598:(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
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664:) 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.
519:(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
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568:(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.
607:. 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
544:(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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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".
401:(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
787:, 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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794:, 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).
805:, the work of swallowing is done by raking with the lower jaw until the prey is far enough back to be helped down by body undulations.
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502:. 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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of food is pushed to the back of the mouth by the tongue, or by stimulation of the palate (palatal reflex).
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Food is mechanically broken down by the action of the teeth controlled by the muscles of mastication (V
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Eating and swallowing are complex neuromuscular activities consisting essentially of three phases, an
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sequentially push the bolus of food through the esophagus into the stomach.
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Process used to transport food and saliva from the mouth to the stomach
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manipulation is similar to the techniques used by sword swallowers.
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Abnormalities of the pharynx and/or oral cavity may lead to
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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,
30:"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
301:. The reflex is initiated by touch receptors in the
85:. Unsourced material may be challenged and removed.
528:The pharynx is pulled upwards and forwards by the
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771:In many birds, the esophagus is largely a mere
938:Swallowing animation (flash) at hopkins-gi.org
733:. Abnormalities of the esophagus may lead to
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946:" = unfunctional or pathological swallowing.
254:, it is an interesting topic with extensive
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48:"Gulp" redirects here. For other uses, see
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866:Alimentary Pharmacology & Therapeutics
524:The pharynx prepares to receive the bolus
145:Learn how and when to remove this message
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316:) and smooth muscles of the pharynx and
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532:and longitudinal pharyngeal muscles –
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372:Food is moistened by saliva from the
184:. Swallowing is an important part of
252:difficulty in swallowing (dysphagia)
83:adding citations to reliable sources
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348:Sagittal view of mouth and pharynx
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625:respiratory center of the medulla
452:Movement of the bolus posteriorly
41:For the family of songbirds, see
878:10.1111/j.1365-2036.2006.03118.x
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594:and the oblique and transverse
70:needs additional citations for
917:Essentials of Human Physiology
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540:(pharyngeal plexus—IX, X) and
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1193:Bile and pancreatic secretion
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825:Speech and language pathology
511:The soft palate is tensed by
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560:(pharyngeal plexus—IX, X),
515:(Vc), and then elevated by
215:in one swallow is called a
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1413:Interstitial cell of Cajal
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507:Closure of the nasopharynx
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262:Coordination and control
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1349:Migrating motor complex
987:gastrointestinal system
872:(9). Wiley: 1385–1394.
779:swallowing a fish or a
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709:can interfere with the
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470:and involves important
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1373:Enteric nervous system
928:Overview at nature.com
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79:improve this article
34:. For the film, see
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68:This article
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19:
1308:Goblet cells
1153:Somatostatin
1120:Gastric acid
1110:Gastric acid
1078:
1036:Gastric acid
942:See : "
921:the original
916:
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859:
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747:Swallowing
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429:genioglossus
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94:"Swallowing"
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77:Please help
72:verification
69:
1409:Peristalsis
1395:Either/both
1354:Borborygmus
1019:Chief cells
658:peristalsis
496:nasopharynx
385:Mastication
248:health care
166:inglutition
162:deglutition
1536:Physiology
1525:Categories
1434:Enterocyte
1359:Defecation
1079:Swallowing
1024:Pepsinogen
831:References
596:arytenoids
575:oropharynx
530:suprahyoid
437:hyoglossus
399:Buccinator
368:Moistening
358:Oral phase
276:esophageal
272:pharyngeal
240:physiology
182:epiglottis
158:Swallowing
105:newspapers
1481:Processes
1452:Accessory
1429:Digestion
1402:Processes
1337:Processes
1292:APUD cell
1238:incretins
1185:paracrine
1181:Endocrine
1146:ECL cells
1141:Histamine
1122:secretion
1072:Processes
820:Occlusion
815:Dysphagia
739:achalasia
643:elevation
613:X (vagus)
609:passively
564:(Vc) and
468:voluntary
421:mylohyoid
318:esophagus
246:, and of
234:In humans
178:esophagus
172:, to the
1531:Reflexes
1217:Secretin
1084:Vomiting
1011:Exocrine
995:GI tract
894:22881225
886:17059520
809:See also
498:and the
190:drinking
135:May 2009
1264:L cells
1252:K cells
1222:S cells
1210:I cells
1158:D cells
1134:G cells
1129:Gastrin
777:seagull
765:pelican
703:strokes
623:. The
303:pharynx
289:of the
198:choking
196:, then
194:trachea
174:pharynx
119:scholar
43:Swallow
1460:Fluids
1321:Fluids
1105:Saliva
1098:Fluids
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884:
803:snakes
745:M-Type
536:(IX),
500:larynx
353:Phases
320:. The
314:tongue
280:medial
228:biting
206:reflex
186:eating
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1259:GLP-1
1173:Lower
1061:Mucus
1003:Upper
890:S2CID
796:gills
781:stork
641:Hyoid
632:apnea
307:bolus
305:as a
242:, of
217:bolus
170:mouth
126:JSTOR
112:books
1467:Bile
882:PMID
792:fish
785:frog
705:and
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619:and
482:and
443:and
435:and
299:pons
297:and
285:and
274:and
268:oral
213:neck
188:and
98:news
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1247:GIP
1053:HCO
874:doi
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