The Anatomy of the Swallowing Process

 
 
 
 
This paper looks at the anatomy of the swallowing process, dealing with the oral cavity, the pharynx, larynx, and esophagus, and the muscles and nerves which make them function. It then looks at the process of normal swallowing, which includes the oral stage, the pharyngeal stage, and the esophageal stage, and the mechanisms which make it function. Next, it describes the types of problems encountered in dysphagia - abnormal swallowing - and how these can occur at various points in the swallowing process, and how these can be affected by anatomical defects and disease. The conclusion draws together all the material covered in the paper and stresses the necessity of an understanding of the complex swallowing process to diagnose and treat dysphagia.

The anatomic areas involved in swallowing include the oral cavity, the pharynx, the larynx, and the esophagus (Logemann, 1998). The oral cavity includes the lips, hard palate, soft palate, uvula, mandible, floor of the mouth, tongue, and faucial arches (13). The pockets created by the natural juxtaposition of structures are important because in dysphagia they are where food or liquid may collect and remain after swallowing, e.g. between the alveolus and cheek or lip superiorly and inferiorly, between the lips or cheeks and the mandible or maxilla. The floor of the mouth is formed by the mylohyoid, geniohyoid, and digastric muscles, which attach to the mandible in the anterior and the hyoid bone in


     
 
 
 
    

 

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allowing and inhibition of the stable tonus in the cricopharyngeus effect opening of the pharyngoesophageal segment. D. Esophagus: The lower portion of the upper vertical subsystem of the swallowing system is the esophagus (Kennedy and Kent, 1985, 261). It extends from the lower boundary of the laryngopharynx to about the 11th thoracic vertebra. It has four constrictions along its length: at its upper end, 7cm inferiorly from where it crosses the aortic arch, 12.5 cm inferior to where it is crossed by the left bronchus, and where it pierces the diaphragm at its inferior termination. The esophagus is composed of a thick mucous membrane, a submucosal areolar layer, a muscular layer, and an external fibrous connective tissue sheath. Mucous glands lie within these tissues. The outer muscle layer is comprised of thick longitudinal fibers, and the inner layer of circular striated fibers in the upper third, and smooth muscle in the lower regions. The inner layer of muscle is continuous with the inferior constrictor at the upper end, and the circular fibers of the stomach at the lower end. The thick longitudinal muscle layer diverges into lateral fasciculi at the upper three to four cm. Valves at the upper and lower ends of the e

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