INGESTION, MASTICATION &

DEGLUTITION

By

N. M. Gidado

SEPTEMBER, 2019.
 INGESTION
 The amount of food ingested at a time is
determined principally by the intrinsic desire for
food called ‘hunger’.
 The food type that a person preferentially seeks is
determined by ‘appetite’.
 Thus, hunger & appetite automatically regulate &
maintain adequate nutritional supply to the body.
 Therefore, food ingestion consists of the mechanics
via which food is supplied to GIT for subsequent
digestion and absorption especially.
 MOUTH/ORAL/BUCCAL CAVITY
 This is the cavity formed by cheeks, lips & palate
enclosing the teeth, tongue & salivary glands.
 It opens anteriorly to the exterior through the lips
& posteriorly through fauces into the pharynx. It
functions include;
 Ingestion of food materials,
 Chewing food and mixing it with saliva,
 Taste appreciation of the ingested food,
 Bolus formation & its transfer to the esophagus,
 Speech articulation,
 Social expressions like smiling, laughter, hissing,
etc.
 MASTICATION (CHEWING)
 Teeth function, with incisors providing strong
cutting action and molars, a grinding action.
 Jaw muscles close the teeth with a force as great as
55 & 200 pounds on incisors & molars, respectively.
 Muscles are mostly innervated by motor branch of
5th CN & is controlled by a nuclei in the brainstem.
 Thus, rhythmic chewing movement can be
triggered by stimulation of;
 Specific reticular areas in brainstem taste centers.
 Areas in hypothalamus, amygdala & cerebral cortex
near sensory areas for taste & smell.
 MASTICATION/CHEWING REFLEX
 Presence of bolus at 1st initiates reflex inhibition of
mastication muscles leading to dropping of L. jaw.
 This in turn initiates stretch reflex of jaw muscles
leading to rebound contraction raising the jaw & in
turn causing automatic closure of the teeth.
 This compresses the bolus again against linings of
the mouth inhibiting the jaw muscles once again.
 This allows the jaw to drop & rebound another
time. This repeats again and again.
 Thus, chewing breaks cellulose membrane, incr.
food surface area & prevents excoriation of GIT.
 SWALLOWING (DEGLUTITION)
 It is a complex mechanism in which pharynx is
converted for only a few seconds at a time into
tract for propulsion of food. It can be divided into;
I. Oral stage: Food is voluntarily rolled posteriorly
into pharynx by upward & backward movement of
the tongue against the palate.
II. Pharyngeal stage: This is involuntary and involves
food passage through pharynx into the esophagus.
o It is initiated in response to stimulation of
‘epithelial swallowing receptor areas’ around
pharyngeal opening.
o Impulse are then generated to brainstem to initiate
series of automatic pharyngeal muscle contraction;
I. Upward pulling of soft palate to close posterior
nares & food reflux into nasal cavities.
II. Palatopharyngeal folds approximate each other to
form a sagittal slit through which masticated food
must pass into the posterior pharynx.
III. Tight approximation of vocal cord, larynx upward
& anterior pulling by neck muscles & presence of
epiglottis-upward-mov’t-preventing-ligaments all
act to prevent food passage into trachea & nose.
IV. Larynx upward mov’t relaxes pharyngoesophageal
sphincter to allow easy passage of food into upper
esophagus.
V. Larynx upward mov’t lifts glottis out of food flow
main stream so that food passes on each side of
the epiglottis rather than its surface.
VI. This is followed by contraction of pharyngeal
muscles superior-inferiorly propelling food by
peristalsis into esophagus.
o Thus, trachea is closed, esophagus is opened & a
fast peristaltic wave initiated by pharynx NS forces
bolus into upper esophagus in less than 2 seconds.
o Deglutition/swallowing center is formed by areas
in medulla & lower pons, receive input via
trigeminal & glossopharyngeal nerves.
o Motor impulses are transmitted to pharynx &
upper esophagus via 5th, 9th, 10th & 12th CN.
o Swallowing center specifically inhibits respiratory
center halting respiration at any point in its cycle
to allow swallowing to proceed.
III. Esophageal stage: an involuntary phase that
transports food through pharynx into stomach.
o To achieve this, esophagus exhibit two types of
peristaltic mov’t, primary & secondary peristalsis.
I. Primary Peristalsis: This is the continuation of
pharyngeal peristalsis that spread into esophagus.
 It passes from pharynx to stomach in about 8 to 10
seconds & is usually facilitated by force of gravity.
II. Secondary Peristalsis: This results from distension
of esophagus by retained food & it continued until
all the food is emptied into stomach.
 This is partly initiated by intrinsic neural circuit &
partly by pharyngeal reflexes transmitted via vagal
afferent to the medulla & back to esophagus via
vagal efferent & glossopharyngeal nerve fibers.
 Receptive Relaxation of the Stomach: When the
esophageal peristaltic wave approaches stomach;
o Myenteric inhibitory neurons transmit relaxation
waves to stomach which precedes the peristalsis.
o Stomach & duodenum become relaxed ready to
receive food being propelled into it.
 Gastroesophageal Sphincter: This is formed by the
distal 3 cm esophageal circular muscles & prevents
reflux of stomach content into esophagus.
 It remains tonically constricted (with valve-like
closure at the distal end) & its receptive relaxation
is initiated to precede peristalsis during deglutition.
 ESOPHAGEAL SECRETION
 Esophageal secretions are entirely mucus which
provides lubrication for easy swallowing.
 Simple & compound mucus glands are found
densely in main body of esophagus, its gastric end
& initial portion to a lesser extent.
 The mucus prevents mucosal excoriation by newly
entering food.
 It also protect the esophageal wall from digestive
effect of acidic gastric juices that often reflux into
the esophagus.
 DISORDERS OF DEGLUTITION
 Dysphagia:
 This is the condition characterised by difficulty in
swallowing. It commonly results from;
o Mechanical obstruction of esophagus by tumor,
strictures, diverticular hernia, among others,
o Decreased esophageal peristalsis resulting from
neurological disorders such as Parkinson disease,
o Muscular disorders leading to swallowing difficulty
during oral or esophageal phases of deglutition.
 Esophageal Achalasia or Achalasia Cardia:
 A neuromuscular disease characterised by
accumulation of food substance in the esophagus
preventing normal swallowing.
o It commonly results from failure of cardiac
sphincter to relax during swallowing. Accumulated
food substance dilates the esophagus.
o Common features include;
• Dysphagia,
• Chest pain,
• Weight loss,
• cough.
 Gastroesophageal Reflux Disease (GERD):
 A disease condition characterised by regurgitation
of acidic gastric content into the esophagus. This
flows into pharynx or mouth.
o It commonly results from incompetence of cardiac
sphincter. Its common features include;
• Heartburn or pyrosis (painful burning sensation in
the chest due to reflux of acid containing gastric
contents),
• Esophagitis, esophageal ulcers or even cancers,
• Dysphagia and cough
• Change of voice,
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