Anatomical and Physiological Overview

  • Emmett T. CunninghamJr.
  • Martin W. Donner
  • Bronwyn Jones
  • Stuart M. Point


The seemingly effortless act of swallowing, is, in reality, quite complex, involving approximately 50 paired muscles and virtually all levels of the central nervous system. For historical reasons, and as a matter of convenience, students of swallowing have somewhat arbitrarily divided this act into three anatomically and temporally distinct stages, or phases. The first, or oral phase, is primarily preparatory, and is that period during which foodstuffs are chewed and mixed with saliva, thus providing the proper texture and consistency for smooth transit through the pharynx and esophagus. The second, or pharyngeal phase, begins when the bolus passes the faucial pillars to enter the upper pharynx, and ends when it crosses the pharyngoesophageal sphincter. The third, or esophageal phase, covers that period during which the bolus is transported from the pharynx to the stomach via the esophagus.


Soft Palate Hyoid Bone Solitary Tract Posterior Pharyngeal Wall Oral Phase 


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  1. 1.
    Pernkopf E: Atlas der topographischen Anatomie des Menschen, 1. Band. Munich, Urban and Schwarzenberg, 1963.Google Scholar
  2. 2.
    Williams PL, Warwick R: Gray’s Anatomy, ed 37. Philadelphia, WB Saunders Co, 1989.Google Scholar
  3. 3.
    Murakami Y, Fukuda H, Kirchner JA: The cricopharyngeus muscle. Acta Otolaryngol [Suppl] (Stockh) 1972;311:5–19.Google Scholar
  4. 4.
    Dickson DR: Anatomy of the normal velopharyngeal mechanism. Clin Plast Surg 1975;2:235–248.PubMedGoogle Scholar
  5. 5.
    Archer CR, Friedman W II, Yeager VL, et al: Computer tomography of the larynx. J Comput Assist Tomogr 1978;2:404–411.PubMedCrossRefGoogle Scholar
  6. 6.
    Netter FH: The CIBA Collection of Medical Illustrations, vol 1, Nervous System, part 1: Anatomy and Physiology. Summit, NJ, Ciba; 1983.Google Scholar
  7. 7.
    Netter FH: The CIBA Collection of Medical Illustrations, vol 3, Digestive System, part 1: Upper Digestive Tract. Summit, NJ, Ciba; 1978.Google Scholar
  8. 8.
    Bosma JF, Donner MW, Tanako E, Robertson D: Anatomy of the pharynx, pertinent to swallowing. Dysphagia 1986;1:23–33.CrossRefGoogle Scholar
  9. 9.
    Miller AJ: Deglutition. Physiol Rev 1982;62:129–184.PubMedGoogle Scholar
  10. 10.
    Miller AJ: Neurophysiological basis of swallowing. Dysphagia 1986;1:91–100.CrossRefGoogle Scholar
  11. 11.
    Curtis DJ: Laryngeal dynamics. CRC Crit Rev Diagn Imaging 1982;18:29–80.Google Scholar
  12. 12.
    Curtis DJ: Radiology of the laryngopharynx, in English GM (ed): Otolaryngology. New York, Harper and Row, 1985, pp 65–130.Google Scholar
  13. 13.
    Curtis DJ: Radiographic anatomy of the pharynx. Dysphagia 1986;1:51–62.CrossRefGoogle Scholar
  14. 14.
    Logemann J: Anatomy and physiology of normal deglutition, in Logemann J (ed): Evaluation and Treatment of Swallowing Disorders. San Diego, College Hill Press, 1983, pp 9–36.Google Scholar
  15. 15.
    Lufkin R, Larson S, Hanafee W: NMR anatomy of the larynx and tongue base. Radiology 1983 ;148:173–175.PubMedGoogle Scholar
  16. 16.
    Lufkin RB, Hanafee WN, Wortham D, Hoover L: MRI of the larynx and hypopharynx using surface coils. Radiology 1986;158:747–754.PubMedGoogle Scholar
  17. 17.
    Lufkin R, Hanafee W: Surface coil MRI of the larynx and hypopharynx. AJNR 1985;6:491–497.Google Scholar
  18. 18.
    Hill BJ: Radiology of the larynx. Otolaryngol Clin North Am 1973;6:549–561.PubMedGoogle Scholar
  19. 19.
    Silver AJ, Sane P, Hilal SK: CT of the nasopharyngeal region: Normal and pathologic anatomy. Radiol Clin North Am 1984;22:161–176.PubMedGoogle Scholar
  20. 20.
    Hollinshead WH: Anatomy of the pharynx and esophagus, in English GM (ed): Otolaryngology. New York, Harper and Row, 1985, pp 1–21.Google Scholar
  21. 21.
    Donner MW, Bosma JF, Robertson DL: Anatomy and physiology of the pharynx. Gastrointest Radiol 1985;10:196–212.PubMedGoogle Scholar
  22. 22.
    McMyn JK: The anatomy of the salpingopharyngeus muscle. J Laryngol Otol 1940;55:1–22.CrossRefGoogle Scholar
  23. 23.
    Hoover LA, Wortham DG, Kaiser MC, et al: Magnetic resonance imaging of the larynx and tongue base: Clinical applications. Otolaryngol Head Neck Surg 1987;97:245–256.PubMedGoogle Scholar
  24. 24.
    Rubesin SE, Rabischong P, Bilaniuk LT, Laufer I, Levine MS: Contrast examination of the soft palate which cross sectional correlation. RadioGraphics 1988;8:641–665.PubMedGoogle Scholar
  25. 25.
    Rubesin SE, Jones B, Donner MW: Radiology of the adult soft palate. Dysphagia 1987;2:8–17.PubMedCrossRefGoogle Scholar
  26. 26.
    Rubesin SE, Jessurun J, Robertson D, Jones B, Donner MW: Lines of the pharynx. Radiographics 1987;7:217–237.PubMedGoogle Scholar
  27. 27.
    Christianson R, Lufkin R, Hanafee W: Normal magnetic resonance imaging anatomy of the tongue, oropharynx, hypopharynx, and larynx. Dysphagia 1987;1:119–127.CrossRefGoogle Scholar
  28. 28.
    Sasaki CT, Isaacson G: Functional anatomy of the larynx. Otolaryngol Clin North Am 1988;21:595–612.PubMedGoogle Scholar
  29. 29.
    Mafee MF, Campos M, Faju S, Samett E, Mahamadi H, Sadighi S, Heffex L, Friedman M, Chow JM: Head and neck: High field magnetic resonance imaging versus computed tomography. Otolaryngolog Clin North Am 1988; 21: 513–546.Google Scholar
  30. 30.
    Gritzmann N, Fruhwald F. Sonographic anatomy of tongue and floor of the mouth. Dysphagia 1988;2:196–202.PubMedCrossRefGoogle Scholar
  31. 31.
    Bryan RN, McCluggage CW, Horowitz CW, Jenkins D: The normal and abnormal neck, in Latchaw RE (ed): Computed Tomography of the Head, Neck and Spine. Chicago, Year Book Medical Publishers, 1990 (in press).Google Scholar
  32. 32.
    Jones B, Gayler BW, Donner MW: Pharynx and cervical esophagus, in Levine MS (ed): Radiology of the Esophagus. Philadelphia, WB Saunders Company, 1989, pp 311–336.Google Scholar
  33. 33.
    Cannon WB: The Mechanical Factors of Digestion. New York, Longmans, Green and Co, 1911.Google Scholar
  34. 34.
    Negus VE: The second stage of swallowing. Acta Otolaryngol [suppl] (Stockh) 1948 49;78:79–82.Google Scholar
  35. 35.
    Negus VE: The mechanism of swallowing. J Laryngol Otol 1943;58:46–59.CrossRefGoogle Scholar
  36. 36.
    Ardan G, Kemp F: The mechanism of swallowing. Proc R Soc Med 1951;44:1038–1040.Google Scholar
  37. 37.
    Bosma J: A correlated study of the anatomy and motor activity of the upper pharynx by cadaver dissection and by cinematic study of patients after maxillofacial surgery. Ann Otol Rhinol Laryngol 1953;62:51–72.PubMedGoogle Scholar
  38. 38.
    Bosma J: Deglutition: Pharyngeal stage. Physiol Rev 1957;37:275–300.PubMedGoogle Scholar
  39. 39.
    Bosma J: Physiology of the mouth, pharynx, and esophagus, in Paparell M, Shumrick D (eds): Otolaryngology: vol 1, Basic Sciences and Related Disciplines. Philadelphia, WB Saunders Company, 1973, pp 356–370.Google Scholar
  40. 40.
    Ingelfinger FJ: Esophageal motility. Physiol Rev 1958;38:533–584.PubMedGoogle Scholar
  41. 41.
    Bosma J, Fletcher SG: The upper pharynx: A review, Part II, physiology. Ann Otol Rhinol Laryngol 1962;71:134–157.PubMedGoogle Scholar
  42. 42.
    Kawamura Y: Recent concepts of the physiology of mastication. Adv Oral Biol 1964;1:77–109.PubMedGoogle Scholar
  43. 43.
    Code CF, Schlegel JF: Motor action of the esophagus and its sphincters, in Heidel D (exec ed): Handbook of Physiology. Section 6: Alimentary Canal, vol 4: Motility; Code CF (section ed). Bethesda, MD, American Physiological Society, 1968, pp 1821–1839.Google Scholar
  44. 44.
    Lowe A: The neural regulation of tongue movement. Prog Neurobiol 1981;15:295–344.CrossRefGoogle Scholar
  45. 45.
    Dellow P: The general physiological background of chewing and swallowing, in Sessle B, Hannan A (eds): Mastication and Swallowing. Toronto, University of Toronto Press, 1976, pp 6–21.Google Scholar
  46. 46.
    Bosma JF, Donner MW: Physiology of the pharynx, in Paparella MM, Shumrick DA (eds): Otolaryngology. Philadelphia: WB Saunders Company 1980, pp 332–345.Google Scholar
  47. 47.
    Hendrix TR: The motility of the alimentary canal, in Mountcastle VB (ed). Medical Physiology, ed 14. St. Louis, CV Mosby Company, 1980, pp 1320–1347.Google Scholar
  48. 48.
    Goyal RK, Cobb BW: Motility of the pharynx, esophagus, and esophageal sphincters, in Johnson LR (ed): Physiology of the Gastrointestinal Tract. New York, Raven Press, 1981, pp 359–391.Google Scholar
  49. 49.
    Logemann JA: Swallowing physiology and pathophysiology. Otolaryngol Clin North Am 1988;21:613–623.PubMedGoogle Scholar
  50. 50.
    Curtis DJ, Cruess DF, Dachman AM: Normal swallowing: Normal function incidence of variation. Invest Radiol 1985;20:717–720.PubMedCrossRefGoogle Scholar
  51. 51.
    Kennedy JG, Kent RD: Physiological substrates of normal deglutition. Dysphagia 1988;3:24–37.PubMedCrossRefGoogle Scholar
  52. 52.
    Kennedy JG, Kent RD: Anatomy and physiology of deglutition and related functions, in Logemann J (ed): Seminars in speech and language. New York, Thieme-Stratton, 1985, vol 6: The Relationship Between Speech and Swallowing, pp 1–12.Google Scholar
  53. 53.
    Miller AJ: Swallowing: Neurophysiologic control of the esophageal phase. Dysphagia 1987;2:72–82.PubMedCrossRefGoogle Scholar
  54. 54.
    Diamant NE: Physiology of the esophagus, in Sleisenger M, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, ed 4. Philadelphia, WB Saunders Company, 1989, pp 548–559.Google Scholar
  55. 55.
    Diamant NE: Normal esophageal physiology, in Cohen S, Soloway RD (eds): Diseases of the Esophagus. New York, Churchill Livingstone, 1982, pp 1–33.Google Scholar
  56. 56.
    Diamant NE: Physiology of esophageal motor function. Gastroenterol Clin North Am 1989;18(2):179–194.PubMedGoogle Scholar
  57. 57.
    Christensen J: Motor functions of the pharynx and esophagus, in Johnson LR (ed): Physiology of the Gastrointestinal Tract, ed 2. New York, Raven Press, 1987, pp 595–612.Google Scholar
  58. 58.
    Christensen J: The esophagus, in Christensen J, Wingate D (eds): A Guide to Gastrointestinal Motility. Bristol, England, John Wright PSG, 1982, pp 75–100.Google Scholar
  59. 59.
    Gidda JS: Control of esophageal peristalsis. Viewpoints Dig Dis 1985;17:13–16.Google Scholar
  60. 60.
    Goyal RK, Crist JR: Neurology of the gut, in Sleisenger M, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, ed 4. Philadelphia, WB Saunders Company, 1989, pp 21–52.Google Scholar
  61. 61.
    Dodds WJ: The physiology of swallowing. Dysphagia 1989;3:171–178.PubMedCrossRefGoogle Scholar
  62. 62.
    Sumi T: Neuronal mechanisms in swallowing. Pflugers Arch 1964;278:467–477.CrossRefGoogle Scholar
  63. 63.
    Doty RW: Neural organization of deglutition, in Heidel D (exec ed): Handbook of physiology. Section 6: Alimentary Canal, vol 4: Motility; Code CF (section ed). Bethesda, MD, American Physiological Society, 1968, pp 1861–1902.Google Scholar
  64. 64.
    Weisbrodt NW: Neuromuscular organization of esophageal and pharyngeal motility. Arch Intern Med 1976;136:524–531.PubMedCrossRefGoogle Scholar
  65. 65.
    Diamant NE, El-Sharkawy TY: Neural control of esophageal peristalsis. A conceptual analysis. Gastroenterology 1977;72:546–556.PubMedGoogle Scholar
  66. 66.
    Dubner R, Sessle BJ, Storey AT: The Neural Basis of Oral and Facial Function. New York, Plenum Press, 1978.CrossRefGoogle Scholar
  67. 67.
    Hockman CH, Bieger D, Weerasuriya A: Supranuclear pathways of swallowing. Prog Neurobiol 1978;12:15–32.CrossRefGoogle Scholar
  68. 68.
    Roman C, Gonella J: Extrinsic control of digestive tract motility, in Johnson LR (ed): Physiology of the Gastrointestinal Tract. New York, Raven Press, 1981, pp 223–278.Google Scholar
  69. 69.
    Roman C, Gonella J: Extrinsic control of digestive tract motility, in Johnson LR (ed): Physiology of the Gastrointestinal Tract, ed 2. New York, Raven Press, 1987, pp 507–553.Google Scholar
  70. 70.
    Roman C: Contrôle nerveux de la déglutition et la motricité oesophagienne chex les mammifères. J Phyiol (Paris) 1986;81:118–131.Google Scholar
  71. 71.
    Roman C: Nervous control of esophageal and gastric motility, in Bertaccini G (ed): Handbook of Experimental Pharmacology, vol 59. Berlin, Springer-Verlag, 1982, pp 223–278.Google Scholar
  72. 72.
    Jean A: Control of the central swallowing program by inputs from the peripheral receptors. A review. J Auton Nerv Syst 1984;10:225–233.PubMedCrossRefGoogle Scholar
  73. 73.
    Jean A: Brainstem organization of the swallowing network. Brain Behav Evol 1984;25:109–116.PubMedCrossRefGoogle Scholar
  74. 74.
    Morrell RM: The neurology of swallowing, in Groher ME (ed): Dysphagia: Diagnosis and Management. Boston, Butterworth, 1984, pp 3–35.Google Scholar
  75. 75.
    Morrell RM: Neurologic disorders of swallowing, in Groher ME (ed): Dysphagia: Diagnosis and Management. Boston, Butterworth, 1984, pp 37–59.Google Scholar
  76. 76.
    Buchholz D: Neurologic causes of dysphagia. Dysphagia 1987;1:152–156.CrossRefGoogle Scholar
  77. 77.
    Buchholz D: Neurologic evaluation of dysphagia. Dysphagia 1987;1:187–193.CrossRefGoogle Scholar
  78. 78.
    Kirshner HS: Causes of neurogenic dysphagia. Dysphagia 1989;3:184–188.PubMedCrossRefGoogle Scholar
  79. 79.
    Sessle BJ, Henry JL: Neural mechanisms of swallowing: Neurophysiological and neurochemical studies on brain stem neurons in the solitary tract region. Dysphagia 1989;4:61–75.PubMedCrossRefGoogle Scholar
  80. 80.
    Carpenter DO: Central nervous system mechanisms in deglutition and emesis, in Wood JD (exec ed): Handbook of physiology. Section O: Title of Section, vol 4: Gastrointestinal Motility and Circulation; Schultz SG (section ed). Bethesda, MD, American Physiological Society 1989; pp 685–714.Google Scholar
  81. 81.
    Cunningham ET Jr, Sawchenko PE: Central neural control of esophageal motility: A review. Dysphagia 1990;5:35–51.PubMedCrossRefGoogle Scholar
  82. 82.
    Hughes CV, Baum BJ, Fox PC, Marmary Y, Yeh C-K, Sonies BC: Oral-pharyngeal dysphagia: A common sequela of salivary gland dysfunction. Dysphagia 1987;1:173–177.CrossRefGoogle Scholar
  83. 83.
    Kapila YV, Dodds WJ, Helm JF, Hogan WJ: Relationship between swallow rate and salivary flow. Dig Dis Sci 1984;29:528–533.PubMedCrossRefGoogle Scholar
  84. 84.
    Tomura Y, Ide Y, Kamijo Y: Studies on the morphological changes of the tongue movements during mastication by x-ray TV cinematography, in Kawamura Y, Dubner R (eds): Oral Sensory and Motor Functions. Tokyo, Quintessence, 1931, pp 45–52.Google Scholar
  85. 85.
    Thexton AJ: Oral reflexes elicited by mechanical stimulation of palatal mucosa in the cat. Arch Oral Biol 1973;18:971–980.CrossRefGoogle Scholar
  86. 86.
    Cook IJ, Dodds WJ, Dantas RO, Kern MK, Massey BT, Shaker R, Hogan WJ: Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia 1989;4:8–15.PubMedCrossRefGoogle Scholar
  87. 87.
    Hamlet S, Stone M, Shawker TH: Posterior tongue grooving in deglutition and speech: Preliminary observations. Dysphagia 1988;3: 65–68.PubMedCrossRefGoogle Scholar
  88. 88.
    Shaker R, Cook IJS, Dodds WJ, Hogan WJ: Pressure-flow dynamics of the oral phase of swallowing. Dysphagia 1988;3:79–84.PubMedCrossRefGoogle Scholar
  89. 89.
    Moller E: The chewing apparatus. Acta Physiol Scand 1966;69:1–229.Google Scholar
  90. 90.
    Anderson D: Mastication, in Heidel W (exec ed): Handbook of Physiology. Section 6: Alimentary Canal, vol 4: Motility; Code CF (section ed). Bethesda, MD, American Physiological Society, 1968, pp 1811–1820.Google Scholar
  91. 91.
    Sessle B, Hannan A (eds): Mastication and Swallowing. Toronto, University of Toronto Press, 1976.Google Scholar
  92. 92.
    Norgren R: Central neural control mechanisms of taste, in Geigers R (exec ed): Handbook of Physiology Section 1: The Nervous System, vol III: Sensory Processes, Part 2; Mountcastle VB (section ed), Bloom FE (vol ed). Bethesda, MD, American Physiological Society, 1984, pp 1087–1124.Google Scholar
  93. 93.
    Loewy AD, Burton H: Nuclei of the solitary tract: Efferent projections to the lower brain stem and spinal cord of the cat. J Comp Neurol 1978;181:421–450.PubMedCrossRefGoogle Scholar
  94. 94.
    Cunningham ET Jr, Sawchenko PE: Brainstem projections from the nucleus of the solitary tract in the rat. Soc Neurosci 1990 (in press).Google Scholar
  95. 95.
    Negus V: The function of the epiglottis. J Anat 1927;62:1–8.PubMedGoogle Scholar
  96. 96.
    Ardran GM, Kemp FH: The protection of the laryngeal airway during swallowing. Br J Radiol 1952;25:406–416.PubMedCrossRefGoogle Scholar
  97. 97.
    Pressman JJ, Kelemen G: Physiolog of the larynx. Physiol Rev 1955;35:506–554.PubMedGoogle Scholar
  98. 98.
    Ardran GM, Kemp FH: Closure and opening of the larynx during swallowing. Br J Radiol 1956;29:205–208.PubMedCrossRefGoogle Scholar
  99. 99.
    Shelton RL, Bosma JF, Sheets BV: Tongue, hyoid and larynx displacement in swallow and phonation. J Appl Physiol 1960;15:283–288.PubMedGoogle Scholar
  100. 100.
    Ardran FM, Kemp FH: The mechanism of the larynx II. The epiglottis and closure of the larynx. Br J Radiol 1967;40:372–389.PubMedCrossRefGoogle Scholar
  101. 101.
    Curtis DJ, Sepulveda GU: Epiglottic motion: Video recording of muscular dysfunction. Radiology 1983;148:473–477.PubMedGoogle Scholar
  102. 102.
    Ekberg O, Sigurjonsson SV: Movement of the epiglottis during deglutition. A cineradiographic study. Gastrointest Radiol 1982;7:101–107.PubMedCrossRefGoogle Scholar
  103. 103.
    Laitman J, Crelin E, Conlogue F: The function of the epiglottis in monkey and man. Yale J Biol Med 1977;50:43–48.PubMedGoogle Scholar
  104. 104.
    Ekberg O: Defective closure of the laryngeal vestibule during deglutition. Acta Otolaryngol (Stockh) 1982;93:309–317.CrossRefGoogle Scholar
  105. 105.
    Curtis DJ, Sepulveda GU: Epiglottic motion: Video recording of muscular dysfunction. Radiology 1983;148:473–477.PubMedGoogle Scholar
  106. 106.
    Curtis DJ, Hudson T: Laryngotracheal aspiration: Analysis of specific neuromuscular factors. Radiology 1983;149:517–522.PubMedGoogle Scholar
  107. 107.
    Kahrilas PJ, Dodds WJ, Dent J, Logemann JA, Shaker R: Upper esophageal sphincter function during deglutition. Gastroenterology 1988;95:52–62.PubMedGoogle Scholar
  108. 108.
    Cook IJ, Dodds WJ, Dantas RO, Massey B, Kern MK, Lang IM, Brasseur JG, Hogan WJ: Opening mechanisms of the human upper esophageal sphincter. Am J Physiol 1989; 257:G748-G759.Google Scholar
  109. 109.
    Nilsson ME, Isacsson G, Isberg A: The mobility of the upper esophageal sphincter in relation to the cervical spine-a morphological study. Dysphagia 1989;3:161–170.PubMedCrossRefGoogle Scholar
  110. 110.
    Fyke FE, Code CF: Resting and deglutition pressure in the pharyngoesophageal region. Gastroenterology 1955;29:24–34.PubMedGoogle Scholar
  111. 111.
    Fyke FE, Code CF, Schlegel JC: The gastroesophageal sphincter in healthy human beings. Gastroenterologia 1956;86:135–150.PubMedCrossRefGoogle Scholar
  112. 112.
    Atkinson M, Kramer P, Wyman SM, Ingelfinger FJ: The dynamics of swallowing. I. Normal pharyngeal mechanisms. J Clin Invest 1957;36:581–588.PubMedCrossRefGoogle Scholar
  113. 113.
    Sokol E, Heitmann P, Wolf B, Cohen B: Simultaneous cineradiographic and manometric study of the pharynx, hypopharynx, and cervical esophagus. Gastroenterology 1966;51:660–674.Google Scholar
  114. 114.
    Dodds WJ, Hogan WJ, Lydon SB, Stewart ET, Stef JJ, Arndorfer RC: Quantification of pharyngeal motor function in normal human subjects. J Appl Physiol 1975;39:692–696.PubMedGoogle Scholar
  115. 115.
    Berlin BP, Tedesco F, Fierstein JT, Ogura JH: Manometric studies of the upper esophageal sphincter. Ann Owl Rhinol Laryngol 1977;86:598–602.Google Scholar
  116. 116.
    Asoh R, Goyal RK: Manometry and electromyography of the upper esophageal sphincter in the opossum. Gastroenterology 1978;74:514–520.PubMedGoogle Scholar
  117. 117.
    Newman A: Manometry in the evaluation of esophageal function. Otolaryngol Clin North Am 1978;11:405–417.PubMedGoogle Scholar
  118. 118.
    Orlowski J, Dodds WJ, Linehan JH, Dent J, Hogan WJ, Arndorfer RC: Requirements for accurate manometric recording of pharyngeal and esophageal peristaltic pressure waves. Invest Radiol 1982;17:567–572.PubMedCrossRefGoogle Scholar
  119. 119.
    Welch RW, Luckman K, Ricks PM, Drake ST, Gates GA: Manometry of the normal upper esophageal sphincter and its alterations in laryngectomy. J Clin Invest 1979;63:1036–1041.PubMedCrossRefGoogle Scholar
  120. 120.
    Dodds WJ, Kahrilas PJ, Dent J, Hogan WJ: Considerations about pharyngeal manometry. Dysphagia 1987;1:209–214.CrossRefGoogle Scholar
  121. 121.
    Kahrilas PJ, Dent J, Dodds WJ, Hogan WJ, Arndorfer RC: A method for continuous monitoring of upper esophageal sphincter pressure. Dig Dis Sci 1987;32:121–128.PubMedCrossRefGoogle Scholar
  122. 122.
    Doty RW, Bosma JF: An electromyographic analysis of reflex deglutition. J Neurophysiol 1956;19:44–60.PubMedGoogle Scholar
  123. 123.
    Faaborg-Anderson K: Electromyographic investigation of intrinsic laryngeal muscles in humans. Acta Physiol Scand [Suppl] 1957;140:1–149.Google Scholar
  124. 124.
    Basmajian JV, Cutta CR: Electromyography of pharyngeal constrictors and levator palati in man. Anat Rec 1961;139:561–563.PubMedCrossRefGoogle Scholar
  125. 125.
    Kawasaki M, Ogura JH, Takenouchi S: Neurophysiologic observations of normal deglutition. I. Its relationship to the respiratory cycle. Laryngoscope 1965;74:1747–1765.Google Scholar
  126. 126.
    Shipp T, Deatsch WW, Robertson K: Pharyngoesophageal muscle activity during swallowing in man. Laryngoscope 1970;80:1–16.PubMedCrossRefGoogle Scholar
  127. 127.
    Yoshida T: Electromyographic and x-ray investigation of normal deglutition. Otol Fukuoka 1979;25:824–872.Google Scholar
  128. 128.
    Hairston LE, Sauerland EK: Electromyography of the human palate. Electromyogr Clin Neurophysiol 1981;21:287–297.PubMedGoogle Scholar
  129. 129.
    Palmer JB, Tanaka E, Siebens AA: Electromyography of the pharyngeal musculature. Arch Phys Med Rehabil 1989;70:283–287.PubMedGoogle Scholar
  130. 130.
    Palmer JB: Electromyography of the muscles of oropharyngeal swallowing: Basic concepts. Dysphagia 1989;3:192–198.PubMedCrossRefGoogle Scholar
  131. 131.
    Barclay AE: The normal mechanism of swallowing. Br J Radiol 1930;3:534–546.CrossRefGoogle Scholar
  132. 132.
    Johnstone AS: A radiological study of deglutition. J Anat 1942;77:97–100.PubMedGoogle Scholar
  133. 133.
    Rushmer RF, Hendron JA: The act of deglutition: A cinefluorographic study. J Appl Physiol 1951;3:622–630.PubMedGoogle Scholar
  134. 134.
    Saunders JB, De CM, Davis C, Miller ER: The mechanism of deglutition (second stage) as revealed by cine-radiography. Ann Otol Rhinol Laryngol 1951;60:897–916.PubMedGoogle Scholar
  135. 135.
    Ramsey GH, Watson JS, Gramiak R, Weinberg SA: Cinefluorographic analysis of the mechanism of swallowing. Radiology 1955;64:498–518.PubMedGoogle Scholar
  136. 136.
    Shedd DP, ScatliffJH, Kirchner JA: The buccopharyngeal propulsive mechanism in human deglutition. Surgery 1960;48:846–853.Google Scholar
  137. 137.
    Shedd DP, Kirchner JA: Oral and pharyngeal components of deglutition. Arch Surg 1961;82:373–380.CrossRefGoogle Scholar
  138. 138.
    Sloan RF, Brummett SW, Westover JL: Recent cinefluorographic advances in palatopharyngeal roentgenography. Am J Roentgenol Radium Ther Nucl Med 1964;92:977–985.PubMedGoogle Scholar
  139. 139.
    Cleall JF: Deglutition: A study of form and function. Am J Orthodont 1965;51:566–594.PubMedCrossRefGoogle Scholar
  140. 140.
    Moll KL: A cinefluorographic study of velopharyngeal function in normals during various activities. Cleft Palate J 1965;2:112–122.Google Scholar
  141. 141.
    Hedges RB, McLean CD, Thompson FA: A cinefluorographic study of tongue patterns in function. Angle Orthod 1965;35:253–268.PubMedGoogle Scholar
  142. 142.
    Donner MW, Silbiger ML: Cinefluorographic analysis of pharyngeal swallowing in neuromuscular disorders. Am J Med Sci 1966;251:600–616.PubMedCrossRefGoogle Scholar
  143. 143.
    Sokol E, Heitmann P, Wolf B, Cohen B: Simultaneous cineradiographic and manometric study of the pharynx, hypopharynx, and cervical esophagus. Gastroenterology 1966;51:660–674.Google Scholar
  144. 144.
    Perry HT Jr: Muscle contraction patterns in swallowing. Angle Orthod 1972;42:66–80.PubMedGoogle Scholar
  145. 145.
    Flowers CR, Morris HL: Oral-pharyngeal movements during swallowing and speech. Cleft Palate J 1973;10:181–191.PubMedGoogle Scholar
  146. 146.
    Ekberg O, Nylander G: Cineradiography of the pharyngeal stage of deglutition in 150 individuals without dysphagia. Br J Radiol 1982;55:253–277.PubMedCrossRefGoogle Scholar
  147. 147.
    Jones B, Kramer SS, Donner MW: Dynamic imaging of the pharynx. Gastrointest Radiol 1985;10:213–224.PubMedCrossRefGoogle Scholar
  148. 148.
    Birch-Iensen M, Borgstrom PS, Ekberg O: Cineradiography in closed and open pharyngeal swallow. Acta Radiol 1988;29:407–410.PubMedCrossRefGoogle Scholar
  149. 149.
    Curtis DJ, Cruess DF: Pharyngoesophageal swallowing: A review of 618 videorecorded cases. Milit Med 1984;l49:545–549.Google Scholar
  150. 150.
    Curtis DJ, Cruess DF, Berg T: The cricopharyngeal muscle: A videorecording review. Am J Roentgenol 1984;142:497–500.CrossRefGoogle Scholar
  151. 151.
    Palmer JB, Tanaka E, Siebens AA: Motions of the posterior pharyngeal wall in swallowing. Laryngocope 1988;98:414–417.Google Scholar
  152. 152.
    Hamlet SL, Muz J, Patterson R, Jones L: Pharyngeal transit time: Assessment with videofluoroscopic and scintigraphic techniques. Dysphagia 1989;4:4–7.PubMedCrossRefGoogle Scholar
  153. 153.
    vanOverbeek JJM, Wit HP, Paping RHL, Segenhout HM: Simultaneous manometry and electromyography in the pharyngoesophageal segment. Laryngoscope 1985;95:582–584.Google Scholar
  154. 154.
    Cohen BR, Wolf BS: Cineradiographic and intraluminal pressure correlations in the pharynx and esophagus, in Heidel W (exec ed): Handbook of Physiology. Section 6: Alimentary Canal, vol 4: Motility; Code CF (section ed). Bethesda, MD, American Physiological Society, 1968, pp 1841–1860.Google Scholar
  155. 155.
    Isberg A, Nilsson ME, Schiratzki J: Movement of the upper esophageal sphincter and a manometric device during deglutition. Acta Radiol [Diagn] 1985;26:381–388.Google Scholar
  156. 156.
    Isberg A, Nilsson ME, Schiratzki J: The upper esophageal sphincter during normal deglutition. Acta Radiol [Diagn] 1985;26:563–568.Google Scholar
  157. 157.
    McConnel FMS: Analysis of pressure generation and bolus transit during pharyngeal swallowing. Laryngoscope 1988;98:71–78.PubMedGoogle Scholar
  158. 158.
    McConnel FMS, Cerenko D, Hersh T, Weil LJ: Evaluation of pharyngeal dysphagia with manofluorography.. Dysphagia 1988;2:187–195.PubMedCrossRefGoogle Scholar
  159. 159.
    McConnel FMS, Cerenko D, Jackson RT, Hersh T: Clinical application of manofluorogram. Laryngoscope 1988;98:705–711.PubMedGoogle Scholar
  160. 160.
    McConnel FMS, Cerenko D, Jackson RT, Guffin TN Jr: Timing of major events of pharyngeal swallowing. Arch Otolaryngol Head Neck Surg 1988;114:1413–1418.PubMedCrossRefGoogle Scholar
  161. 161.
    Cerenko D, McConnel FMS, Jackson RT: Quantitative assessment of pharyngeal bolus driving forces. Otolaryngol Head Neck Surg 1989;100:57–63.PubMedGoogle Scholar
  162. 162.
    Nilsson ME, Isberg A, Schiratzki H: The location of the upper esophageal sphincter and its behavior during bolus propagation-a simultaneous cineradiographic and manometric investigation. Acta Otolaryngol 1988;106:314–320.PubMedCrossRefGoogle Scholar
  163. 163.
    Borgstrom PS, Ekberg O: Speed of peristalsis in pharyngeal constrictor musculature: Correlation of age. Dysphagia 1988;2:140–144.PubMedCrossRefGoogle Scholar
  164. 164.
    Sonies BC, Parent LJ, Morrish K, Baum BJ: Durational aspects of the oral-pharyngeal phase of swallow in normal adults. Dysphagia 1988;3:1–10.PubMedCrossRefGoogle Scholar
  165. 165.
    Clark GA: Deglutition apnoea. J Physiol (Lond) 1920;54:1ix.Google Scholar
  166. 166.
    Kawasaki M, Ogura JH, Takenouchi S: Neurophysiologic observations of normal deglutition. I. Its relationship to the respiratory cycle. Laryngoscope 1965;74:1747–1765.Google Scholar
  167. 167.
    Nishino T, Yonezawa T, Honda Y: Effects of swallowing on the pattern of continuous respiration in human adults. Am Rev Respir Dis 1985;132:1219–1222.PubMedGoogle Scholar
  168. 168.
    Selley WG, Flack FC, Ellis RE, Brooks WA: Respiratory patterns associated with swallowing: Part 1. The normal adult pattern and changes with age. Age Ageing 1989;18:168–172.PubMedCrossRefGoogle Scholar
  169. 169.
    Ekberg O, Olsson R, Sundgren-Borgstrom P: Relation of bolus size and pharyngeal swallow. Dysphagia 1988;3:69–72.PubMedCrossRefGoogle Scholar
  170. 170.
    Kramer SS, Anderson JH, Strandberg JD, Donner MW: A permanent radiopaque marker technique for the study of pharyngeal swallowing in dogs. Dysphagia 1987;1:163–167.CrossRefGoogle Scholar
  171. 171.
    Zerhouni EA, Bosma JF, Donner MW: Relationship of cervical spine disorders to dysphagia. Dysphagia 1987;1:129–144.CrossRefGoogle Scholar
  172. 172.
    Paterson WG, Rattan S, Goyal RK: Experimental induction of isolated lower esophageal sphincter relaxation in anesthetized opossums. J Clin Invest 1986;77:1187–1193.PubMedCrossRefGoogle Scholar
  173. 173.
    Vantrappen G, Janssens J: Gastro-oesophageal reflux disease, an important cause of angina-like chest pain. Scand J Gastroenterol [Suppl] 1989;168:73–79.Google Scholar
  174. 174.
    Rothstein RD, Ouyang A: Chest pain of esophageal origin. Gastroenterol Clin North Am 1989;18(2):257–273.PubMedGoogle Scholar
  175. 175.
    Richter JE, Bradley LA, Castell DO: Esophageal chest pain: Current controversies in pathogenesis, diagnosis, and therapy. Ann Intern Med 1989;110:66–78.PubMedGoogle Scholar
  176. 176.
    Palmer ED: The abnormal upper gastrointestinal vagovagal reflexes that affect the heart. Am J Gastroenterol 1976;66(6):513–522.PubMedGoogle Scholar
  177. 177.
    Greenspon AJ, Volosin KJ: Swallowinginduced tachycardia: Electrophysiologic and pharmacologic observations. PACE 1988; 11:1566–1570.PubMedCrossRefGoogle Scholar
  178. 178.
    Matsubara K, Inoue D, Moridawa Y, Shirayama T, Omori I, Katsume H, Nakagawa M: Swallowing-induced arrhythmia. Clin Cardiol 1988;11:798–800.PubMedCrossRefGoogle Scholar
  179. 179.
    Khan QA, Khan B: Swallowing-induced tachycardia. J Tenn Med Assoc 1988;81(3):141–143.PubMedGoogle Scholar
  180. 180.
    Ransbottom JC, Mirro MJ: Refractory swallowing-induced paroxysmal supraventricular tachycardia. Clin Cardiol 1988;11:51–52.PubMedCrossRefGoogle Scholar
  181. 181.
    Levin B, Posner JB: Swallow syncope: Report of a case and review of the literature. Neurology 1972;22:1086–1093.PubMedCrossRefGoogle Scholar
  182. 182.
    Armstrong PW, McMillan DG, Simon JB: Swallow syncope. Can Med Assoc J 1985;132:1281–1284.PubMedGoogle Scholar
  183. 183.
    Kalloo AN, Lewis JH, Maher K, Benjamin SB: Swallowing: An unusual cause of syncope. Dig Dis Sci 1989;34(7):1117–1120.PubMedCrossRefGoogle Scholar
  184. 184.
    Elam MP, Laird JR, Johnson S, Stratton JR: Swallow syncope associated with complete atrioventricular block: A case report and review of the literature. Milit Med 1989;9:465–466.Google Scholar
  185. 185.
    Bellgaumkar TK, Scott KE: Apnea in premature infants: Recording by arterial catheter. Eur J Pediatr 1976;123:301–305.CrossRefGoogle Scholar
  186. 186.
    Wilson SL, Thach BT, Brouillette RT, AbuOsba YK: Swallowing associated with respiratory pauses in infants (abstract). Pediatr Res 1980;14:653.Google Scholar
  187. 187.
    Menon A, Schefft G, Thach BT: Frequency and significance of swallowing during prolonged apnea in infants. Am Rev Respir Dis 1984;130:969–973.PubMedGoogle Scholar
  188. 188.
    Roberts JL, Mathew OP, Thach BT: Observations made on severe apneic spells in two infants at risk for sudden death. Early Hum Dev 1985;10:261–271.PubMedCrossRefGoogle Scholar
  189. 189.
    Pickens DL, Schefft G, Thach BT: Prolonged apnea associated with upper airway protective reflexes in apnea of prematurity. Am Rev Respir Dis 1988;137:113–118.PubMedCrossRefGoogle Scholar
  190. 190.
    Pope CE II: Respiratory complications of gastro-oesophageal reflux. Scand J Gastroenterol [Suppl] 1989;168:67–72.Google Scholar
  191. 191.
    Goldman JM, Bennett JR: Gastro-oesophageal reflux and asthma; a common association, but of what clinical importance? Gut 1990;31:1–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Emmett T. CunninghamJr.
  • Martin W. Donner
  • Bronwyn Jones
  • Stuart M. Point

There are no affiliations available

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