Voluntary versus spontaneous swallowing in man. 2011

Cumhur Ertekin
Clinical Neurophysiology and Neurology, Medical School Hospital, Ege University, Bornova, 35100, Izmir, Turkey. cumhurertekin@gmail.com

This review examines the evidence regarding the clinical and neurophysiological differences between voluntary and spontaneous swallows. From the clinical point of view, voluntary swallow (VS) occurs when a human has a desire to eat or drink during the awake and aware state. Spontaneous swallow (SS) is the result of accumulated saliva and/or food remnants in the mouth. It occurs without awareness while awake and also during sleep. VS is a part of eating behavior, while SS is a type of protective reflex action. In VS, there is harmonized and orderly activation of perioral, lingual, and submental striated muscles in the oral phase. In SS, the oral phase is bypassed in most cases, although there may be partial excitation. Following the oral phase, both VS and SS have a pharyngeal phase, which is a reflex phenomenon that protects the upper airway from any escape of food and direct the swallowed material into the esophagus. This reflexive phase of swallowing should not be confused with SS. VS and SS are similar regarding their dependence on the swallowing Central Pattern Generator (CPG) at the brainstem, which receives sensory feedback from the oropharynx. There are differences in the role of the corticobulbar input between VS and SS.

UI MeSH Term Description Entries
D007830 Larynx A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE. Anterior Commissure, Laryngeal,Anterior Commissure, Larynx,Laryngeal Anterior Commissure,Laryngeal Posterior Commissure,Posterior Commissure, Laryngeal,Posterior Commissure, Larynx,Anterior Commissures, Laryngeal,Anterior Commissures, Larynx,Commissure, Laryngeal Anterior,Commissure, Laryngeal Posterior,Commissure, Larynx Anterior,Commissure, Larynx Posterior,Commissures, Laryngeal Anterior,Commissures, Laryngeal Posterior,Commissures, Larynx Anterior,Commissures, Larynx Posterior,Laryngeal Anterior Commissures,Laryngeal Posterior Commissures,Larynx Anterior Commissure,Larynx Anterior Commissures,Larynx Posterior Commissure,Larynx Posterior Commissures,Posterior Commissures, Laryngeal,Posterior Commissures, Larynx
D009305 Nasopharynx The top portion of the pharynx situated posterior to the nose and superior to the SOFT PALATE. The nasopharynx is the posterior extension of the nasal cavities and has a respiratory function. Rhinopharynx,Choanae,Nasopharynges,Nasopharynxes,Rhinopharynges,Rhinopharynxes
D009960 Oropharynx The middle portion of the pharynx that lies posterior to the mouth, inferior to the SOFT PALATE, and superior to the base of the tongue and EPIGLOTTIS. It has a digestive function as food passes from the mouth into the oropharynx before entering ESOPHAGUS. Oropharynxs
D012018 Reflex An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord.
D002540 Cerebral Cortex The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions. Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D003679 Deglutition The act of taking solids and liquids into the GASTROINTESTINAL TRACT through the mouth and throat. Swallowing,Deglutitions,Swallowings
D003680 Deglutition Disorders Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS. Dysphagia,Swallowing Disorders,Esophageal Dysphagia,Oropharyngeal Dysphagia,Deglutition Disorder,Disorders, Deglutition,Dysphagia, Esophageal,Dysphagia, Oropharyngeal,Swallowing Disorder
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D004594 Electrophysiology The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.

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