Section 1

CN V Trigeminal Motor Innervation

all jaw muscles except geniohyoid

CN V Trigeminal Sensory Innervation

face, anterior 2/3 of tongue, and soft palate

CN VII Facial Motor Innervation

all muscles of the face

CN VII Facial Sensory Innervation

taste sensation for the anterior 2/3 of tongue

CN IX Glossopharyngeal Motor Innervation

all intrinsic pharyngeal and palatal muscles except tensor veli palatini and stylopharyngeus

CN IX Glossopharyngeal Sensory Innervation

• general sensory and taste for posterior 2/3 of tongue

• general sensory from the nasopharynx

CN X Vagus Motor Innervation

all intrinsic laryngeal muscles and the esophagus

CN X Vagus Sensory Innervation

general sensation and taste for the larynx and esophagus

CN XII Hypoglossal Motor Innervation

all tongue muscles except the palatoglossus

CN XII Hypoglossal Sensory Input

none

Pharyngeal Plexus

CN IX and X

Pharyngeal Plexus Motor

• innervates pharyngeal constrictors

• responsible for pharyngeal drive and bringing food down

Pharyngeal Plexus Sensory

receives sensory input from oropharynx and laryngopharynx

Phases of Oral Stage

• bolus anticipation/recognition

• bolus acceptance

• lip closure

• lingual control

• mastication

• posterior lingual propulsion

Bolus anticipation/recognition

oral stage component involving anticipation and recognition of the bolus

Bolus acceptance

oral stage component for accepting the bolus

Lip closure

oral stage component for ensuring anterior containment

Lingual control

• oral stage component involving tongue management

• tongue contacts velum to form a posterior seal for bolus containment

Mastication

lingual, jaw, buccal movement + saliva = mash/grind bolus

Posterior lingual propulsion

• oral stage phase for moving the bolus backward

• bolus efficiency and squeeze back

Phases of Pharyngeal Stage

• swallow trigger

• velar elevation

• LVC

• pharyngeal constriction and elevation

• UES opening

Swallow trigger/onset

all or none event that initiates the cascade of other swallowing events

Velar elevation

• responsible for velar pharyngeal closure

• prevents food from going into the nose

• generates pressure

Laryngeal vestibule closure (LVC)

• arytenoids pivoting (adduction and anterior movement)

• aryepiglottic folds bunch

• epiglottic inversion

Epiglottic inversion

posterior lingual propulsion + hyo-laryngeal elevation facilitates movement of the epiglottis to horizontal position

Pharyngeal constriction and elevation

• pharyngeal constrictors compresses on the tail, or end, of the bolus and sweeps it down

• longitudinal pharyngeal muscles complete epiglottic inversion by bringing the tip of the epiglottis down over the laryngeal vestibule

UES opening

opens to allow bolus to pass from pharynx to esophagus via laryngeal traction and relaxation

Esophageal Stage

• brings food and fluid from pharynx to stomach via rhythmic contractions (peristalsis)

• acid clearance of refluxed gastric contents

• reflex activities - vomiting and belching