GI Motility Online

Table 7 - Elements of normal adult swallowing physiology (key events)

From the following article

How to perform video-fluoroscopic swallowing studies

Gary D. Gramigna

GI Motility online (2006)

doi:10.1038/gimo95

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1. Bolus resting on tongue dorsum or controlled anteriorly, glossopalatal seal intact, tongue tip (oral tongue) elevates and ramps up to alveolar ridge beginning the voluntary act of propelling the bolus posteriorly.
2. Tongue and bolus move back in an organized efficient fashion. Bolus contacts receptors of afferent fibers from superior laryngeal nerve (SLN) and glossopharyngeal nerves sending impulses to nucleus tractus solitarius (NTS) in brainstem (medulla). This is approximately the point where the ramus of the mandible crosses the tongue.
3. The patterned input results in patterned sequential output as the more automatic element of swallowing begins and a series of neuromuscular events occur in an intricately timed sequence.
4. Soft palate elevates to seal nasopharynx.
5. Pharynx constricts and moves anteriorly and medially.
6. Tongue base (pharyngeal tongue) moves forcefully to meet pharynx and squeeze the bolus.
7. Hyoid and larynx by way of strap muscle attachments move superiorly and anteriorly (get out of the way).
8. Epiglottis inverts.
9. Larynx closes (bottom to top).
10. Upper esophageal sphincter (UES) region opens to allow bolus to enter esophagus.
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