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As soon as the bolus of food is ready to be swallowed, the ORAL STAGE OF SWALLOWING process begins. When this moment is reached, a number of processes must take place in a sequential manner. Normally, the tongue base is raised in the posterior during mastication, but it now lowers down and pulls posteriorly as a result of this change. While chewing, the anterior tongue lifts to the hard palate and press the bolus back toward the faucial pillars. Mastication has come to an end.
This stage appears to be triggered by contact with the fauces, the soft palate, or the posterior tongue base, and it appears to be triggered by contact with the posterior tongue base. As highlighted by Logemann (1998), this "trigger point" appears to shift during the course of an adult's life, with the geriatric swallow being activated at a more posterior region in the body.
Muscles Involved in Bolus Propulsion
o Labial Muscles
▪ Orbicularis Oris
o Facial Muscles
▪ Risorius
▪ Buccinator
o Lingual Muscles
▪ Intrinsic
▪ Extrinsic
o Mandibular Elevators
▪ Masseter
▪ Medial Pterygoid
▪ Temporalis
o Laryngeal Elevators
▪ Digastric
▪ Geniohyoid
▪ Mylohyoid
DEFICITS IN THE ORAL STAGE
Sensory and motor dysfunction are the most prevalent deficiencies in the oral stage. Movements that are weakened result in a reduction in the oral transit time of the bolus toward the pharynx. Food may linger on the tongue or hard palate after passage if there is a larger degree of motor participation.
The epiglottis fails to invert over the laryngeal opening in individuals who have oral-phase involvement, while the hyoid is only partially elevated in those who do not have oral-phase involvement. The researchers discovered that people with such a deficiency had higher pooling of food or liquid within the valleculae.
A sensory impairment may cause difficulty commencing a reflexive swallow. This procedure has been used for many years to help these people swallow, but its effectiveness is still being studied.
REFERENCES:
Fuller, D. R., Pimentel, J. T., & Peregoy, B. M. (2012). Applied anatomy & physiology for speech-language pathology & audiology. Wolters Kluwer/Lippincott Williams & Wilkins Health.
Seikel, J. A., Drumright, D. G., & Seikel, P. (2013). Essentials of anatomy & physiology for communication disorders. Delmar Cengage Learning.
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