Physiology of Swallowing and Dysphagia Flashcards Preview

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Flashcards in Physiology of Swallowing and Dysphagia Deck (12)
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1
Q

Mastication including reflexes

A

Important beginning of digestion for carbs

incisors for tearing and molars to crush

Voluntary and involutnary

Tonic tone in masseter

Reflexie - muscles are innervated by trigeminal nerve and can be inittiatied by hypothalamus or cortec

Chewing reflex - bolus of food against lining of the mouth causes reflexive relaxation of striated jaw muscles…jaw drops…monosynoatic stretch reflex causes rebound contraction

Masseter relaxes-=–jaw drops—musucle stretched—-muscle spindles act—-initiates reflex contraction—-inc tension activates golgi tendon organs—reflex relaxation

2
Q

Strenght of chewing

A

Role of periodontal ligament

If false teeth, cannot exert as much force

3
Q

Deglutition

A

Can be initiated voluntarily but after oral phase, becomes reflexive

NTS - needs CNS innervation

Includes a reflex component to inhibit inspiration and prevent aspiration

4
Q

Phases of deglutition

A

Buccal - tactile receptors in mouth and pharynx - affarnet (5,7,9,10) and efferent (5,7,9,10,12)

Pharyngeal - soft palate moved up and palatopharyngeal folds close…epiglottis covers trachea…UES relaxes (as well as LES)…peristaltic wave begins in superior contstrictor

Esophageal - strong peristaltic wave ocnducted donw

5
Q

Peristalsis

A

Moving ring contractions controlled both extrinscially and intrinsically

Upper requires CNS control

Mainly as a conduit

6
Q

Wave like contraction

A

Circular smooht muscle contracts behind and relaxes in front of

Followed by longitudinal contraction

After food to stomach, LES constricts

7
Q

Primary and seoncdary peristalsis

A

Pirmary - controlled by BS…need vagal efferent

LES is relaxed at beginnign and stays open til end due to BS control and vagal activity (VIP/NO)

When drinking, occurs only after the last swallow

Cold water eliminates peristalsis but LES relaxes

If food cannot move through, initiates less eff secondary peristalsis

8
Q

General features of esophagus

A

Negative pressure throught but stomach pressure pos

LES maintains greater pressure than stomach

Ach and gastrin inc constriction of LES

9
Q

Dysphagias

A

LES cannot close completely and esophageal lining is damaged

Pregnancy - progesterone and inc abdomina tone

Peristaltic cirucity incomplete in infatns

10
Q

Heartburb-GERD-esophagitis

A

Bruning sensation

Pressure in stmoach
Eff of LES
Clearance of esopahgis\
Aciditiy of regurged contents
Repair of esophagus
11
Q

Achalasia

A

LES does not relax properly so food accumulates above the LES

Results in secondary peristalsis

Usually due to myhenteric pleus probs

Painless and progressive dysphagia

12
Q

Diffuse esophageal spasm

A

Abnormal sequencing of peristalsis prevents food from moving

Simulataneous long contraction of lower esoph…can be triggered by hot or cold fluids