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Mastication and deglutition ii
1. Mastication and Deglutition-II
•A 42-year-old woman reports difficulty in swallowing solid foods;
liquids are less difficult to swallow. She frequently regurgitates
after eating. When the recumbent patient underwent fluoroscopy
after a barium swallow, her lower esophagus was somewhat
dilated compared with normal, but her upper esophagus was of
normal caliber. Subsequent swallows initiated by the patient
showed that the barium was cleared from the esophagus very
slowly. Monomeric studies showed that resting pressure in the
lower esophageal sphincter decreased after a swallow. The
patient was treated with forceful dilation of the lower esophageal
sphincter. The patient’s ability to swallow solid food was
dramatically improved after the dilation procedure.
Prof. Dr. Rashid Mahmood
2. 1. What is the mechanism of slow rate of
barium clearance from the
esophagus?
2. What will be the effect on esophageal
musculature of this patient?
3. How the above-mentioned therapy for
this patient’s improved swallowing
difficulties
4. Recap
• Ingestion of food involves two processes: Mastication
(Chewing) & Swallowing (Deglutition)
• Teeth cut & grind the bolus of food
• Mastication is brought about by Muscles of Chewing,
Controlled mainly by 5th Nerve.
• Chewing Reflex, initiated by bolus of food in mouth results in
reflex inhibition of Muscles of Mastication. This results in
Stretch Reflex, causing their Rebound Contraction
• Swallowing (Deglutition) occurs in three stages: Voluntary
Stage, Pharyngeal Stage and Esophageal Stage
• Voluntary Stage involves mainly tongue, pushing the bolus of
food in pharynx
• Pharyngeal Stage is Involuntary; in this stage swallowing
reflex results in Series of Automatic Pharyngeal Muscle
Contractions
5. Objectives
• Specific Objectives: At the end of the lesson
student will be able to:
• Explain the Esophageal Stage of swallowing
• Understand how food is transferred to stomach
• Classify types of peristalsis of esophagus
• Describe physiological anatomy of oesophagus
• Describe the Nervous Control of Lower esophageal
sphincter
• Describe the mechanism of Protection of
Esophageal Reflux
Goal/Aim: To give the understanding of the
physiology of Mastication and Deglutition
elevated pressure in the lower esophageal sphincter at rest and after a swallow contributes to the dilation of the lower esophagus during a barium swallow
increased pressure in the lower esophageal sphincter is often associated with hypertrophy of the lower esophageal sphincter
surgical weakening of the lower esophageal sphincter may cause long-term improvement of the patient’s swallowing