Anatomy of the Swallow
Anatomy and Swallowing
Lateral sides of the cranium
Just below the earlobe
Digastric (floor of mouth)
Hook like projection
Forms with zygomatic bone
Attachment site for various muscles of facial exp.
Initial portion hard palate
Orbital and nasal cavity
U-shaped bone with a ramus on each side
Mental symphysis-anterior midline where fuses
Coronoid process-ramus anterior projection
Condylar process-ramus posterior projection (TMJ)
Condylar process at the mandibular fossa of the temporal bone
(depression, elevation, protrusion, retraction, lateralization)
Vermillion border (bottom border of upper and lower lip)
Cupid's Bow-dipped part of upper lip
Columellae-2 columns from top lip to nose
Philtrum-the groove between the columellae
Anterior and Posterior Faucial Pillars
Formed by palatoglossus and palatopharyngeus muscles
Between the palatine tonsils
Median raphe-midline groove
Torus palatinus-anterior midline raphe-appears as bulge or pad
True Vocal Cords
Believed to occur with elevation of hyolarygneal complex.
Contraction of lateral cricoarytenoid, interarytenoids, vocalis (thyroarytenoid or
thyrovocalis) and thyromuscularis.
Adduction of vocal cords for phonation with increased pressure for swallowing.
Made of base of tongue and epiglottis.
On the side of the hyoepiglottic ligament, between the tongue base and epiglottis.
Either side of the thyroid cartilage at the bottom of the pharynx.
Created as fibers of the inferior constrictor wrap to attach to the anterior
It's the velum's lack of action that assists in oral phase of the swallow.
Rests low to help contain the bolus.
Simultaneous contraction of the horizontal fibers of the palatopharyngeus and
superior constrictor creating a bulge on the posterior pharyngeal wall.
Circumvallate Papillae-V-shaped region of bumps on the anterior tongue
Most important structure of the oral swallow.
Holds and manipulates bolus and transports.
Innervated by the autonomic nervous system
Both sympathetic and parasympathetic fibers
Posterior and inferior cheeks
Can stimulate by massage just below the ear lobe
CN IX from inferior salivary nucleus in the pons of the brainstem
Located immediately beneath the mucousal surface of the floor of
the mouth along the internal surface of the jaw
Rests on mylohyoid between genioglossus and mandible
CN VII-superior salivary nucleus in the pons
Deep to mylohyoid
CN VII, superior salivary nucleus
Lateral boundary for bolus containment and manipulation
Cheek tension-minimize pocketing
Cheek tension=buccinator and risorius (CN VII)
Buccinator-pterygomandibular ligament (raphe) runs horizontal muscle splits
and inserts into orbicularis oris.
Fire when mechanically deformed, mucosal contact with bolus or with other
oral structures during mastication.
allow us to know the position of our articulators in space relative to one
another; located in the muscle fibers and tendons; help to maintain muscle
tone and facilitate controlled movement; stretch reflex; found in
muscles of tongue, jaw and velum and in TMJ.
responds to changes in temperature (in oral mucosa).
mediate sensation of pain in response to tissue damage.
(taste is a form of); taste buds; salty, sweet, sour and bitter; CN VII, IX
through brainstem and thalamus; chemical characteristics of food
stimulate the automatic nervous system, modifying salivary flow
and critical in bolus preparation.
18-25 cm tube.
At rest, collapsed or flattened.
Can stretch 3 cm lateraland 2 cm A-P
Top 1/3 is skeletal muscle.
Peristalsis (primary, secondary, tertiary)
Primary-initiated by the pharyngeal swallow.
Secondary-normal, not initiated by a swallow.
Tertiary-Mostly in older adults, contractions at the same time as
primary and secondary peristalsis (may be painful)
CN X (recurrent laryngeal)
Carries material to stomach and allows for retrograde movement
when vomit and burp.
Liquids require decreased peristalsis.
Nucleus Tractus Solitarius (NTS)
When the NTS receives appropriate intensity of sensory input, efferent
response is triggered atthe nucleus ambiguus.
Probably the overall pattern of stimulation that triggers the swallow.
Bolus stimulates CN IX, X, XI in the medullary reticular formation (NTS).
IncorporatesNTS input from V, VII, XII.
NTS signals motor nuclei in nucleus ambiguus to help fire IX, X, XI.
Nucleus Ambiguus innervates muscles of velum, pharynx, larynx
and upper esophagus (IX, X, XI) producing thepharyngeal swallow
Strongest oral ties to NTS=anterior faucial arches, posterior tongue
at the lower edge of the mandible, valleculae, pyriform sinuses and