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Oro-pharyngeal and esophageal motility and dysmotility

Published on January 5, 2011 Updated on May 15, 2020   54 min

A selection of talks on Gastroenterology & Nephrology

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0:00
Hello, my name is Doctor John E Pandolfino, I'm an associate professor at Northwestern University, and Director of the Esophageal Center at Northwestern Memorial Hospital. It is my privilege and honor to provide you with a talk on oro-pharyngeal and esophageal motility and dysmotility for the Henry Stewart Talks series.
0:21
Oro-pharyngeal and esophageal motility encompass a very delicate interplay between anatomy and neuromuscular function. The primary functional responsibilities of the oropharynx are to transfer food, prevent aspiration, and aid in breathing and speech. In addition, the primary functional responsibilities of the esophagus are to transport food, prevent aspiration and to prevent reflux. Although all of these functional responsibilities are extremely important, today I will focus primarily on the transfer of food through the oropharynx and the transport of food through the esophagus. Focusing on these two functional responsibilities will give us a very nice overview of oropharyngeal and esophageal motility and dysmotility.
1:10
As mentioned previously, the function of swallowing through the oropharynx and the esophagus is a very complicated interplay between the neuromuscular function and anatomy of these particular anatomic components. When looking at the stages of a swallow, it is typically broken up into three specific components, the oral phase, the pharyngeal phase and the esophageal phase. When reviewing the various stages of a swallow, it is important to realize that there are many differences between the oropharyngeal phase of swallowing and the pharyngeal phase of swallowing, as well as the esophageal phase of swallowing. In terms of the muscle type, in the oral phase and the pharyngeal phase it is predominantly striated muscle. In contrast, in the esophageal phase, it is a combination of the striated and smooth muscle. In addition, there are many differences in terms of the nervous system control of the stages of swallow. As we can see here, in the oral phase it is predominated by the cortex and the medulla, while in the pharyngeal and the esophageal there's more of a complex of medulla, and in the esophageal phase of swallowing specifically, the enteric nervous system is extremely important. In terms of volitional control, in oral it is complete, in pharyngeal there is some, and in the esophageal phase it is poor. In terms of sensation, it is very precise in the oral phase, it is somewhat good in the pharyngeal phase, but extremely poor in the esophageal phase.
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Oro-pharyngeal and esophageal motility and dysmotility

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