SWALLOW-MECHANISM

(Biomech Reflex Chain)

Myofunktional Exercise  Collect ion

Application:

to enlaarge click picture

The description in the paragraph “Discussion” is practically taking apart the reflex chain in a biomechanical view of the succession of steps in the single links. (Anatomy: Area III, Page 24f.f.)

Contents:

No direct exercise contents. The exercise specific reference to the topic is discussed in the chapter SWALLOW REFLEX EXERCISES.

Materials:

Exercise specific.

Procedure:

Exercise specific.

Characteristics:

Feed-Back, Reflex exercise

Remarks:

See “Discussion”.

Discussion:

The deglutition process occurs within a physiological frame, this is to say, within a specified bandwidth of variance potential which is adjusted via receptors in a feed-back adjustment for effect optimization.

So we can find variations in the sequence of the deglutition process as, for example, saliva swallowing, CONTINUOUS SWALLOW (drinking), MASH SWALLOW, CRUMB SWALLOW and convulsive

swallowing. In this listing the examples are itemized in a row of increasing intensity. The mash swallowing would be the standard type and so is serving as basic in the following discussion. So the chewing matter is defined as “mush” being gathered up after mastication and insalivation, ready for deglutition.

The masticatory process is followed by the deglutition process. It proceeds in the later on described principle; a generally applicable standard sequence of actions is rather not available as it is different between organisms. Furthermore there do exist different variants within each individual. Crucial, here as well, is the observance of a physiological frame, the gaining of an optimum effect under optimum texture burdening – this is the principle. The precision adjusting is obtained receptor-guided after the feed-back principle.

Within the variation range approved by the function frame for example the following  deglutition processes, arranged after their action intensity, can be differentiated:

The (also nocturnal) saliva swallowing (“idle swallowing”), the CONTINUOUS SWALLOW

 (LIQUID SWALLOW, drinking), MASH SWALLOW, the CRUMB SWALLOW

 and the pill swallowing.

The convulsive swallowing at a startle reaction or with the taking of a bitter medicine will surely “fall out of the frame”.

The description of the architecture of the reflex chain, the before described principle, shall now be given in the ‘part of the natural order’ sequence while it should be taken into account that some actions are going off simultaneously or overlapping.

 An example for a deglutition procedure:

 In this example the mash swallow will be set as standard, not, because today’s diet often is to mashy in its consistency, but because every chewing stuff is prepared in the masticatory process in a way, that it embodies a mashy Bolus in grain size and saliva imbibition. The chewing process is followed by the

(1) Compilation to form the Bolus upon the tongue back. This process is, in accordance with the schematic sketch  (Area I, Page 10),  aided by the inner muscle bulb and the outer sheath. These have to cooperate in a mutually adjusted tonicity to avoid injuries on the textures. Those damages in a minor extend and good healing tendency are the bite injuries on the cheek inner surface or the lateral border of the tongue (frequent mutilation of the same site may cause problems). More serious consequences which should need some therapy are the bending of the jaw arches respectively the tilting of teeth.

Possibly pressoreceptors within the periodontal tissue of the teeth and in the investment of the neighbouring mucous areas , here, are taking on the task to control the muscular tonicity and its balance to a inside-outside balance. During the action of bolus gathering the special anatomical construction of the involved textures has a favourable effect. Into the mucous surface of the tongue as well as of the cheeks and lips muscle fibres do directly run in so that, especially on the tongue surface, quasi every square millimetre is movable on its own.

This at the one hand explains effect known as physiological self-cleaning of the mouth (and the interdental spaces) at the other hand it becomes evident why single teeth are moving, tilting or turning, shifting, “migrating” as it is mistakenly called . Teeth do not migrate, they “are migrated”. And this can only be halted by adequate MFT measures and exercises.

The mucous surface is able to cause such defects out of dysfunctions with smallest muscular extroversions (also see detail photo page 24).

Responsible for this mechanism which physiologically exists to pick the chewing stuff out of the “corners”, the funnel-shaped indentations of the interdental spaces in a way that, as is well known, not even the whipping around of the tongue after swallowing is necessary for cleaning up.

This collecting is taken over in the inside (cavum) by the rim of the tongue while the armamentarium with the papillae still increases the cleaning effect. Along with this it is a rather theoretical question whether the papillae originally serve as location for the gustatory sensors and contribute the cleaning effect on the side, or if the surface morphology primarily serves biomechanical purposes and got the gustatory receptors just because of the adequate constitution [also see (11)].

(2) As the next step the outer space (vestibulum) between dental bow and cheek inner wall gets completely collapsed all around by the muscle chain of the “belt” (Anatomy: Areal I, Page 11), for the front region this is achieved by the vestibulum compression known as the ‘ZIP’ . At the same time >

(3) the Rima Oris (lip fissure) is closed as the primary partial step. This is of major importance as a feed-back stimulus as with the normal course of events lip contact has to be reported by the receptors. This stimulus can be got around by the contact tongue – lip, an MFT case which leads to damage. If anatomical lacks are present this method becomes a substitute reflex which (as all substitute reflexes) should be seen as prognostically unfavourable. It is known that an incompetent lip closure leads to the Grimacing Swallow wit a cramping of the orofacial musculature.

In connection with this should be mentioned especially the Mentalis the hyperactivity of which can cause substantial damage, as well as the region around the Modiolus, the wheel-spike hub, crossing point and insertion of several muscle tracks (Anatomy: Area I, Page 11, Img.17), the increased contraction of which is known as the dimple.

(4)  Meanwhile on the tongue surface in the first third another DIMPLE has formed which gave the name to an exercise being a cent-sized gutter or indentation; before this got known the mechanism of the bolus transport was compared with the “squeezing out of a tube”. This motion pattern indeed exists. Only, that we should see in it rather the substitute reflex which admittedly has a lifesaving function in case of a loss of the DIMPLE mechanism but at the same time represents a motion pattern of less efficiency under remarkably higher muscular effort. In the long run this will cite texture damages; we do have an MFT case.

The bolus being positioned >

(5) the tongue tip is fixed at the POINT. This momentum is practiced with the exercise  TOUCH-THE-BUTTON. This is commonly seen as the moment when the unconscious and partly deliberately stoppable part of the swallow reflex sets into act.  The action does not – as the description may suppose – some time before but nearly simultaneous to the ‘ZIP’ and precisely at the POINT. Everything going on spatially or chronologically before or after this will become an MFT-case

From this moment on

(6) a caterpillar mechanism is put in action by which the DIMPLE, the indentation, is shifted retrally together with its content, the bolus. If this wave movement does not take place (either DIMPLE or substitute tube squeeze) the “chicken method” is performed as compensation – a quite miserable and functionally unsatisfying replacement but for the organism a chance to survive (see chicken).

It conveys only the major part of the foodstuff course throat as the tongue bends some way behind the first third leaving it to gravitation or a flush to ship the stuff.

Simultaneously to the “caterpillar-mechanism”, meanwhile, on the tongue surface a micro-bio-mechanical process is going on guaranteeing the particularly comprehensive transportation effect.

(7) The tongue surface is capable, according to computer-controlled evaluations presented in special literature, to perform a movement which resembles that of the foot of a sewing-machine: Pushing up and tossing backward, release and reverse of motion and this in continuation. In this process again the papillous tongue surface is of great benefit.

(8) As, now, the most retral part of the tongue is shutting of throat against oral cavity and the Velum lifts up for the sealing of against the upper airway the peristalsis in the faucal region starts. This mechanism takes over the Bolus for the further transportation giving the cue for a further simultaneous process during the retraldirected transport.

(9) The latter getting comprehensible through the fact that according to evolution the material transport had to find its way through the muscle tube of the worm (stadium): The peristalsis wave gets in action foremost sphincter muscle. This effect can be reconstructed and comprehended at the reflex chain of the deglutition.

In this way the reflex – adding further detail steps – becomes better understandable.

 (10) This archaic process for example also explains the setting upon of the molar teeth for swallowing. This is indeed physiological though empirically not really necessary (often even noxious) to carry out an efficient deglutition process especially as this setting the teeth upon each other can be consciously substituted by supporting the mandible against the palate with the aid of the tongue. This is happening in the exercise   CONTINUOUS SWALLOW and can get important as a therapeutic measure for a tone reducing method with hyperactive adductors.

11) In connection with the peristalsis aspect an observant therapist will state the muscle wave does not only move backwards on the tongue but that it is also passing from the lips through the “belt” over the Orbicularis – Risorius – Buccinator (which latter is known to show direct fibre track connections to the throat muscles) and in a simultaneous process also in the Diaphragma Oris.

The peristalsis wave at the same time is (as described above) designed in a way that, through fine motor local muscle actions the funnels to the interdental spaces are emptied.

This effect is, as experience shows, vestibular from the anatomy of the mucosa not as effective as at the inside of the dental bow towards the mouth hole. On the inside the papillae make an essential addition to the cleaning process.

As said, minimal Diverticuli of the organ surface are by neuro-muscular regulation pressed into those funnels. As this wave is running in distal direction by nature the Diverticuli being caught in the funnels are heaving automatically a reciprocal mesial-pointing force.

This should be a biomechanically comprehensible explanation for the mesial “migration” tendency of the molar teeth. This is why it can not so rarely be observed that the gap between teeth does migrate along with the teeth.

In reference to the categorization of the swallow reflex in an analogue manner the therapy method counted up. This has been done in the exercise catalogue under the headline SWALLOW REFLEX EXERCISES.

Instructions: