587:(all recurrent laryngeal nerve of vagus). Since the true vocal folds adduct during the swallow, a finite period of apnea (swallowing apnea) must necessarily take place with each swallow. When relating swallowing to respiration, it has been demonstrated that swallowing occurs most often during expiration, even at full expiration a fine air jet is expired probably to clear the upper larynx from food remnants or liquid. The clinical significance of this finding is that patients with a baseline of compromised lung function will, over a period of time, develop respiratory distress as a meal progresses. Subsequently, false vocal fold adduction, adduction of the aryepiglottic folds and retroversion of the epiglottis take place. The aryepiglotticus (recurrent laryngeal nerve of vagus) contracts, causing the arytenoids to appose each other (closes the
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Occupational
Therapists may also offer swallowing rehabilitation services as well as prescribing modified feeding techniques and utensils. Consultation with a dietician is essential, in order to ensure that the individual with dysphagia is able to consume sufficient calories and nutrients to maintain health. In terminally ill patients, a failure of the reflex to swallow leads to a build-up of mucus or saliva in the throat and airways, producing a noise known as a
653:) is normally closed and only opens for the advancing bolus. Gravity plays only a small part in the upright position—in fact, it is possible to swallow solid food even when standing on one's head. The velocity through the pharynx depends on a number of factors such as viscosity and volume of the bolus. In one study, bolus velocity in healthy adults was measured to be approximately 30–40 cm/s.
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508:(pharyngeal plexus—IX, X) to close the nasopharynx. There is also the simultaneous approximation of the walls of the pharynx to the posterior free border of the soft palate, which is carried out by the palatopharyngeus (pharyngeal plexus—IX, X) and the upper part of the superior constrictor (pharyngeal plexus—IX, X).
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Prior to the following stages of the oral phase, the mandible depresses and the lips abduct to allow food or liquid to enter the oral cavity. Upon entering the oral cavity, the mandible elevates and the lips adduct to assist in oral containment of the food and liquid. The following stages describe
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commonly diagnose and treat this condition since the speech process uses the same neuromuscular structures as swallowing. Diagnostic procedures commonly performed by a speech pathologist to evaluate dysphagia include
Fiberoptic Endoscopic Evaluation of Swallowing and Modified Barium Swallow Study.
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At the end of the oral preparatory phase, the food bolus has been formed and is ready to be propelled posteriorly into the pharynx. In order for anterior to posterior transit of the bolus to occur, orbicularis oris contracts and adducts the lips to form a tight seal of the oral cavity. Next, the
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A trough is then formed at the back of the tongue by the intrinsic muscles (XII). The trough obliterates against the hard palate from front to back, forcing the bolus to the back of the tongue. The intrinsic muscles of the tongue (XII) contract to make a trough (a longitudinal concave fold) at the
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Finally the larynx and pharynx move down with the hyoid mostly by elastic recoil. Then the larynx and pharynx move down from the hyoid to their relaxed positions by elastic recoil. Swallowing therefore depends on coordinated interplay between many various muscles, and although the initial part of
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Like the pharyngeal phase of swallowing, the esophageal phase of swallowing is under involuntary neuromuscular control. However, propagation of the food bolus is significantly slower than in the pharynx. The bolus enters the esophagus and is propelled downwards first by striated muscle (recurrent
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by bringing the aryepiglottic folds together), and draws the epiglottis down to bring its lower half into contact with arytenoids, thus closing the aditus. Retroversion of the epiglottis, while not the primary mechanism of protecting the airway from laryngeal penetration and aspiration, acts to
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palatopharyngeal arches, the tonsillar fossa, uvula and posterior pharyngeal wall. Stimuli from the receptors of this phase then provoke the pharyngeal phase. In fact, it has been shown that the swallowing reflex can be initiated entirely by peripheral stimulation of the internal branch of the
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of the oropharynx, the pharyngeal phase, which is reflex and involuntary, then begins. Receptors initiating this reflex are proprioceptive (afferent limb of reflex is IX and efferent limb is the pharyngeal plexus- IX and X). They are scattered over the base of the tongue, the palatoglossal and
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With practice, people can learn to swallow fluidly without closing the mouth by merely manipulating the tongue and jaw to drive fluids or foods down the esophagus. With a continuous motion, an individual forges breathing and priorities the swallowed matter. This intermediate level of muscle
557:(pharyngeal plexus—IX, X) in the closure of the nasopharynx and elevation of the pharynx opens the auditory tube, which equalises the pressure between the nasopharynx and the middle ear. This does not contribute to swallowing, but happens as a consequence of it.
596:. Additionally, the larynx is pulled up with the pharynx under the tongue by stylopharyngeus (IX), salpingopharyngeus (pharyngeal plexus—IX, X), palatopharyngeus (pharyngeal plexus—IX, X) and inferior constrictor (pharyngeal plexus—IX, X). This phase is
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laryngeal, X) then by the smooth muscle (X) at a rate of 3–5 cm/s. The upper esophageal sphincter relaxes to let food pass, after which various striated constrictor muscles of the pharynx as well as peristalsis and relaxation of the
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is directly inhibited by the swallowing center for the very brief time that it takes to swallow. This means that it is briefly impossible to breathe during this phase of swallowing and the moment where breathing is prevented is known as
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533:(pharyngeal plexus—IX, X) to receive the bolus. The palatopharyngeal folds on each side of the pharynx are brought close together through the superior constrictor muscles, so that only a small bolus can pass.
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The primary laryngopharyngeal protective mechanism to prevent aspiration during swallowing is via the closure of the true vocal folds. The adduction of the vocal cords is affected by the contraction of the
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superior longitudinal muscle elevates the apex of the tongue to make contact with the hard palate and the bolus is propelled to the posterior portion of the oral cavity. Once the bolus reaches the
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which takes place by sequential contraction of the superior, middle and inferior pharyngeal constrictor muscles (pharyngeal plexus—IX, X). The lower part of the inferior constrictor (
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with contributions from the motor cortex and other cortical areas. The pharyngeal swallow is started by the oral phase and subsequently is coordinated by the swallowing center on the
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853:
Clave, P.; De Kraa, M.; Arreola, V.; Girvent, M.; Farre, R.; Palomera, E.; Serra-Prat, M. (2006). "The effect of bolus viscosity on swallowing function in neurogenic dysphagia".
390:(VII) helps to contain the food against the occlusal surfaces of the teeth. The bolus is ready for swallowing when it is held together by saliva (largely mucus), sensed by the
776:, swallowing consists largely of the bird lifting its head with its beak pointing up and guiding the prey with tongue and jaws so that the prey slides inside and down.
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783:, the tongue is largely bony and much less mobile and getting the food to the back of the pharynx is helped by pumping water in its mouth and out of its
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phase. Each phase is controlled by a different neurological mechanism. The oral phase, which is entirely voluntary, is mainly controlled by the
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The oropharynx is kept closed by palatoglossus (pharyngeal plexus—IX, X), the intrinsic muscles of tongue (XII) and styloglossus (XII).
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491:. When the pharyngeal phase begins, other activities such as chewing, breathing, coughing and vomiting are concomitantly inhibited.
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the normal and necessary actions to form the bolus, which is defined as the state of the food in which it is ready to be swallowed.
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in scientific contexts, is the process in the body of a human or other animal that allows for a substance to pass from the
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Swallowing comes so easily to most people that the process rarely prompts much thought. However, from the viewpoints of
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The hyoid is elevated by digastric (V & VII) and stylohyoid (VII), lifting the pharynx and larynx up even further.
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For the pharyngeal phase to work properly all other egress from the pharynx must be occluded—this includes the
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can occur. In the human body the automatic temporary closing of the epiglottis is controlled by the swallowing
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swallowing is under voluntary control, once the deglutition process is started, it is quite hard to stop it.
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Eating and swallowing are complex neuromuscular activities consisting essentially of three phases, an
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back of the tongue. The tongue is then elevated to the roof of the mouth (by the
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sequentially push the bolus of food through the esophagus into the stomach.
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The portion of food, drink, or other material that will move through the
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manipulation is similar to the techniques used by sword swallowers.
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Swallowing is a complex mechanism using both skeletal muscle (
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Abnormalities of the pharynx and/or oral cavity may lead to
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of the tongue (VII—chorda tympani and IX—lesser petrosal) (V
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Swallowing becomes a great concern for the elderly since
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The bolus moves down towards the esophagus by pharyngeal
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anatomically direct the food bolus laterally towards the
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controlled reflexively and involves cranial nerves V,
19:"Swallowed" redirects here. For the song by Bush, see
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Normal
Swallowing and Dysphagia: Pediatric Population
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Anatomy and physiology of swallowing at dysphagia.com
290:. The reflex is initiated by touch receptors in the
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74:. Unsourced material may be challenged and removed.
517:The pharynx is pulled upwards and forwards by the
760:In many birds, the esophagus is largely a mere
927:Swallowing animation (flash) at hopkins-gi.org
722:. Abnormalities of the esophagus may lead to
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8:
935:" = unfunctional or pathological swallowing.
243:, it is an interesting topic with extensive
37:"Gulp" redirects here. For other uses, see
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855:Alimentary Pharmacology & Therapeutics
513:The pharynx prepares to receive the bolus
134:Learn how and when to remove this message
305:) and smooth muscles of the pharynx and
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521:and longitudinal pharyngeal muscles –
361:Food is moistened by saliva from the
173:. Swallowing is an important part of
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241:difficulty in swallowing (dysphagia)
72:adding citations to reliable sources
337:Sagittal view of mouth and pharynx
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614:respiratory center of the medulla
441:Movement of the bolus posteriorly
30:For the family of songbirds, see
867:10.1111/j.1365-2036.2006.03118.x
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583:and the oblique and transverse
59:needs additional citations for
906:Essentials of Human Physiology
529:(pharyngeal plexus—IX, X) and
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1182:Bile and pancreatic secretion
814:Speech and language pathology
500:The soft palate is tensed by
549:(pharyngeal plexus—IX, X),
504:(Vc), and then elevated by
204:in one swallow is called a
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1402:Interstitial cell of Cajal
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670:lower esophageal sphincter
496:Closure of the nasopharynx
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1477:Enterohepatic circulation
1333:Segmentation contractions
902:"Section 6/6ch3/s6ch3_15"
839:Oxford English Dictionary
711:(not to be confused with
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700:autonomic nervous system
453:superior laryngeal nerve
311:autonomic nervous system
251:Coordination and control
1407:Basal electrical rhythm
1338:Migrating motor complex
976:gastrointestinal system
861:(9). Wiley: 1385–1394.
768:swallowing a fish or a
720:oropharyngeal dysphagia
698:can interfere with the
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459:and involves important
384:temporomandibular joint
1362:Enteric nervous system
917:Overview at nature.com
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663:Esophageal peristalsis
641:Bolus transits pharynx
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1271:Enteroendocrine cells
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686:Clinical significance
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39:Gulp (disambiguation)
1264:Endocrine cell types
933:déglutition atypique
724:esophageal dysphagia
191:pulmonary aspiration
68:improve this article
23:. For the film, see
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696:Alzheimer's disease
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26:
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1297:Goblet cells
1142:Somatostatin
1109:Gastric acid
1099:Gastric acid
1067:
1025:Gastric acid
931:See : "
910:the original
905:
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736:Swallowing
733:
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430:genioglossus
422:styloglossus
418:genioglossus
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83:"Swallowing"
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66:Please help
61:verification
58:
1398:Peristalsis
1384:Either/both
1343:Borborygmus
1008:Chief cells
647:peristalsis
485:nasopharynx
374:Mastication
237:health care
155:inglutition
151:deglutition
1525:Physiology
1514:Categories
1423:Enterocyte
1348:Defecation
1068:Swallowing
1013:Pepsinogen
820:References
585:arytenoids
564:oropharynx
519:suprahyoid
426:hyoglossus
388:Buccinator
357:Moistening
347:Oral phase
265:esophageal
261:pharyngeal
229:physiology
171:epiglottis
147:Swallowing
94:newspapers
1470:Processes
1441:Accessory
1418:Digestion
1391:Processes
1326:Processes
1281:APUD cell
1227:incretins
1174:paracrine
1170:Endocrine
1135:ECL cells
1130:Histamine
1111:secretion
1061:Processes
809:Occlusion
804:Dysphagia
728:achalasia
632:elevation
602:X (vagus)
598:passively
553:(Vc) and
457:voluntary
410:mylohyoid
307:esophagus
235:, and of
223:In humans
167:esophagus
161:, to the
1520:Reflexes
1206:Secretin
1073:Vomiting
1000:Exocrine
984:GI tract
883:22881225
875:17059520
798:See also
487:and the
179:drinking
124:May 2009
1253:L cells
1241:K cells
1211:S cells
1199:I cells
1147:D cells
1123:G cells
1118:Gastrin
766:seagull
754:pelican
692:strokes
612:. The
292:pharynx
278:of the
187:choking
185:, then
183:trachea
163:pharynx
108:scholar
32:Swallow
1449:Fluids
1310:Fluids
1094:Saliva
1087:Fluids
881:
873:
792:snakes
734:M-Type
525:(IX),
489:larynx
342:Phases
309:. The
303:tongue
269:medial
217:biting
195:reflex
175:eating
110:
103:
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81:
1248:GLP-1
1162:Lower
1050:Mucus
992:Upper
879:S2CID
785:gills
770:stork
630:Hyoid
621:apnea
296:bolus
294:as a
231:, of
206:bolus
159:mouth
115:JSTOR
101:books
1456:Bile
871:PMID
781:fish
774:frog
694:and
675:13)
661:12)
639:11)
627:10)
608:and
471:and
432:and
424:and
288:pons
286:and
274:and
263:and
257:oral
202:neck
177:and
87:news
1236:GIP
1042:HCO
863:doi
790:In
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