Stages of Swallow

Stages of Swallow

1. 1) Oral Preparatory Stage

   • Labial Seal
   • Open nasal airway
   • Mastication of Bolus
   • Manipulation of the Bolus
   • Tongue Cups Bolus to move to back of mouth
   • 2) Oral Transit
     • Move from oral prep to beginning of transit
     • Tongue moves bolus posteriorly
     • Ends when bolus reaches anterior faucial pillars
     • 1 second
     • 3. Pharyngeal Stage
       • Initiates when the bolus head reaches any point between the anterior faucial pillars and the point where the tongue base crosses the lower rim of the mandible
         • Not always true for adults over 70 and infants. They may initiate from the valleculae.
       • Sensory receptors in oropharynx and tongue are stimulated, sending sensory information to the cortex and brainstem to initiate the swallow.
         • Elevation and retraction of velum (Closes nasopharynx)
           • Hyolaryngeal excursion - Elevation of hyoid and larynx superiorly and anteriorly
             • Closure of larynx at 3 levels • True VF adduct • Laryngeal entrance o False VF adduct o Arytenoids rock medially and forward o Thickening of epiglottis base as larynx elevates • Epiglottis retroflexion o (Makes contact with arytenoids) o (Hyolaryngeal excursion also helps retroflexion)
               • Opening of c-p • (Cricopharyngeal sphincter—part of upper esophageal sphincter; opens when it is relax
             • Responsible for retroflection of epiglottis and UES opening)