3.1 Swallowing + Aging Flashcards
What are general physiological changes in swallowing that occur due to aging?
(7)
Reduction in mass (Atrophy)
Decreased range of motion, speed and strength.
Diminished sensory abilities.
Respiratory compromise
Atrophy + Calcification
Laryngeal penetration
Trouble coordinating breathing and swallowing together
What are two conditions that occur to muscles due to aging?
Atrophy
Calcification
Is laryngeal penetration a normal occurrence in swallowing due to aging?
Yes but aspiration is never normal
What can cause decreased tongue pressure?
Hypertrophy of the tongue (enlargement)
What happens when sensory abilities are impaired?
What does this imply?
Poor discrimination of viscosity (whether a substance is thick or thin)
Not able to differentiate between thicker and thin liquids.
In regards to poor dentition, can losing teeth cause problems with mastication?
Yes
What is the problem with prolonged mastication?
It takes too long for the individual to swallow.
What four problems can occur during the oral stage?
Hypertrophy of the tongue
Impaired sensory abilities
Prolonged mastication
Poor dentition
What six problems can occur during the pharyngeal stage?
Delayed swallow initiation
Inadequate hyolaryngeal excursion
Impairments in cricopharyngeal contraction and relaxation (UES)
Increased instances of laryngeal penetration (no aspiration)
Poor laryngeal adductor reflex
Sensory and motor impairments leading to residue
How do we rate penetration?
3
Shallow (just entered the larynx)
Middle (has gone further down into the larynx)
Deep (on the vocal folds)
What is the FEEST?
2
Endoscopy-based test
It is the FEES with sensory testing (ST)
What does the FEEST measure?
Adductor reflex
What is the laryngeal reflex?
It is when the vocal folds adduct
What causes the laryngeal reflex?
When there is air on the arytenoids
What kind of information do you need for the laryngeal reflex?
Sensory information
What could cause the lack of sensory information?
Damage to the SLN branch of the Vagus Nerve
What does damage of pharyngeal stripping cause?
It causes there to be residue left after the swallow.
How do you get rid of the residue left?
Swallow again
Use water/liquid to wash the food down further
When do you take a second swallow?
When you sense the residue
What three problems can occur during the esophageal stage?
Decreased motility of UES, LES and the esophageal body
Impaired resting pressure of UES
Peristalsis is poor - more pronounced in secondary peristalsis
What are the three stages of aspiration?
before, during, and after
What can you do to improve damaged physiology?
Exercises taught by therapist
