW:
- unco-ordinated tongue retraction to propel food
- delayed airway closure ->food enters airways
- Delayed and ineffective cough can lead to food making its way into the lungs
How would a therapist help a cerebellum haematoma?
Flex the patients neck forward during the swallow and this prevents the aspiration of bolus into the airway
How would removing(excising) an acoustic Neuroma (tumour) from the brain impair swallowing?
It can leave patient with a lower motor neuron lesion so they have ipsilateral paralysis of pharynx, larynx and the tongue=problems in propelling the bolus of food into the Pharynx = Pharyngeal and oral residue
Failure of airway to close= aspiration
What is aspiration?
breathing foreign objects into your airways
How would a therapist treat an ipsilateral weakness?
Rotate the head to direct the bolus down the strong side of the pharynx= helps increase airway closure as well
How would Parkinson’s disease impair swallowing?
Difficulty in initiating the swallow:
repetitive tongue movements linked with rigidity and inability to lower the back of the tongue
delayed swallow
How would a therapist help someone with Parkinson’s swallow?
Physiotherapy- attempt an active range of tongue and lip exercises
How can you look at a normal swallow
1- Fluoroscopy and giving patient a bolus of barium to swallow as this appears to be black when viewing
2-Endoscopic camera: vocal cords adduct to produce voice and close the airway, saliva is cleared in a single swallow and does not accumulate, water swallow in less than 1 second, no residue in pharynx or trachea
What is swallowing regulated by?
Regulated at a cortical and brainstem level
Involves synchronised movements of the oral pharyngeal laryngeal esophageal component
