In the past, swallowing was considered to be controlled by the pons and medulla of the brain stem. However, recent fMRI and PET scan studies during swallowing have revealed numerous cortical areas also are involved in the regulation of swallowing, including the thalamus, sensorimotor cortex, supplemental motor cortex, insula, basal ganglia, putamen, globus pallidus, and anterior cingulate gyrus. In addition, several cranial nerves are involved in swallowing, including the trigeminal, facial, glossopharyngeal, vagus, and hypoglossal. Therefore, both the CNS and the PNS are involved in swallowing.
Individuals may have problems in any or all four of the phases of swallowing, and a problem at an earlier phase may cause or contribute to a problem …show more content…
There may be a delayed swallow response from a few to many seconds after the patient attempt to swallow. Timing and coordination of the oral-pharyngeal structures may be impaired. An overall decrease in pharyngeal strength, causing excessive pooling in the valleculae and pyriform sinuses, may be present. The soft palate may be too weak to close the velopharyngeal port to prevent material from entering the nasal passages. The suprahyoid muscles may be weak, preventing good elevation of the hyoid bone and larynx, which would affect the dropping down motion of the epiglottis as the first line of defense from food accidentally entering the open airway. Weak pharyngeal muscles (superior, middle, and inferior pharyngeal constrictors) may not provide sufficient peristalsis to move the bolus down efficiently. The true and false vocal folds may not have strong closure, allowing material that may enter the larynx to pass below the vocal …show more content…
Slow or absent esophageal peristalsis may not carry the bolus through the esophagus in an efficient and complete manner, causing discomfort or pain in the chest and leaving residue on the esophageal walls that may result in infection. In some patients, the lower esophageal sphincter does not sufficiently relax to allow the food in the esophagus to flow into the stomach, resulting in achalasia. Gastroenterologists are the medical professionals who treat esophageal
Individuals may have problems in any or all four of the phases of swallowing, and a problem at an earlier phase may cause or contribute to a problem …show more content…
There may be a delayed swallow response from a few to many seconds after the patient attempt to swallow. Timing and coordination of the oral-pharyngeal structures may be impaired. An overall decrease in pharyngeal strength, causing excessive pooling in the valleculae and pyriform sinuses, may be present. The soft palate may be too weak to close the velopharyngeal port to prevent material from entering the nasal passages. The suprahyoid muscles may be weak, preventing good elevation of the hyoid bone and larynx, which would affect the dropping down motion of the epiglottis as the first line of defense from food accidentally entering the open airway. Weak pharyngeal muscles (superior, middle, and inferior pharyngeal constrictors) may not provide sufficient peristalsis to move the bolus down efficiently. The true and false vocal folds may not have strong closure, allowing material that may enter the larynx to pass below the vocal …show more content…
Slow or absent esophageal peristalsis may not carry the bolus through the esophagus in an efficient and complete manner, causing discomfort or pain in the chest and leaving residue on the esophageal walls that may result in infection. In some patients, the lower esophageal sphincter does not sufficiently relax to allow the food in the esophagus to flow into the stomach, resulting in achalasia. Gastroenterologists are the medical professionals who treat esophageal