3.2 Bolus Flow + Physiological Correlates

Question 1

You don’t treat bolus flow; you treat the ______.

You want patient to get full ______ and _____.

Answer 1

Physiology

Nutrition

Hydration

Question 2

What physiological changes are seen with Higher Bolus Volume?

(2)

Answer 2

Greater hyoid displacement

Prolonged UES open times

Question 3

What physiological changes are seen with THICKER Bolus Viscosity?

(3)

Answer 3

Increased oral pressures

Better airway protection

Greater chances of residue

Question 4

What physiological changes are seen with THINNER Bolus Viscosity?

Answer 4

Higher chances of laryngeal penetration/aspiration

Question 5

Prolonged Mastication is a sign that ___________ is impaired.

Answer 5

Oral bolus prep

Question 6

Prolonged Oral Transit Time is a sign that ___________ is impaired.

What is Prolonged Oral Transit Time?

Answer 6

Oral bolus prep

Amount of time to move bolus to pharynx)

Question 7

Premature Spillage of bolus either anteriorly or posteriorly is a sign that ___________ is impaired.

When does Premature Spillage happen?

Answer 7

Oral bolus prep

During bolus formation –food goes back or forward

Question 8

Oral stasis (residue) is a sign that ___________ is impaired.

Answer 8

Oral bolus prep

Question 9

Pre-swallow pooling is a sign that ___________ is impaired.

What happens?

Answer 9

Swallow initiation (delay)

Bolus falls back into the pharyngeal/laryngeal area before the patient actually wants to swallow

Question 10

Laryngeal penetration/aspiration before the swallow is a sign that ___________ is impaired.

Laryngeal penetration/aspiration during the swallow is a sign that ___________, or ___________ is impaired.

Answer 10

Swallow initiation (delay)

Epiglottic inversion

Laryngeal vestibule squeeze

Question 11

Residue in the valleculae is a sign that __________ is impaired.

Why does this happen?

Answer 11

Tongue base retraction

Doesn’t create the needed pressure changes to move the bolus

Question 12

Residue in the pyriform sinuses is a sign that __________ or __________ is impaired.

Answer 12

UES opening

Hyoid excursion

Question 13

Laryngeal penetration/aspiration after the swallow
is a sign that __________ or __________ is impaired.

Why does this occur?

Answer 13

UES opening

Hyoid excursion

Residue b/c builds up over multiple swallow attempts

Question 14

Diffuse pharyngeal residue (in the posterior pharyngeal walls, valleculae, pyriform sinuses) is a sign that __________ is impaired.

Answer 14

Pharyngeal propulsion/pharyngeal stripping wave

Question 15

Prolonged pharyngeal transit time is a sign that __________ is impaired.

Answer 15

Pharyngeal propulsion/pharyngeal stripping wave

Question 16

What might be the physiology behind laryngeal penetration during the swallow?

Answer 16

Impaired protection of airway

Question 17

What might be the physiology behind residue in the posterior pharyngeal wall?

Answer 17

Poor pharyngeal stripping

Question 18

What might be the physiology behind pre-swallow pooling of bolus to the pyriform sinuses?

Answer 18

Delayed swallow initiation

Question 19

What might be the physiology behind residue in the base of the tongue?

Answer 19

Impaired tongue base retraction

Question 20

What might be the physiology behind aspiration after the swallow of thin liquid?

(2)

Answer 20

Impaired UES function

Impaired hyoid excursion

(Depends. Where was residue?)

Question 21

What might be the physiology behind pt. taking 3 seconds to propel pudding into the oropharynx?

Answer 21

Impaired oral stage