嚥下障害を簡単に②👄編

前回、嚥下障害を「口」、「咽頭」、「喉」のどに分けて考えるとわかりやすいのではないかと提案しました。

今回は、「口」の評価について書いてみます。評価と言っても、その場でできる簡単なものばかりです😊

①顔をみる②発話をきく③口を動かすの順番でみていきましょう。

①顔をみる
顔みると様々な情報が分かりますね。例えば口角下垂や鼻唇溝がなければ顔面神経麻痺の可能性、口が開いていれば、閉口する筋肉が弱い可能性（口呼吸になってるかもしれないですが...)を考えられます。

②発話をきく
会話してみて、発話が歪んできれば口のどこかに問題がある可能性がらありますね。歪んでいれば、「パパパ•••」みたいな感じで、「パ」「タ」「カ」「ラ」をそれぞれ連続で言ってもらいましょう。
「パ」:唇　「タ」:舌の先　「カ」:舌の奥　「ラ」:舌の先　を使うのでどの音が歪んでいるのかが分かれば、口のどこに問題があるのか予想できますね。

③口を動かす
一般的な口の体操で行う項目で一通り確認しましょう。①、②で問題があるかな？っと思った箇所を中心に確認していくのも良いと思います。

①〜③の順番でみていく事で患者さんの口の問題点がみえてきたのではないでしょうか？ここで見えてきた問題点を頭に入れて、実際の患者さんの食事場面を見ると更に問題点が明確になってくると思います🙆

Dysphagia Made Easy ②👄edition

In the last issue, I suggested that it might be easier to understand dysphagia if we divide it into the "mouth," "pharynx," and "throat" throats.

In this article, I will write about "mouth" evaluations. The evaluation is just a simple one that can be done on the spot 😊.

Let's look at them in the following order: (1) look at their faces, (2) listen to their speech, and (3) move their mouths.

(1) Look at the face
Looking at the face can reveal a variety of information. For example, if there is no drooping of the corners of the mouth or nasolabial folds, there is a possibility of facial paralysis, and if the mouth is open, there is a possibility that the muscles that close the mouth are weak (mouth breathing might be a problem...).

(2) Listen to the speech.
If the speech is distorted, there is a possibility that there is a problem somewhere in the mouth. If the speech is distorted, ask him to say "Pa", "Ta", "Ka", and "La" in succession, like "PaPaPa---".
Pa": lips "Ta": tip of the tongue "Ka": back of the tongue "La": tip of the tongue are used, so if you know which sound is distorted, you can predict where in the mouth the problem is.

(3) Mouth exercises
Let's go through the items you do in general mouth exercises. It is also a good idea to focus on the areas where you thought there might be a problem in (1) and (2). It is also a good idea to check around the areas that you think are

By looking at the order of (1) to (3), I hope you have been able to see the problems of the patient's mouth. I believe that the problems will become even clearer when you look at the actual eating situation of the patient with the problems revealed here in mind🙆.