Variations in swallow trigger

Question 1

Where can the swallow be triggered

Answer 1

The swallow can be triggered in three places:

• Faucial Arches:
• Vallecula
• Pyriform Sinus - material can gather in the pyfirom sinus

Question 2

What are the Faucial Arches

Answer 2

The Faucial arches are a space in the oral cavity. It is made up of
The right and left palatoglossus muscles create ridges in the lateral pharyngeal wall, referred to as the palatoglossal arches These pillars separate the oral cavity and the oropharynx — the muscle functions as an antagonist to the levator veli palatini muscle.

Question 3

Where did people used to think that the swallow was ALWAYS triggered

Answer 3

There was a previous idea that the swallow was triggered as the bolus passes the Faucial Arches - however we now know that this is not the case. Sometimes the bolus can get down as far as the vallecula and in some people it is as low as the pyiform sinus

Question 4

What is the clinical significance of the Pyriform Sinus

Answer 4

The Pyriform Sinus is a common place for food particles to become trapped; if foreign material becomes lodged in the piriform fossa of an infant, it may be retrieved nonsurgically. If the area is injured (e.g., by a fish bone), it can give the sensation of food stuck in the subject’s throat.

Question 5

What may cause the swallow trigger to change/ be ‘delayed’

Answer 5

The swallow trigger is varying with age so the trigger moves down with age. This is clinically significant as you may have a client in clinic and you see there is a collection of food (via VF) in the vallecula / pyriform sinus. In the past we may have thought that this was an abnormal swallow and may have diagnosed them with Dysphagia