Njengoko kulula njengoko kubonakala ngathi, ukugwinya ngenye yezona zenzo ezinzima kakhulu ezenziwa yimibutho yethu. Isenzo esibonakala ngathi sisilula kwaye sizenzekelayo siquka uluhlu lwezenzo ezimele zenzeke ngokulandelelana ngokulandeleleneyo kwezinto ezintathu, ezibandakanya iinkalo ezininzi zesimiso senzwa.
Kukho ukuzithandela, okanye izenzo ezinokuzibandakanya ezibandakanyekayo ekugwityeni, kunye nokungabikho kokuzibandakanya, okanye izenzo ezithintekayo ekubandakanyekeni.
Izigaba ezintathu zokugwinya zichazwe ngezantsi:
Isigaba somlomo
Ukulahla kuqala ngesigaba somlomo. Esi sigaba siqala xa ukutya kufakwa emlonyeni kwaye kumanyiswe ngamathe. Ukutya okumanzi kuthiwa yi-bolus yokutya.
I-bolus yokutya isetshenziswe ngokuzithandela ngamazinyo alawulwa yimisipha ye-mastication (ukuhlafuna). Ngethuba lesi sigaba, ukutya "kulungiselelwe" kwinqanaba elincinci elincinciweyo ukuze likwazi ukugqithiswa kalula ukusuka phambili ukuya emlonyeni. I-bolus yokutya ihamba ngokuzithandela iqhubekele phambili kwi-oropharynx (inxalenye ephezulu yomqala).
Ukususela kwi-oropharynx, i-bolus yokutya iqhutshwa phambili emva kweelwimi kunye nezinye izihlunu kwisahluko esezantsi se-pharynx (umphunga). Eli nyathelo nalo lifuna ukuphakama ngokuzithandela kwilungu elithambileyo ukukhusela ukutya ukungena ekhaleni.
Iimisipha ezilawula isigaba somlomo sokugwinya zivuselelwa ngamaxhala asebuchosheni, obubizwa ngokuba yimisipha yokunyakaza.
Iimbilini ezinobungozi ezibandakanyekayo ekulungiseni le nqanaba ziquka i-nerve trigeminal, i-neial facial, kunye ne-hypoglossal nerve.
ISigaba seSigaba seSigaba
Njengoko ukutya kwe-bolus kufinyelela kwi-pharynx, iintsholongwane ezikhethekileyo zentsholongwane zisebenzise isigaba sokuzibandakanya sokugwinya. I-reflex yokugwinya, ehambelana nendawo yokugwinya kwi-medulla (inxalenye engezantsi ye-brainstem), ibangela ukuba ukutya kuqhutywe kwakhona kwi-pharynx kunye ne-esophagus (ibhobho yokutya) ngokuchasana ngesigqi kunye nokungazibandakanyeki kwezihlunu ezininzi emva emlonyeni, pharynx, kunye neesophagus.
Ngenxa yokuba umlomo kunye nomqala usebenza njengendlela yokungena kokutya kunye nomoya, umlomo unikeza indlela yokuya emoyeni ukuya emiphakeni, kwaye inika neendlela zokutya ukuze zingene kwisisu nangesisu.
Icandelo elibalulekileyo lesigaba se-pharyngeal kukuvalwa kokungabandakanyeki kwe-larynx yi-epiglottis kunye neentambo zamagama, kunye nokuvalwa kwexeshana lokuphefumla. Ezi zenzo zithintela ukutya ekuhambeni "phantsi kombhobho ongalunganga" kwi-trachea (i-windpipe).
Ukuvalwa kwe-larynx yi-epiglottis ikhusela imiphunga ekulimaleni, njengokutya kunye nezinye iindidi ezingene kwimiphunga zingakhokelela kwizifo ezikhuselekileyo kunye nokucaphuka kwamathambo emiphunga. Izifo ezithintekayo ezibangelwa ziziingxaki zesigaba se-pharyngeal ye-reflex yokugwinya iyaziwa ngokuba yi- aspiration pneumonia .
Isigaba se-Esophageal
Njengoko ukutya kushiya i-pharynx, kungena kwi-esophagus, isakhiwo esinjenge-tube-like muscular ekhokelela ukutya kwisisu ngenxa yezinto ezinamandla ezidibeneyo ezixubileyo. Ingqungquthela yokutya nge-esophagus ngeli nqanaba idinga isenzo esilungeleleneyo se- vagus nerve , i-glossopharyngeal nererve, kunye neentambo ze-nerve ezivela kwinkqubo ye-nervous sympathetic system.
I-esophagus inezimbini ezibalulekileyo ezivulekileyo kwaye zivale ngokucatshulwa njengokuba i-bolus yokutya ihlaselwa ngexesha lokugwinya. Ezi zihlunu, ezibizwa ngokuthi i-sphincters, zivumela ukuba i-bolus yokutya igele phambili kwindlela ekuthintela ngayo ukuba ingene kwicala elingalunganga (ukuhlaziywa kwakhona).
Bobabini be-sphincters, abaqalayo phezulu, kunye nezantsi, bavulele ukuphendula kwingcinezelo ye-bolus yokutya kunye nokuvala emva kokugqithiswa kwe-bolus yokutya.
I-sphincter ephezulu ye-esophageal ivimbela ukutya okanye umquba ekubuyiselweni kwakhona emlonyeni, ngelixa i-sphincter esezantsi iqinisekisa ukuba ukutya kuhlala esiswini, kukuthintela ukubuyisela emuva kwisigxina.
Ngokwenza njalo, i-sphincters i-esophageal isebenza njengesithintelo somzimba kwisidlo sokulungiswa.
Dysphagia
Ngokuqhelekileyo, abantu abanempilo banokugwinya ngengcamango encinci kunye nomzamo. Ukuba inkqubo ye-nervous iphazamiseka ngenxa yesifo okanye esinye isifo, iingxaki ngokugwinya zingenzeka. Ukujongana nobunzima kuthiwa yi-dysphagia. I-Dysphagia inokubangela iingxaki ezinjengokukhahlela, ukungabi nxilweni kunye nokulahleka kwesisindo, kunye nokufuna ukuphalaza.
ILizwi
Ukuba uye wafumana isigulo okanye esinye isifo sengqondo, unokufumana ukuvavanya ukuvavanya ukuqinisekisa ukuba unayo i-dysphagia. Ukuba unemiqondiso ye-dysphagia, kuya kufuneka ube neentetho kunye nokugwinya unyango ukwenzela ukuba izihlunu zakho ezigwinya zingenakho ithuba lokuphucula kangangoko kunokwenzeka.
> Imithombo:
> Ubudlelwane phakathi kweDysphagia, iiNational Institutes of Health Stroke Score Scale, kunye ne-Predictors ye-Pneumonia emva kweSkemikic Stroke, uRiiroiro PW, Cola PC, i-Gatto AR, da Silva RG, i-Luvizutto GJ, i-Braga GP, i-Schelp AO, i-Arruda Henry MA, i-Bazan R , J Stroke Cerebrovasc Dis. 2015 Sep; 24 (9): 2088-94