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4.Swallowing

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7 views

4.Swallowing

Uploaded by

lamyaahmed001
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Swallowing

-
Mastication)chewing(
Mastication stimulate the secretion of-1
saliva
breaks up large food particles-2
mixes the food with the secretions of the-3
. saliva , this aids swallowing and digestion
Large food particles can be digested but
they cause strong and painful contractions
. of the esophageal muscles
Small particles in absence of saliva also
make swallowing difficult because they
.don’t form a bolus
Mastication is started as voluntary but
.continues as involuntary reflex

the contact of the food particles with teeth


and gum induces reflex opening of the jaws
,followed by closure

this produces rhythmic closure and opening


.at about one cycle per second
Lateral Pterygoid

Medial Pterygoid Temporalis

Masseter
When the bolus is of suitable of
.consistency and size it will be swallowed

The number of chews that is optimal


depends on the food, but ranges from 20 to
.25
Swallowing ( deglutition )
is a reflex response

Afferent impulses from the pharynx and


:oesophagus
in trigeminal ,glossopharyngeal and vagus
.Integrated in swallowing center in the medulla

Efferent fibers : pass to pharyngeal muscle,


oesophagus, lanynx and tongue via trigeminal,
facial , vagus and hypoglossal nerves.
The swallowing process is considered in three stages
,buccal, pharyngeal and oesophageal

the buccal stage is voluntary (1s)but the pharyngeal(2s)


and esophageal(8s), stages are reflexes
Buccal stage
.Pieces of food are collected by tongue into a bolus

The tip of the tongue is pressed against the hard palate,


thus creating a chamber between the tongue and the
.palate

Contraction of the mylohoid and styloglossus muscles


.causes the tongue to move upward and backward

.It propels the bolus toward the pharynx


Extrinsic muscles
Palatoglossus [elevates the Genioglossus – protrusion &
tongue & approximates the depression; prevents the tongue from
palatoglossal folds] sinking back / obstructing respiratory
passage

Styloglosssus [draws the tongue


up & backwards]

Hyoglossus
[depression]

Genioglossus
The soft palate rises and the posterior pharyngeal
wall moves forward as a result of contraction of
.the superior constrictor muscle of the pharynx

They meet and close off the nasopharynx


.

, Respiration is inhabited during swallowing

the larynx starts to rise at the end of the buccal


stage and at this moment the process becomes
.involuntary
during the buccal stage the lips and the jaws are closed
Swallowing is difficult if not impossible when the
mouth is open

.Pharyngeal stage
This requires highly coordinated muscle contraction to
propel the bolus to upper end of the esophagus while
.avoiding the entrance to air passages at the larynx
The tongue moves further backward and pushes the
bolus against the epiglottis, which bends over the
.larynx and divides the bolus into two parts

. The epiglottis is not essential for swallowing


The bolus is propelled downwards by the
contraction of the middle and inferior constrictors of
the pharynx and reaches the upper end of the
.esophagus

The cricopharyngeal sphincter relaxes for about 1 s.


As soon as the bolus enters the esophagus, the
cricopharyngeal sphincter closes, the larynx drops
.and the epiglottis returns to its previous position
.Esophageal stage
A peristaltic ring of esophageal muscle forms
behind materials ,then swept down esophagus at
speed of about 4cm\s ,when man in
position ,liquid and semisolid food fall by gravity a
head of peristaltic wave .

Vagal impulses relax the lower esophageal


sphincter via VIP and NO. ahead of peristaltic
, wave
the bolus enter the
Stomach and the sphincter then closes rather
slowly, taking 7-10s
A normal adult swallows frequently while eating ,
. swallowing continues between meals
The total number of swallows per day about 600:
, 200 while eating and drinking

while awake without food and 50 while 350


. sleeping
The lower oesophageal sphincter is under neural
.and hormonal control

Efferent impluses in vagus are in hibitory cause


. sphincter to relax during swallowing

Gastrin contract the LOS , Secretin and CCK relax


. the sphincter
Difficult in swallowing is dysphagia

Achalasia, the lower oesophageal sphincter fails


to relax lead to obstruction oesophagus dilates
.and food accumlate in it

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