Gastrointestinal: swallowing: practice question

A Physiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Physiology · Gastrointestinal: swallowing

Sample item

A 60-year-old man after a lateral medullary stroke can start a swallow voluntarily but the food is not carried through the pharynx and he aspirates. Which structure normally coordinates the involuntary pharyngeal stage?

AThe cerebellar vermisBThe myenteric plexus of the pharyngeal wall aloneCThe primary motor cortex of the face areaDThe medullary swallowing centre near the nucleus tractus solitarius and nucleus ambiguus

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. The medullary swallowing centre near the nucleus tractus solitarius and nucleus ambiguus

The oral stage is voluntary, while the pharyngeal stage is a reflex programmed by the swallowing centre in the medulla, involving the nucleus tractus solitarius and nucleus ambiguus with cranial nerves IX and X. This stage includes elevation of the larynx, closure of the glottis and relaxation of the upper oesophageal sphincter. Medullary lesions therefore cause dysphagia and aspiration.

Option by option

A. The cerebellar vermis
The cerebellum does not coordinate the swallow reflex.
B. The myenteric plexus of the pharyngeal wall alone
The pharynx has striated muscle without a myenteric plexus, and swallowing needs brainstem coordination.
C. The primary motor cortex of the face area
The motor cortex initiates the voluntary stage that is preserved here.
D. The medullary swallowing centre near the nucleus tractus solitarius and nucleus ambiguus (correct)
Correct. The brainstem centre coordinates the reflex stage.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is D, The medullary swallowing centre near the nucleus tractus solitarius and nucleus ambiguus. The oral stage is voluntary, while the pharyngeal stage is a reflex programmed by the swallowing centre in the medulla, involving the nucleus tractus solitarius and nucleus ambiguus with cranial nerves IX and X.

Why is "The cerebellar vermis" not the answer?

The cerebellum does not coordinate the swallow reflex.

Why is "The myenteric plexus of the pharyngeal wall alone" not the answer?

The pharynx has striated muscle without a myenteric plexus, and swallowing needs brainstem coordination.

Why is "The primary motor cortex of the face area" not the answer?

The motor cortex initiates the voluntary stage that is preserved here.

What concept does this question test?

It tests Gastrointestinal: swallowing in Physiology. This stage includes elevation of the larynx, closure of the glottis and relaxation of the upper oesophageal sphincter. Medullary lesions therefore cause dysphagia and aspiration.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal: swallowing?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.