CMSD3010 MODULE 8A

What is the flexible tube that runs through the diaphragm to the stomach

esophagus

What are the 3 sections of the esophagus?

cervical, thoracic, and abdominal esophagus

what part of the esophagus consists of only striated muscle?

cervical (upper) esophagus 

what part of the esophagus consists of striated and smooth muscle?

thoracic esophagus

what part of the esophagus consists of only smooth muscle?

abdominal (lower) esophagus

what is the esophagus bounded by?

upper and lower esophageal sphincters

what is a large saclike structure on the left side of the abdominal cavity below the diaphragm?

stomach

what side of the abdominal cavity is the stomach like?

left 

what does the stomach connect to?

esophagus via the lower esophageal sphincter and small intestine via the pyloric sphincter

how much substance does the stomach hold after a meal?

1 liter

the process of mastication and deglutition is ___ for most individuals

automatic 

the process of mastication and deglutition is under ____ control

volitional 

what does it mean if something can be interrupted at will?

volition

the process of mastication and deglutition is a complex process that involves what?

motor and sensory events in the oral cavity, pharynx, larynx, and esophagus

what prepares food into ready-to-swallow mass

mastication

a ready-to-swallow mass is also known as what?

bolus

what propels the bolus from the oral cavity into the stomach for digestion?

deglutition 

deglutition is more ___ than ____

reflexive, voluntary

how do we choose to initiate the process of deglutition?

volitionally

what ensures efficient transportation of boluses through the pharynx into esophagus

process of deglutition 

what can we do to the pharyngeal swallow to some degree

interrupt it

how is foreign material entering the airway categorized?

how deeply it passes into the airway

foreign material passes into the airway but does not pass below the true vocal folds

penetration 

foreign material passes into the airway below the true vocal folds

aspiration 

any change that decreases function outside the normal range

dysphagia

what describes the movement of the bolus though the oral, pharyngeal, and esophageal segments of the apparatus 

stages of swallowing 

what are the stages of mastication and deglutition?

oral preparatory, oral transport, pharyngeal, and esophageal

in the oral preparatory stage of mastication and deglutition where is food placed?

mouth

what happens to food during the first stage of mastication and deglutition?

it is manipulated, masticated, and readied into a bolus 

what is the second stage of mastication and deglutition?

oral transport

what stage in mastication and deglutition does mastication stop and the tongue propels the blue posteriorly toward the pharynx

oral transport 

what stage of mastication and deglutition begins as the pharyngeal swallow is triggered and the bolus moves into and through the pharynx 

pharyngeal 

during the pharyngeal stage of mastication and deglutition what is triggered that causes the bolus to move through the pharynx 

swallow 

what stage of mastication and deglutition that occurs once the bolus enters the esophagus and is carried through the esophagus to the stomach 

esophageal 

what enters the esophagus during the esophageal stage of mastication and deglutition and is carried through the esophagus to the stomach?

bolus

what is the primary function of oral preparatory stage?

ready a bite of food into a bolus for swallowing 

what is the velum doing during the oral preparatory stage?

depressed

what does the oral preparatory stage do to food?

grind food into small pieces and it mixes with saliva

where does breathing occur during the oral preparatory stage?

nose

what does the orbicular oris do during the oral preparatory stage?

seal oral cavity 

what does the teeth do during the oral preparatory stage?

cut, bitten, and masticated

what does the mandible do during the oral preparatory stage?

bring teeth together

what does the salivary glands do during the oral preparatory stage?

moisturize bolus for deglutition 

what does the buccal cavity do during the oral preparatory stage?

prevents food from falling into buccal cavity and pushes bolus against molars 

what does the tongue do during the oral preparatory stage?

rotates jaw, places food between teeth, crushes certain consistences of food against hard palate, back on tongue raise to prevent premature spillage into pharynx 

How does the oral preparatory phase begin?

substance touches structures of the anterior oral vestibule

what does the mandible do during the oral preparatory phase?

lowers and causes the lips to abduct

how long is liquid held in the anterior cavity during the oral preparatory phase?

1 second using the tongue to form a cup 

what is open and breathing may continue or stop temporarily (apnea interval) during oral preparatory phase?

velopharynx 

How long can the oral preparatory phase last?

20 seconds

What is the primary function of the oral transport stage?

transport bolus posteriorly towards the pharynx

what does the oral transport stage trigger:?

pharyngeal swallow

what are the lips doing during the oral transport stage?

closed

what are the teeth doing during the oral transport stage?

mastication stops

what does the mandible do during the oral transport stage?

raises, teeth not touching but are approximated 

what is the tongue doing during the oral transport stage?

posterior tongue drops, apex rises against hard palate, and body squeezes bolus posteriorly towards oropharynx 

what is the anterior faucial pillar doing during the oral transport phase?

receptors send signal to brainstem to trigger pharyngeal swallow 

what is the velum doing during the oral transport phase?

elevated

what is the upper esophageal sphincter doing during the oral transport phase?

begins to relax

how long does the oral transport phase last?

1 second

what is the primary function of the pharyngeal stage?

move bolus over airway to deliver into esophagus

what passes into the body through the mouth and passes through the pharynx during the pharyngeal stage?

hydration and nutrition

what does the pharyngeal swallow activate?

finely coordinated actions by structures of the pharynx

pharyngeal swallow is ____

reflexive 

when stating that the pharyngeal swallow is reflexive, what does that mean?

actions are below the level of awareness 

what is the velum doing during the pharyngeal stage?

elevated to seal off the velopharyngeal port and repent nasal regurgitation 

what is the tongue doing during the pharyngeal stage?

base of tongue moves posteriorly to contact pharyngeal wall

what is the larynx doing during the pharyngeal stage?

raises

what is the vestibular and true vocal folds doing during the pharyngeal stage?

adducted tightly to seal off airway

how does the posterior wall of the pharynx move during the pharyngeal stage?

anteriorly to contact tongue 

what does the upper esophageal sphincter do doing during the pharyngeal stage?

relaxes to allow bolus to pass into esophagus

what is pharyngeal peristalsis?

rhythmic contraction

what does the pharyngeal peristalsis do during the pharyngeal stage?

moves bolus inferiorly to esophagus

how is the pharyngeal phase triggered?

bolus and anterior facial pillars is under automatic control and occurs rapidly

what is the velopharynx doing during the pharyngeal phase?

closes forcefully

how does the hyoid bone and larynx move during the pharyngeal phase?

upward and forward

what divides to pass through the left and right epiglottic valleculae to the left and right pyriform sinuses

bolus

what does the upper esophageal sphincter do during the pharyngeal phase?

open 

how long does the pharyngeal phase last?

1 second or less 

what is the fourth and final stage of deglutition?

esophageal stage 

the esophagus is divided into how many sections?

3

what is the upper esophageal sphincter doing during the esophageal stage?

closes behind bolus to prevent regurgitation or reflux

what does the transit time depend on during the esophageal stage?

size and consistency of bolus

how long does the transit time last during the esophagus stage last?

8-20 seconds

where does the bolus enter during the esophageal phase?

upper esophageal sphincter

how is the bolus propelled through the esophagus during the esophageal phase?

peristaltic actions of the esophageal walls 

how can the overlap of phases occur?

oral preparation continues while part of the bolus moves toward the pharynx 

how can the overlap of phases be apparent?

actions of individuals structures are considered rather than the status of the bolus

what has primary control over the automatic phases of swallowing

brainstem (medulla)

what regions have primary control over the voluntary phases of swallowing 

cortical and subcortical 

what is critical to the generation of the swallow?

afferent(sensory) input 

what nerves are involved in control of all four subsystems?

peripheral 

what protects the pulmonary airways from liquid/food during the pharyngeal transport phase?

closure of larynx and cessation of breathing

what usually occurs during expiration in an expiration-swallow-expiration pattern?

swallow 

when does swallowing usually occur in relation to the lungs?

lung volumes 10 to 20% larger than the resting expiratory level 

__ can cause ____in people with pulmonary disease

apnea, dyspnea 

apnea usually last how long?

1 second but can last longer