Module 18: The Digestive System

Lesson 3: The Mouth, Pharynx, and Esophagus

Khoang Miệng, Họng, Và Thực Quản

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Mỗi bài học (lesson) bao gồm 4 phần chính: Thuật ngữ, Luyện Đọc, Luyện Nghe, và Bàn Luận.
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Dưới đây là danh sách những thuật ngữ Y khoa của module The Digestive System.
Khái quát được số lượng thuật ngữ sẽ xuất hiện trong bài đọc và nghe sẽ giúp bạn thoải mái tiêu thụ nội dung hơn. Sau khi hoàn thành nội dung đọc và nghe, bạn hãy quay lại đây và luyện tập (practice) để quen dần các thuật ngữ này. Đừng ép bản thân phải nhớ các thuật ngữ này vội vì bạn sẽ gặp và ôn lại danh sách này trong những bài học (lesson) khác của cùng một module.

Medical Terminology: The Digestive System

absorption
passage of digested products from the intestinal lumen through mucosal cells and into the bloodstream or lacteals
accessory digestive organ
includes teeth, tongue, salivary glands, gallbladder, liver, and pancreas
accessory duct
(also, duct of Santorini) duct that runs from the pancreas into the duodenum
acinus
cluster of glandular epithelial cells in the pancreas that secretes pancreatic juice in the pancreas
alimentary canal
continuous muscular digestive tube that extends from the mouth to the anus
aminopeptidase
brush border enzyme that acts on proteins
anal canal
final segment of the large intestine
anal column
long fold of mucosa in the anal canal
anal sinus
recess between anal columns
appendix
(vermiform appendix) coiled tube attached to the cecum
ascending colon
first region of the colon
bacterial flora
bacteria in the large intestine
bile
alkaline solution produced by the liver and important for the emulsification of lipids
bile canaliculus
small duct between hepatocytes that collects bile
bilirubin
main bile pigment, which is responsible for the brown color of feces
body
mid-portion of the stomach
bolus
mass of chewed food
brush border
fuzzy appearance of the small intestinal mucosa created by microvilli
cardia
(also, cardiac region) part of the stomach surrounding the cardiac orifice (esophageal hiatus)
cecum
pouch forming the beginning of the large intestine
cementum
bone-like tissue covering the root of a tooth
central vein
vein that receives blood from hepatic sinusoids
cephalic phase
(also, reflex phase) initial phase of gastric secretion that occurs before food enters the stomach
chemical digestion
enzymatic breakdown of food
chief cell
gastric gland cell that secretes pepsinogen
chylomicron
large lipid-transport compound made up of triglycerides, phospholipids, cholesterol, and proteins
chyme
soupy liquid created when food is mixed with digestive juices
circular fold
(also, plica circulare) deep fold in the mucosa and submucosa of the small intestine
colon
part of the large intestine between the cecum and the rectum
common bile duct
structure formed by the union of the common hepatic duct and the gallbladder’s cystic duct
common hepatic duct
duct formed by the merger of the two hepatic ducts
crown
portion of tooth visible superior to the gum line
cuspid
(also, canine) pointed tooth used for tearing and shredding food
cystic duct
duct through which bile drains and enters the gallbladder
deciduous tooth
one of 20 “baby teeth”
defecation
elimination of undigested substances from the body in the form of feces
deglutition
three-stage process of swallowing
dens
tooth
dentin
bone-like tissue immediately deep to the enamel of the crown or cementum of the root of a tooth
dentition
set of teeth
deoxyribonuclease
pancreatic enzyme that digests DNA
descending colon
part of the colon between the transverse colon and the sigmoid colon
dipeptidase
brush border enzyme that acts on proteins
duodenal gland
(also, Brunner’s gland) mucous-secreting gland in the duodenal submucosa
duodenum
first part of the small intestine, which starts at the pyloric sphincter and ends at the jejunum
enamel
covering of the dentin of the crown of a tooth
enteroendocrine cell
gastric gland cell that releases hormones
enterohepatic circulation
recycling mechanism that conserves bile salts
enteropeptidase
intestinal brush-border enzyme that activates trypsinogen to trypsin
epiploic appendage
small sac of fat-filled visceral peritoneum attached to teniae coli
esophagus
muscular tube that runs from the pharynx to the stomach
external anal sphincter
voluntary skeletal muscle sphincter in the anal canal
fauces
opening between the oral cavity and the oropharynx
feces
semisolid waste product of digestion
flatus
gas in the intestine
fundus
dome-shaped region of the stomach above and to the left of the cardia
G cell
gastrin-secreting enteroendocrine cell
gallbladder
accessory digestive organ that stores and concentrates bile
gastric emptying
process by which mixing waves gradually cause the release of chyme into the duodenum
gastric gland
gland in the stomach mucosal epithelium that produces gastric juice
gastric phase
phase of gastric secretion that begins when food enters the stomach
gastric pit
narrow channel formed by the epithelial lining of the stomach mucosa
gastrin
peptide hormone that stimulates secretion of hydrochloric acid and gut motility
gastrocolic reflex
propulsive movement in the colon activated by the presence of food in the stomach
gastroileal reflex
long reflex that increases the strength of segmentation in the ileum
gingiva
gum
haustral contraction
slow segmentation in the large intestine
haustrum
small pouch in the colon created by tonic contractions of teniae coli
hepatic artery
artery that supplies oxygenated blood to the liver
hepatic lobule
hexagonal-shaped structure composed of hepatocytes that radiate outward from a central vein
hepatic portal vein
vein that supplies deoxygenated nutrient-rich blood to the liver
hepatic sinusoid
blood capillaries between rows of hepatocytes that receive blood from the hepatic portal vein and the branches of the hepatic artery
hepatic vein
vein that drains into the inferior vena cava
hepatocytes
major functional cells of the liver
hepatopancreatic ampulla
(also, ampulla of Vater) bulb-like point in the wall of the duodenum where the bile duct and main pancreatic duct unite
hepatopancreatic sphincter
(also, sphincter of Oddi) sphincter regulating the flow of bile and pancreatic juice into the duodenum
hydrochloric acid (HCl)
digestive acid secreted by parietal cells in the stomach
ileocecal sphincter
sphincter located where the small intestine joins with the large intestine
ileum
end of the small intestine between the jejunum and the large intestine
incisor
midline, chisel-shaped tooth used for cutting into food
ingestion
taking food into the GI tract through the mouth
internal anal sphincter
involuntary smooth muscle sphincter in the anal canal
intestinal gland
(also, crypt of Lieberkühn) gland in the small intestinal mucosa that secretes intestinal juice
intestinal juice
mixture of water and mucus that helps absorb nutrients from chyme
intestinal phase
phase of gastric secretion that begins when chyme enters the intestine
intrinsic factor
glycoprotein required for vitamin B12 absorption in the small intestine
jejunum
middle part of the small intestine between the duodenum and the ileum
labial frenulum
midline mucous membrane fold that attaches the inner surface of the lips to the gums
labium
lip
lactase
brush border enzyme that breaks down lactose into glucose and galactose
lacteal
lymphatic capillary in the villi
large intestine
terminal portion of the alimentary canal
laryngopharynx
part of the pharynx that functions in respiration and digestion
left colic flexure
(also, splenic flexure) point where the transverse colon curves below the inferior end of the spleen
lingual frenulum
mucous membrane fold that attaches the bottom of the tongue to the floor of the mouth
lingual lipase
digestive enzyme from glands in the tongue that acts on triglycerides
lipoprotein lipase
enzyme that breaks down triglycerides in chylomicrons into fatty acids and monoglycerides
liver
largest gland in the body whose main digestive function is the production of bile
lower esophageal sphincter
smooth muscle sphincter that regulates food movement from the esophagus to the stomach
main pancreatic duct
(also, duct of Wirsung) duct through which pancreatic juice drains from the pancreas
major duodenal papilla
point at which the hepatopancreatic ampulla opens into the duodenum
maltase
brush border enzyme that breaks down maltose and maltotriose into two and three molecules of glucose, respectively
mass movement
long, slow, peristaltic wave in the large intestine
mastication
chewing
mechanical digestion
chewing, mixing, and segmentation that prepares food for chemical digestion
mesoappendix
mesentery of the appendix
micelle
tiny lipid-transport compound composed of bile salts and phospholipids with a fatty acid and monoacylglyceride core
microvillus
small projection of the plasma membrane of the absorptive cells of the small intestinal mucosa
migrating motility complex
form of peristalsis in the small intestine
mixing wave
unique type of peristalsis that occurs in the stomach
molar
tooth used for crushing and grinding food
motilin
hormone that initiates migrating motility complexes
motility
movement of food through the GI tract
mucosa
innermost lining of the alimentary canal
mucosal barrier
protective barrier that prevents gastric juice from destroying the stomach itself
mucous neck cell
gastric gland cell that secretes a uniquely acidic mucus
muscularis
muscle (skeletal or smooth) layer of the alimentary canal wall
myenteric plexus
(plexus of Auerbach) major nerve supply to alimentary canal wall; controls motility
nucleosidase
brush border enzyme that digests nucleotides
oral cavity
(also, buccal cavity) mouth
oral vestibule
part of the mouth bounded externally by the cheeks and lips, and internally by the gums and teeth
oropharynx
part of the pharynx continuous with the oral cavity that functions in respiration and digestion
palatoglossal arch
muscular fold that extends from the lateral side of the soft palate to the base of the tongue
palatopharyngeal arch
muscular fold that extends from the lateral side of the soft palate to the side of the pharynx
pancreas
accessory digestive organ that secretes pancreatic juice
pancreatic amylase
enzyme secreted by the pancreas that completes the chemical digestion of carbohydrates in the small intestine
pancreatic juice
secretion of the pancreas containing digestive enzymes and bicarbonate
pancreatic lipase
enzyme secreted by the pancreas that participates in lipid digestion
pancreatic nuclease
enzyme secreted by the pancreas that participates in nucleic acid digestion
parietal cell
gastric gland cell that secretes hydrochloric acid and intrinsic factor
parotid gland
one of a pair of major salivary glands located inferior and anterior to the ears
pectinate line
horizontal line that runs like a ring, perpendicular to the inferior margins of the anal sinuses
pepsinogen
inactive form of pepsin
peristalsis
muscular contractions and relaxations that propel food through the GI tract
permanent tooth
one of 32 adult teeth
pharynx
throat
phosphatase
brush border enzyme that digests nucleotides
porta hepatis
“gateway to the liver” where the hepatic artery and hepatic portal vein enter the liver
portal triad
bile duct, hepatic artery branch, and hepatic portal vein branch
premolar
(also, bicuspid) transitional tooth used for mastication, crushing, and grinding food
propulsion
voluntary process of swallowing and the involuntary process of peristalsis that moves food through the digestive tract
pulp cavity
deepest portion of a tooth, containing nerve endings and blood vessels
pyloric antrum
wider, more superior part of the pylorus
pyloric canal
narrow, more inferior part of the pylorus
pyloric sphincter
sphincter that controls stomach emptying
pylorus
lower, funnel-shaped part of the stomach that is continuous with the duodenum
rectal valve
one of three transverse folds in the rectum where feces is separated from flatus
rectum
part of the large intestine between the sigmoid colon and anal canal
reticuloendothelial cell
(also, Kupffer cell) phagocyte in hepatic sinusoids that filters out material from venous blood from the alimentary canal
retroperitoneal
located posterior to the peritoneum
ribonuclease
pancreatic enzyme that digests RNA
right colic flexure
(also, hepatic flexure) point, at the inferior surface of the liver, where the ascending colon turns abruptly to the left
root
portion of a tooth embedded in the alveolar processes beneath the gum line
ruga
fold of alimentary canal mucosa and submucosa in the empty stomach and other organs
saccharolytic fermentation
anaerobic decomposition of carbohydrates
saliva
aqueous solution of proteins and ions secreted into the mouth by the salivary glands
salivary amylase
digestive enzyme in saliva that acts on starch
salivary gland
an exocrine gland that secretes a digestive fluid called saliva
salivation
secretion of saliva
segmentation
alternating contractions and relaxations of non-adjacent segments of the intestine that move food forward and backward, breaking it apart and mixing it with digestive juices
serosa
outermost layer of the alimentary canal wall present in regions within the abdominal cavity
sigmoid colon
end portion of the colon, which terminates at the rectum
small intestine
section of the alimentary canal where most digestion and absorption occurs
soft palate
posterior region of the bottom portion of the nasal cavity that consists of skeletal muscle
stomach
alimentary canal organ that contributes to chemical and mechanical digestion of food from the esophagus before releasing it, as chyme, to the small intestine
sublingual gland
one of a pair of major salivary glands located beneath the tongue
submandibular gland
one of a pair of major salivary glands located in the floor of the mouth
submucosa
layer of dense connective tissue in the alimentary canal wall that binds the overlying mucosa to the underlying muscularis
submucosal plexus
(plexus of Meissner) nerve supply that regulates activity of glands and smooth muscle
sucrase
brush border enzyme that breaks down sucrose into glucose and fructose
tenia coli
one of three smooth muscle bands that make up the longitudinal muscle layer of the muscularis in all of the large intestine except the terminal end
tongue
accessory digestive organ of the mouth, the bulk of which is composed of skeletal muscle
transverse colon
part of the colon between the ascending colon and the descending colon
upper esophageal sphincter
skeletal muscle sphincter that regulates food movement from the pharynx to the esophagus
Valsalva’s maneuver
voluntary contraction of the diaphragm and abdominal wall muscles and closing of the glottis, which increases intra-abdominal pressure and facilitates defecation
villus
projection of the mucosa of the small intestine
voluntary phase
initial phase of deglutition, in which the bolus moves from the mouth to the oropharynx
α-dextrin
breakdown product of starch
α-dextrinase
brush border enzyme that acts on α-dextrins
Nội dung này đang được cập nhật.
Dưới đây là các bài văn nằm ở bên trái. Ở bên phải là các bài luyện tập (practice) để đánh giá khả năng đọc hiểu của bạn. Sẽ khó khăn trong thời gian đầu nếu vốn từ vựng của bạn còn hạn chế, đặc biệt là từ vựng Y khoa. Hãy kiên nhẫn và đọc nhiều nhất có kể, lượng kiến thức tích tụ dần sẽ giúp bạn đọc thoải mái hơn.
In this article, you will examine the anatomy and functions of the three main organs of the upper alimentary canal—the mouth, pharynx, and esophagus—as well as three associated accessory organs—the tongue, salivary glands, and teeth.
The cheeks, tongue, and palate frame the mouth, which is also called the oral cavity (or buccal cavity). The structures of the mouth are illustrated in Figure 1.

At the entrance to the mouth are the lips, or labia (singular = labium). Their outer covering is skin, which transitions to a mucous membrane in the mouth proper. Lips are very vascular with a thin layer of keratin; hence, the reason they are “red.” They have a huge representation on the cerebral cortex, which probably explains the human fascination with kissing! The lips cover the orbicularis oris muscle, which regulates what comes in and goes out of the mouth. The labial frenulum is a midline fold of mucous membrane that attaches the inner surface of each lip to the gum. The cheeks make up the oral cavity’s sidewalls. While their outer covering is skin, their inner covering is mucous membrane. This membrane is made up of non-keratinized, stratified squamous epithelium. Between the skin and mucous membranes are connective tissue and buccinator muscles. The next time you eat some food, notice how the buccinator muscles in your cheeks and the orbicularis oris muscle in your lips contract, helping you keep the food from falling out of your mouth. Additionally, notice how these muscles work when you are speaking.

The pocket-like part of the mouth that is framed on the inside by the gums and teeth, and on the outside by the cheeks and lips is called the oral vestibule. Moving farther into the mouth, the opening between the oral cavity and throat (oropharynx) is called the fauces (like the kitchen “faucet”). The main open area of the mouth, or oral cavity proper, runs from the gums and teeth to the fauces.

When you are chewing, you do not find it difficult to breathe simultaneously. The next time you have food in your mouth, notice how the arched shape of the roof of your mouth allows you to handle both digestion and respiration at the same time. This arch is called the palate. The anterior region of the palate serves as a wall (or septum) between the oral and nasal cavities as well as a rigid shelf against which the tongue can push food. It is created by the maxillary and palatine bones of the skull and, given its bony structure, is known as the hard palate. If you run your tongue along the roof of your mouth, you’ll notice that the hard palate ends in the posterior oral cavity, and the tissue becomes fleshier. This part of the palate, known as the soft palate, is composed mainly of skeletal muscle. You can therefore manipulate, subconsciously, the soft palate—for instance, to yawn, swallow, or sing (see Figure 1).

A fleshy bead of tissue called the uvula drops down from the center of the posterior edge of the soft palate. Although some have suggested that the uvula is a vestigial organ, it serves an important purpose. When you swallow, the soft palate and uvula move upward, helping to keep foods and liquid from entering the nasal cavity. Unfortunately, it can also contribute to the sound produced by snoring. Two muscular folds extend downward from the soft palate, on either side of the uvula. Toward the front, the palatoglossal arch lies next to the base of the tongue; behind it, the palatopharyngeal arch forms the superior and lateral margins of the fauces. Between these two arches are the palatine tonsils, clusters of lymphoid tissue that protect the pharynx. The lingual tonsils are located at the base of the tongue.
Perhaps you have heard it said that the tongue is the strongest muscle in the body. Those who stake this claim cite its strength proportionate to its size. Although it is difficult to quantify the relative strength of different muscles, it remains indisputable that the tongue is a workhorse, facilitating ingestion, mechanical digestion, chemical digestion (lingual lipase), sensation (of taste, texture, and temperature of food), swallowing, and vocalization.

The tongue is attached to the mandible, the styloid processes of the temporal bones, and the hyoid bone. The hyoid is unique in that it only distantly/indirectly articulates with other bones. The tongue is positioned over the floor of the oral cavity. A medial septum extends the entire length of the tongue, dividing it into symmetrical halves.

Beneath its mucous membrane covering, each half of the tongue is composed of the same number and type of intrinsic and extrinsic skeletal muscles. The intrinsic muscles (those within the tongue) are the longitudinalis inferior, longitudinalis superior, transversus linguae, and verticalis linguae muscles. These allow you to change the size and shape of your tongue, as well as to stick it out, if you wish. Having such a flexible tongue facilitates both swallowing and speech.

As you learned in your study of the muscular system, the extrinsic muscles of the tongue are the palatoglossus, hyoglossus, styloglossus, and genioglossus muscles. These muscles originate outside the tongue and insert into connective tissues within the tongue. The mylohyoid is responsible for raising the tongue, the hyoglossus pulls it down and back, the styloglossus pulls it up and back, and the genioglossus pulls it forward. Working in concert, these muscles perform three important digestive functions in the mouth: (1) position food for optimal chewing, (2) gather food into a bolus (rounded mass), and (3) position food so it can be swallowed.

The top and sides of the tongue are studded with papillae, extensions of lamina propria of the mucosa, which are covered in stratified squamous epithelium (Figure 2). Fungiform papillae, which are mushroom shaped, cover a large area of the tongue; they tend to be larger toward the rear of the tongue and smaller on the tip and sides. In contrast, filiform papillae are long and thin. Fungiform papillae contain taste buds, and filiform papillae have touch receptors that help the tongue move food around in the mouth. The filiform papillae create an abrasive surface that performs mechanically, much like a cat’s rough tongue that is used for grooming. Lingual glands in the lamina propria of the tongue secrete mucus and a watery serous fluid that contains the enzyme lingual lipase, which plays a minor role in breaking down triglycerides but does not begin working until it is activated in the stomach. A fold of mucous membrane on the underside of the tongue, the lingual frenulum, tethers the tongue to the floor of the mouth. People with the congenital anomaly ankyloglossia, also known by the non-medical term “tongue tie,” have a lingual frenulum that is too short or otherwise malformed. Severe ankyloglossia can impair speech and must be corrected with surgery.
Many small salivary glands are housed within the mucous membranes of the mouth and tongue. These minor exocrine glands are constantly secreting saliva, either directly into the oral cavity or indirectly through ducts, even while you sleep. In fact, an average of 1 to 1.5 liters of saliva is secreted each day. Usually just enough saliva is present to moisten the mouth and teeth. Secretion increases when you eat, because saliva is essential to moisten food and initiate the chemical breakdown of carbohydrates. Small amounts of saliva are also secreted by the labial glands in the lips. In addition, the buccal glands in the cheeks, palatal glands in the palate, and lingual glands in the tongue help ensure that all areas of the mouth are supplied with adequate saliva.

A. The Major Salivary Glands

Outside the oral mucosa are three pairs of major salivary glands, which secrete the majority of saliva into ducts that open into the mouth:

  • The submandibular glands, which are in the floor of the mouth, secrete saliva into the mouth through the submandibular ducts.
  • The sublingual glands, which lie below the tongue, use the lesser sublingual ducts to secrete saliva into the oral cavity.
  • The parotid glands lie between the skin and the masseter muscle, near the ears. They secrete saliva into the mouth through the parotid duct, which is located near the second upper molar tooth (Figure 3).

B. Saliva

Saliva is essentially (99.4 percent) water. The remaining 0.6 percent is a complex mixture of ions, glycoproteins, enzymes, growth factors, and waste products. Perhaps the most important ingredient in saliva from the perspective of digestion is the enzyme salivary amylase, which initiates the breakdown of carbohydrates. Food does not spend enough time in the mouth to allow all the carbohydrates to break down, but salivary amylase continues acting until it is inactivated by stomach acids. Bicarbonate and phosphate ions function as chemical buffers, maintaining saliva at a pH between 6.35 and 6.85. Salivary mucus helps lubricate food, facilitating movement in the mouth, bolus formation, and swallowing. Saliva contains immunoglobulin A, which prevents microbes from penetrating the epithelium, and lysozyme, which makes saliva antimicrobial. Saliva also contains epidermal growth factor, which might have given rise to the adage “a mother’s kiss can heal a wound.”

Each of the major salivary glands secretes a unique formulation of saliva according to its cellular makeup. For example, the parotid glands secrete a watery solution that contains salivary amylase. The submandibular glands have cells similar to those of the parotid glands, as well as mucus-secreting cells. Therefore, saliva secreted by the submandibular glands also contains amylase but in a liquid thickened with mucus. The sublingual glands contain mostly mucous cells, and they secrete the thickest saliva with the least amount of salivary amylase.

C. Regulation of Salivation

The autonomic nervous system regulates salivation (the secretion of saliva). In the absence of food, parasympathetic stimulation keeps saliva flowing at just the right level for comfort as you speak, swallow, sleep, and generally go about life. Over-salivation can occur, for example, if you are stimulated by the smell of food, but that food is not available for you to eat. Drooling is an extreme instance of the overproduction of saliva. During times of stress, such as before speaking in public, sympathetic stimulation takes over, reducing salivation and producing the symptom of dry mouth often associated with anxiety. When you are dehydrated, salivation is reduced, causing the mouth to feel dry and prompting you to take action to quench your thirst.

Salivation can be stimulated by the sight, smell, and taste of food. It can even be stimulated by thinking about food. You might notice whether reading about food and salivation right now has had any effect on your production of saliva.

How does the salivation process work while you are eating? Food contains chemicals that stimulate taste receptors on the tongue, which send impulses to the superior and inferior salivatory nuclei in the brain stem. These two nuclei then send back parasympathetic impulses through fibers in the glossopharyngeal and facial nerves, which stimulate salivation. Even after you swallow food, salivation is increased to cleanse the mouth and to water down and neutralize any irritating chemical remnants, such as that hot sauce in your burrito. Most saliva is swallowed along with food and is reabsorbed, so that fluid is not lost.
The teeth, or dentes (singular = dens), are organs similar to bones that you use to tear, grind, and otherwise mechanically break down food.

A. Types of Teeth

During the course of your lifetime, you have two sets of teeth (one set of teeth is a dentition). Your 20 deciduous teeth, or baby teeth, first begin to appear at about 6 months of age. Between approximately age 6 and 12, these teeth are replaced by 32 permanent teeth. Moving from the center of the mouth toward the side, these are as follows (Figure 4):

  • The eight incisors, four top and four bottom, are the sharp front teeth you use for biting into food.
  • The four cuspids (or canines) flank the incisors and have a pointed edge (cusp) to tear up food. These fang-like teeth are superb for piercing tough or fleshy foods.
  • Posterior to the cuspids are the eight premolars (or bicuspids), which have an overall flatter shape with two rounded cusps useful for mashing foods.
  • The most posterior and largest are the 12 molars, which have several pointed cusps used to crush food so it is ready for swallowing. The third members of each set of three molars, top and bottom, are commonly referred to as the wisdom teeth, because their eruption is commonly delayed until early adulthood. It is not uncommon for wisdom teeth to fail to erupt; that is, they remain impacted. In these cases, the teeth are typically removed by orthodontic surgery.

B. Anatomy of a Tooth

The teeth are secured in the alveolar processes (sockets) of the maxilla and the mandible. Gingivae (commonly called the gums) are soft tissues that line the alveolar processes and surround the necks of the teeth. Teeth are also held in their sockets by a connective tissue called the periodontal ligament.

The two main parts of a tooth are the crown, which is the portion projecting above the gum line, and the root, which is embedded within the maxilla and mandible. Both parts contain an inner pulp cavity, containing loose connective tissue through which run nerves and blood vessels. The region of the pulp cavity that runs through the root of the tooth is called the root canal. Surrounding the pulp cavity is dentin, a bone-like tissue. In the root of each tooth, the dentin is covered by an even harder bone-like layer called cementum. In the crown of each tooth, the dentin is covered by an outer layer of enamel, the hardest substance in the body (Figure 5).

Although enamel protects the underlying dentin and pulp cavity, it is still nonetheless susceptible to mechanical and chemical erosion, or what is known as tooth decay. The most common form, dental caries (cavities) develops when colonies of bacteria feeding on sugars in the mouth release acids that cause soft tissue inflammation and degradation of the calcium crystals of the enamel. The digestive functions of the mouth are summarized in Table 1.
The pharynx (throat) is involved in both digestion and respiration. It receives food and air from the mouth, and air from the nasal cavities. When food enters the pharynx, involuntary muscle contractions close off the air passageways.

A short tube of skeletal muscle lined with a mucous membrane, the pharynx runs from the posterior oral and nasal cavities to the opening of the esophagus and larynx. It has three subdivisions. The most superior, the nasopharynx, is involved only in breathing and speech. The other two subdivisions, the oropharynx and the laryngopharynx, are used for both breathing and digestion. The oropharynx begins inferior to the nasopharynx and is continuous below with the laryngopharynx (Figure 6). The inferior border of the laryngopharynx connects to the esophagus, whereas the anterior portion connects to the larynx, allowing air to flow into the bronchial tree.

Histologically, the wall of the oropharynx is similar to that of the oral cavity. The mucosa includes a stratified squamous epithelium that is endowed with mucus-producing glands. During swallowing, the elevator skeletal muscles of the pharynx contract, raising and expanding the pharynx to receive the bolus of food. Once received, these muscles relax and the constrictor muscles of the pharynx contract, forcing the bolus into the esophagus and initiating peristalsis.

Usually during swallowing, the soft palate and uvula rise reflexively to close off the entrance to the nasopharynx. At the same time, the larynx is pulled superiorly and the cartilaginous epiglottis, its most superior structure, folds inferiorly, covering the glottis (the opening to the larynx); this process effectively blocks access to the trachea and bronchi. When the food “goes down the wrong way,” it goes into the trachea. When food enters the trachea, the reaction is to cough, which usually forces the food up and out of the trachea, and back into the pharynx.
The esophagus is a muscular tube that connects the pharynx to the stomach. It is approximately 25.4 cm (10 in) in length, located posterior to the trachea, and remains in a collapsed form when not engaged in swallowing. As you can see in Figure 7, the esophagus runs a mainly straight route through the mediastinum of the thorax. To enter the abdomen, the esophagus penetrates the diaphragm through an opening called the esophageal hiatus.

A. Passage of Food through the Esophagus

The upper esophageal sphincter, which is continuous with the inferior pharyngeal constrictor, controls the movement of food from the pharynx into the esophagus. The upper two-thirds of the esophagus consists of both smooth and skeletal muscle fibers, with the latter fading out in the bottom third of the esophagus. Rhythmic waves of peristalsis, which begin in the upper esophagus, propel the bolus of food toward the stomach. Meanwhile, secretions from the esophageal mucosa lubricate the esophagus and food. Food passes from the esophagus into the stomach at the lower esophageal sphincter (also called the gastroesophageal or cardiac sphincter). Recall that sphincters are muscles that surround tubes and serve as valves, closing the tube when the sphincters contract and opening it when they relax. The lower esophageal sphincter relaxes to let food pass into the stomach, and then contracts to prevent stomach acids from backing up into the esophagus. Surrounding this sphincter is the muscular diaphragm, which helps close off the sphincter when no food is being swallowed. When the lower esophageal sphincter does not completely close, the stomach’s contents can reflux (that is, back up into the esophagus), causing heartburn or gastroesophageal reflux disease (GERD).

B. Histology of the Esophagus

The mucosa of the esophagus is made up of an epithelial lining that contains non-keratinized, stratified squamous epithelium, with a layer of basal and parabasal cells. This epithelium protects against erosion from food particles. The mucosa’s lamina propria contains mucus-secreting glands. The muscularis layer changes according to location: In the upper third of the esophagus, the muscularis is skeletal muscle. In the middle third, it is both skeletal and smooth muscle. In the lower third, it is smooth muscle. As mentioned previously, the most superficial layer of the esophagus is called the adventitia, not the serosa. In contrast to the stomach and intestines, the loose connective tissue of the adventitia is not covered by a fold of visceral peritoneum. The digestive functions of the esophagus are identified in Table 2.
Deglutition is another word for swallowing—the movement of food from the mouth to the stomach. The entire process takes about 4 to 8 seconds for solid or semisolid food, and about 1 second for very soft food and liquids. Although this sounds quick and effortless, deglutition is, in fact, a complex process that involves both the skeletal muscle of the tongue and the muscles of the pharynx and esophagus. It is aided by the presence of mucus and saliva. There are three stages in deglutition: the voluntary phase, the pharyngeal phase, and the esophageal phase (Figure 8). The autonomic nervous system controls the latter two phases.

A. The Voluntary Phase

The voluntary phase of deglutition (also known as the oral or buccal phase) is so called because you can control when you swallow food. In this phase, chewing has been completed and swallowing is set in motion. The tongue moves upward and backward against the palate, pushing the bolus to the back of the oral cavity and into the oropharynx. Other muscles keep the mouth closed and prevent food from falling out. At this point, the two involuntary phases of swallowing begin.

B. The Pharyngeal Phase

In the pharyngeal phase, stimulation of receptors in the oropharynx sends impulses to the deglutition center (a collection of neurons that controls swallowing) in the medulla oblongata. Impulses are then sent back to the uvula and soft palate, causing them to move upward and close off the nasopharynx. The laryngeal muscles also constrict to prevent aspiration of food into the trachea. At this point, deglutition apnea takes place, which means that breathing ceases for a very brief time. Contractions of the pharyngeal constrictor muscles move the bolus through the oropharynx and laryngopharynx. Relaxation of the upper esophageal sphincter then allows food to enter the esophagus.

C. The Esophageal Phase

The entry of food into the esophagus marks the beginning of the esophageal phase of deglutition and the initiation of peristalsis. As in the previous phase, the complex neuromuscular actions are controlled by the medulla oblongata. Peristalsis propels the bolus through the esophagus and toward the stomach. The circular muscle layer of the muscularis contracts, pinching the esophageal wall and forcing the bolus forward. At the same time, the longitudinal muscle layer of the muscularis also contracts, shortening this area and pushing out its walls to receive the bolus. In this way, a series of contractions keeps moving food toward the stomach. When the bolus nears the stomach, distention of the esophagus initiates a short reflex relaxation of the lower esophageal sphincter that allows the bolus to pass into the stomach. During the esophageal phase, esophageal glands secrete mucus that lubricates the bolus and minimizes friction.

OpenStax. (2022). Anatomy and Physiology 2e. Rice University. Retrieved June 15, 2023. ISBN-13: 978-1-711494-06-7 (Hardcover) ISBN-13: 978-1-711494-05-0 (Paperback) ISBN-13: 978-1-951693-42-8 (Digital). License: Attribution 4.0 International (CC BY 4.0). Access for free at openstax.org.

The mouth includes the lips, tongue, palate, gums, and teeth.

This superior view of the tongue shows the locations and types of lingual papillae.

The major salivary glands are located outside the oral mucosa and deliver saliva into the mouth through ducts.

This figure of two human dentitions shows the arrangement of teeth in the maxilla and mandible, and the relationship between the deciduous and permanent teeth.

This longitudinal section through a molar in its alveolar socket shows the relationships between enamel, dentin, and pulp.

StructureActionOutcome
Lips and cheeksConfine food between teethFood is chewed evenly during mastication
Salivary glandsSecrete salivaMoisten and lubricate the lining of the mouth and pharynxMoisten, soften, and dissolve foodClean the mouth and teethSalivary amylase breaks down starch
Tongue’s extrinsic musclesMove tongue sideways, and in and outManipulate food for chewingShape food into a bolusManipulate food for swallowing
Tongue’s intrinsic musclesChange tongue shapeManipulate food for swallowing
Taste budsSense food in mouth and sense tasteNerve impulses from taste buds are conducted to salivary nuclei in the brain stem and then to salivary glands, stimulating saliva secretion
Lingual glandsSecrete lingual lipaseActivated in the stomachBreak down triglycerides into fatty acids and diglycerides
TeethShred and crush foodBreak down solid food into smaller particles for deglutition

The pharynx runs from the nostrils to the esophagus and the larynx.

The upper esophageal sphincter controls the movement of food from the pharynx to the esophagus. The lower esophageal sphincter controls the movement of food from the esophagus to the stomach.

ActionOutcome
Upper esophageal sphincter relaxationAllows the bolus to move from the laryngopharynx to the esophagus
PeristalsisPropels the bolus through the esophagus
Lower esophageal sphincter relaxationAllows the bolus to move from the esophagus into the stomach and prevents chyme from entering the esophagus
Mucus secretionLubricates the esophagus, allowing easy passage of the bolus

Deglutition includes the voluntary phase and two involuntary phases: the pharyngeal phase and the esophageal phase.

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Dưới đây là video và các luyện tập (practice) của bài này. Nghe là một kĩ năng khó, đặc biệt là khi chúng ta chưa quen nội dung và chưa có nhạy cảm ngôn ngữ. Nhưng cứ đi thật chậm và đừng bỏ cuộc.
Xem video và cảm nhận nội dung bài. Bạn có thể thả trôi, cảm nhận dòng chảy ngôn ngữ và không nhất thiết phải hiểu toàn bộ bài. Bên dưới là script để bạn khái quát nội dụng và tra từ mới.
Script:
  1. In the mouth, the tongue and the teeth begin mechanical digestion, and saliva begins chemical digestion.
  2. The pharynx, which plays roles in breathing and vocalization as well as digestion.
  3. It begins at the top with the nasal and oral cavities, extends downwards towards the esophagus for digestion, and forwards towards the larynx for respiration.
  4. During deglutition or swallowing, the soft palate rises to close off the nasopharynx, the larynx elevates, and the epiglottis folds over the glottis.
  5. The esophagus includes an upper esophageal sphincter made of skeletal muscle and a lower esophageal sphincter made of smooth muscle.
  6. The upper sphincter regulates the movement of food from the pharynx to the esophagus.
  7. On the other hand, the lower sphincter controls the passage of food from the esophagus to the stomach.
  8. Cells in the esophageal wall secrete mucus that eases the passage of the food bolus.
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