嚥下障害を簡単に③👄編

前回は、「口」をみるポイントをお伝えしましたが、今回は物を食べる際の「口」をみるポイントをお伝えしたいと思います。

食べる際に口を使う動作は、①物を唇でとりこむ捕食、②歯で噛む咀嚼、そして③舌などを使って飲み込みやすい形にして、④舌で咽頭に送ります。

①物を唇でとりこむ捕食
唇をとじて食べ物をとりこみますが、上手くいかないと食べこぼしがみられる事があります。

②歯で噛む咀嚼
食べ物を歯で噛切ったり、すり潰したりして細かくしていきます。上手くいかないと、咀嚼した後も食べ物が口の中に形として残っている事があります。

③舌などを使って飲み込みやすい形にする
歯で咀嚼した物を舌など使って唾液と混ぜながら飲み込みやすい形にします。上手くいかないと、口の中に食べ物が残ったり、飲みこみにくかったりします。

④舌で咽頭に送る
飲み込みやすい形にした物（食塊）は舌で咽頭に送られます（5期モデル）。上手くいかないと口腔内に残留がみられます。
※プロセスモデルでは、咀嚼をしながら咽頭に送り込まれます。

①から④で上手くいっていないところがあれば、その動作を行う器官に問題がないか疑ってみると良いと思います。

Dysphagia Made Easy ③👄edition

In the previous issue, we reported on the points to examine the "mouth," and this time we would like to report on the points to examine the "mouth" when eating things.

When eating, the mouth is used in the following four processes: (1) predation, which involves taking in food with the lips; (2) chewing, which involves biting with the teeth; (3) forming food into a form that is easy to swallow using the tongue and other parts of the tongue; and (4) sending the food into the pharynx with the tongue.

(1) Lip-intake predation
The lips are closed and food is sucked in, but if this does not go well, spills may occur.

(2) Mastication, chewing with the teeth
Food is chewed or ground into small pieces with the teeth.If it is not done properly, food may remain in the mouth as a form after chewing.

(3) Use the tongue and other parts of the mouth to make it easier to swallow
Use the tongue to mix the food chewed with the teeth with saliva and make it into a form that is easy to swallow.If this does not go well, food may remain in the mouth or be difficult to swallow.

(4) Sent to the pharynx by the tongue
The food mass is sent to the pharynx by the tongue (5-stage model).If it does not go well, residuals are seen in the oral cavity.
In the *process model, the food is sent to the pharynx while being chewed.

If there is anything that is not working well in (1) through (4), you should suspect a problem with the organ that performs the operation.