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Question 1

What are the stages of normal swallowing?

Answer 1

The stages of normal swallowing are: Anticipatory Phase, Oral Preparatory Phase, Oral Phase, Pharyngeal Phase, and Esophageal Phase.

Question 2

What occurs during the Anticipatory Phase of swallowing?

Answer 2

Before food enters the mouth, sensory checks (sight, smell, and temperature) occur to assess the suitability of food. This stage stimulates saliva production and prepares the body for digestion.

Question 3

What happens in the Oral Preparatory Phase?

Answer 3

The food is chewed and mixed with saliva to form a bolus. Key factors include sufficient saliva, proper dental function, and coordinated movements of the lips, cheeks, and tongue.

Question 4

What is the duration of the Oral Phase?

Answer 4

The Oral Phase lasts about 0.3 to 1 second, depending on the type of food.

Question 5

What occurs during the Pharyngeal Phase?

Answer 5

The bolus is transported through the throat to the esophagus, while airways are protected to prevent choking. This phase typically lasts between 0.5 to 1.5 seconds.

Question 6

What is the Esophageal Phase?

Answer 6

The bolus moves down the esophagus to the stomach through coordinated muscular contractions (peristalsis). The time varies based on age, food volume, and consistency.

Question 7

What is the role of saliva in swallowing?

Answer 7

Saliva aids in digestion, protects teeth and gums, and ensures proper lubrication for speech and swallowing.

Question 8

What are the types of saliva?

Answer 8

There are three types of saliva: Submandibular (70%, serous and mucoid), Parotid (25%, serous only), and Sublingual (5%, serous and mucoid).

Question 9

What is the Tipper Swallow?

Answer 9

The Tipper Swallow begins with the tongue tip pressed against the upper incisors and alveolar ridge.

Question 10

What is the Dipper Swallow?

Answer 10

The Dipper Swallow occurs when the bolus is beneath the anterior tongue and the tongue tip scoops the bolus to the supralingual position.

Question 11

How does swallowing affect respiration?

Answer 11

Swallowing temporarily stops breathing (swallow apnoea) to prevent food from entering the airway.

Question 12

What are the most common respiratory patterns during swallowing?

Answer 12

1. Exhale/swallow apnoea/exhale. 2. Inhale/swallow apnoea/exhale.

Question 13

What are abnormal respiratory patterns during swallowing?

Answer 13

1. Exhale/swallow apnoea/Inhale. 2. Inhale/swallow apnoea/Inhale.

Question 14

What mechanisms protect the airway during swallowing?

Answer 14

Airway protection involves epiglottal descent and ascent, laryngeal ascent, vertical approximation of the arytenoid to the base of the epiglottis, and adduction of the vocal cords.

Question 15

What is the difference between Presbyphagia and Dysphagia?

Answer 15

Presbyphagia refers to normal, age-related changes in swallowing without other health issues, while Dysphagia is more serious and can lead to health problems like malnutrition.

Question 16

What age-related changes occur in swallowing?

Answer 16

Changes include medication effects, structural changes like weaker muscles, and frailty, which can negatively affect swallowing ability.

Question 17

How does aging affect the Preparatory Phase of swallowing?

Answer 17

Older adults may experience reduced taste and smell, making eating less enjoyable, and may have dentition loss and dry mouth, complicating bolus formation.

Question 18

What happens to the Oral Phase as people age?

Answer 18

Decreased tongue strength and weaker jaw muscles make it harder to move food around in the mouth.

Question 19

What changes occur in the Pharyngeal Phase with aging?

Answer 19

This phase slows down with reduced muscle movements and a delayed start of the swallowing reflex, increasing the risk of choking.

Question 20

What is the impact of aging on the Esophageal Phase?

Answer 20

The esophagus takes longer to move food to the stomach, especially with larger food volumes, and there is a reduction in esophageal motility.

Question 21

What are some coping mechanisms for aging swallowing?

Answer 21

Good dental care, chewing longer, taking smaller bites, and cutting food into smaller pieces can help ease swallowing.

Question 22

What gender differences exist in aging swallowing?

Answer 22

Older men have a higher risk of developing swallowing difficulties compared to women, possibly due to larger physical size and sensory awareness decline.

Question 23

What is the significance of the development of swallowing in the womb?

Answer 23

Swallowing skills begin to develop in utero, with key milestones occurring from 9 to 37 weeks.

Question 24

What are the primitive reflexes that help babies feed?

Answer 24

Primitive reflexes include the rooting reflex, suckle-swallow reflex, gag reflex, bite reflex, tongue protrusion reflex, and transverse tongue reflex.

Question 25

How do swallowing skills progress from 0 to 36 months?

Answer 25

Swallowing skills evolve from suckling patterns to more complex chewing and swallowing techniques by 36 months.

Question 26

What is the Suck-Swallow-Breathe coordination?

Answer 26

This coordination is crucial for safe feeding in infants, involving a precise rhythm of sucking, swallowing, and breathing.

Question 27

What factors influence normal swallowing?

Answer 27

Factors include bolus consistency, volume, cup/straw drinking, taste, temperature, carbonation, and posture/positioning.

Question 28

How does bolus consistency affect swallowing?

Answer 28

As viscosity increases, oropharyngeal transit time increases, and oral pressure and duration of transitions also increase.

Question 29

What is the effect of bolus volume on swallowing?

Answer 29

Large bolus volume decreases oral transit time and stage transition duration, making airway closure easier.

Question 30

How does straw drinking influence swallowing?

Answer 30

Straw drinking reduces oral spillage and influences the onset time of the swallowing event.

Question 31

What is the impact of taste on swallowing?

Answer 31

Taste increases tongue pressure and pharyngeal pressure, leading to earlier onset of swallowing.

Question 32

How does carbonation affect swallowing?

Answer 32

Carbonation increases sensory input and enhances the motor swallow response, speeding up pharyngeal swallow response.

Question 33

What is the effect of temperature on swallowing?

Answer 33

Cold bolus speeds up the pharyngeal swallow response and improves UES opening.

Question 34

How can verbal cueing alter swallowing?

Answer 34

Verbal cues can initiate swallowing in healthy adults by positioning the bolus more posteriorly in the oral cavity.

Question 35

What effect does cold bolus have on UES opening?

Answer 35

Cold bolus speeds up the pharyngeal swallow response, increases pharyngeal pressure, improves UES opening, and reduces airway compromise in pre-term dysphagic infants.

Question 36

What is the effect of cold-sour bolus on swallowing?

Answer 36

Cold-sour bolus results in shorter pharyngeal transit.

Question 37

How can verbal cueing affect swallowing?

Answer 37

Verbal cueing can alter swallowing initiation in healthy adults, positioning the bolus more posteriorly and resulting in shorter swallow durations in older adults.

Question 38

What is the impact of posture/positioning on swallowing?

Answer 38

Chin tuck position widens the vallecular space and narrows the airway entrance, decreasing pharyngeal contraction and reducing velopharyngeal pressure at 45 and 90 degrees compared to upright.

Question 39

What are the differences between sequential and discrete swallowing?

Answer 39

Sequential swallows are more reflective of real-life drinking, and sequential swallowing from a straw may differ from that from a cup.

Question 40

What are the effects of sequential swallowing?

Answer 40

Sequential swallowing leads to decreased oral transit time, increased stage transition duration, and decreased duration of UES opening.