1. Esophageal motility and pathophysiology of reflux disease
Dr. Moizuddin Khan
Dr. Beenish Mukhtar
Chapter 22, Respiratory System

2. Objectives: Mastication & chewing Salivary glands Secretion of saliva
Contents of saliva
Functions of saliva
Control of salivary secretion
Swallowing
Types of esophageal peristalsis
Function of lower esophageal sphincter
اسم ورقم المقرر – Course Name and No.
4/23/2019

3. اسم ورقم المقرر – Course Name and No.
4/23/2019

5. CHEWING REFLEX
Also called mastication Bolus of food touches the mouth from inside reflex inhibition of muscles of mastication jaw drops initiates stretch reflex of jaw muscles causes rebound contraction closure of mouth bolus touches the buccal mucosa again and the cycle continues.

23. REFLEX REGULATION OF SALIVA
CONDITIONED REFLEX:- on taking food, stimulation of chemoreceptors in oral cavity and afferents conducted to salivary center
UNCONDITIONED REFLEX:- this happens without taking food, just thought, sight or smell of food
Reflex is through cerebral cortex stimulating salivary center

27. II. Pharyngeal stage Soft palate is pulled up
Palatophryngeal folds are pulled medially to approximate each other
Vocal cords strongly approximate and larynx is pulled upwards and anteriorly by neck muscles

30. Chapter 23: Digestive System

35. Esophageal peristalsis
Esophageal peristalsis can be initiated by deglutition ("primary" peristalsis) or local distention ("secondary" peristalsis).
The UES opens upon activation of the deglutition reflex, allowing the food bolus to pass through -than rapidly shuts to prevent retrograde passage of the bolus.
The esophageal phase of deglutition takes over. This involves two major phenomena, namely the
Sequential contraction of circular muscle of the esophageal body-Peristaltic wave that pushes the food toward the stomach, and relaxation and opening of the LES.
اسم ورقم المقرر – Course Name and No.
4/23/2019

36. Motility Disorders
An esophageal motility disorder (EMD) is any medical disorder causing difficulty in swallowing, regurgitation of food and a spasm-type pain which can be brought on by an allergic reaction to certain foods. The most prominent one is dysphagia.
upper esophageal
UES disorders
neuromuscular disorders
esophageal body
achalasia
diffuse esophageal spasm
nutcracker esophagus
LES
hypertensive LES
اسم ورقم المقرر – Course Name and No.
4/23/2019

37. THANK YOU
References:-