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Mouth and Esophagus

Dr Raghuveer Choudhary

Mastication
Also called chewing Mastication muscles close the jaws Slide or rock lower jaw from side to side Chewing involves mandible:
elevation and depression protraction and retraction medial and lateral movement

Mastication 1. Mastication is important for the digestions of fruits and raw vegetables.

Cellulose membrane

2. Mastication increases the rate of digestion by grinding the food into particles.

Total surface area exposed to the digestive juices

3. Mastication prevents excoriation of GI and increase the emptying of food.

MASTICATION Chewing (mastication) reduces the particle size of food and increases its exposure to saliva. This process lubricates food for swallowing and also aids in carbohydrate digestion by the enzyme salivary amylase. The distribution of foodstuffs around the mouth during chewing stimulates the taste receptors.

Pharynx
Connects nasal and oral cavities with larynx & esophagus Divisions _ nasopharynx, oropharynx, laryngopharynx Superior, middle, inferior PHARYNGEAL CONSTRICTORS circular force food down during swallowing

Divisions
Nasopharynx - air
Most superior to soft palate

Oropharynx - Food & air


Posterior to mouth Soft palate to esophagus

Laryngopharynx - food
Esophagus to cricoid cartilage Passageway to esophagus;

Swallowing The process of food coming into the stomach from oral cavity . 1.Voluntary stage 2.Pharyngeal stage 3.Esophageal stage Oral cavity Pharynx Esophagus Pharynx Esophagus Stomach

1.Voluntary stage

Oral cavity

Pharynx

The pressure of the tongue upward and backward against the palate.

SWALLOWING
Swallowing (deglutition) carries food from the pharynx into the esophagus. There is a voluntary stage when food is shaped into a bolus, collected on the tongue, and pushed into the pharynx. The tongue is then raised against the hard palate to create a pressure gradient that forces the bolus into the pharynx and beyond. When food enters the pharynx, the following involuntary events of the swallowing refl ex occur:

Once food is forced into the pharynx by the voluntary elevation of the tongue, receptors in the pharynx send messages to the pons and medulla to reflexively cause:

The tongue to block the mouth The soft palate to rise The epiglottis to close off the glottis Peristalsis to move the food down the esophagus Relaxation of the cardiac sphincter so that food can enter the stomach.

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Soft palate raised

Tongue block oropharynx

Epiglottis close-off the glottis

2.Pharyngeal stage

Pharynx

Esophagus

Receptors (pharynx)

Trigeminal nerves

Glossopharyngeal nerves

Brain stem 5th,9th,10th,12th cranial nerves Series of automatic pharyngeal muscle contractions

The nasopharynx is closed by the soft palate.


Food is prevented from entering the airway by elevation and forward displacement of the larynx and deflection of the food bolus by the epiglottis. The upper esophageal sphincter relaxes to allow the bolus to enter the esophagus.

2.Pharyngeal stage

Pharynx

Esophagus

1.the trachea is closed 2.the passage between the pharynx and nasal cavities is closed 3.the esophagus is opened 4.a fast peristaltic wave originates in the pharynx and forces the bolus of food into the upper esophagus.

The upper esophageal sphincter tone prevents the aspiration of the esophageal contents into the airway.
It also prevents the entry of air into the esophagus, since the esophageal body exists at below atmospheric pressure in the thorax.

The above events are coordinated by a center in the reticular formation, which also inhibits breathing until food is in the esophagus.

The oral and pharyngeal component of swallowing is controlled solely by extrinsic nerves. Neurologic damage (e.g., the result of a stroke)
can adversely affect this phase of swallowing.

Swallowing induces a wave of peristalsis in the esophagus known as primary peristalsis. If this wave is insufficient to move a bolus all the way to the stomach, distension of the esophageal wall by a remaining bolus induces secondary peristalsis, which is repeated until the bolus enters the stomach.

3.Esophageal stage primary The continuation of the peristaltic wave that begins in the pharynx and spread into the esophagus

Esophagus

Stomach

peristalsis secondary Distension of the esophagus


Vagal afferent

Myenteric nervous system

medulla
Vagal efferent

Glossopharyngeal nervous

esophagus

Lower esophageal sphincter (gastroesophageal sphincter) Oral cavity

Prevents reflux of stomach contents into the esophagus


sphincter

stomach

From Mouth to Stomach

(continued)

Involuntary muscular contractions and relaxations in the pharynx, and esophagus are coordinated by the swallowing center in the medulla. Esophagus:
Connects pharynx to the stomach.
Upper third contains skeletal muscle. Middle third contains a mixture of skeletal and smooth muscle. Terminal portion contains only smooth muscle.

The Esophagus

Figure 2410

ESOPHAGUS
Gross anatomy Esophageal hiatus Mucosa Muscularis Sphincters
upper lower (gastroesophageal)
stratified squamous epithelium upper esophageal sphincter

gastroesophageal sphincter

esophagus

lumen

mucosa submucosa IC muscularis externa OL adventitia

ESOPHAGUS The function of the esophagus is to move food and liquid to the stomach and to keep it there.

The esophagus has three functional zones: 1. The upper zone, which is 68 cm long, is closely related to the pharyngeal musculature and consists of striated muscle.
2. The middle zone (main body), which is 1214 cm long, consists of smooth muscle.
3. The lower zone, which is 34 cm long, consists of smooth muscle and corresponds with the lower esophageal sphincter.

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