Adult Client Groups Flashcards
what four physiological aspects of a stroke will greater increase the severity of dysphagia?
- bilateral not unilateral lesions
- strokes involving larger vessels
- if the lesion is in the brainstem
- hemiplegia
where are the four places an slt can work regarding stroke?
acute unit
rehab
community
out patient follow up
what are the pre oral presentations of dysphagia in dementia?
agnosia of food
reduced concentration
reduced interest
what is the oral presentation of dysphagia in dementia?
reduced ability to chew
what are the pharyngeal presentations of dysphagia in dementia?
delayed triggering
reduced laryngeal elevation
apraxia
how would an SLT manage dysphagia in dementia?
they can have a modified diet but there is more behavioural work e.g.
bright coloured placemats
finger food
hand over hand feeding
discuss dysphagia in PD
most patients with PD will develop dysphagia however it is not the first symptom.
If it is the first symptom it is more likely to be MSA or PSP
what kind of swallowing problems will a patient with PD have?
reduced spontaneous swallowing of saliva
delayed triggering of swallow
aspiration
residue in vallecular space
what might you need to consider when assessing dysphagia in PD?
the impact of tremor
timing to suit ON-OFF meds
how would you manage dysphagia in PD?
modified diet
postural changes
How will dysphagia in MND present?
swallowing in bulbar-type of MND presents with rapid loss of function
- tongue mobility
- lip closure
- velar function (nasal regurgetation)
- triggering swallow
- aspiration
what can impact the swallow of a patient with MND?
fatigue
what would you also need to consider with MND?
that respiratory function declines with the disease so the protective cough mechanism becomes less effective
how would you manage dysphagia in MND?
modified diet as long as possible and then discuss option of PEG
what case history information would you want to know when collecting data on MS?
what type of strain the have of the disease
the progression - cognition, pain may fluctuate
how would dysphagia in MS present?
combination of sensory and motor impairments
reduced speed of the oropharyngeal structures
how would you manage dysphagia in MS?
as in all cases, make the patient aware of risks
modified diet
strategies such as effortful swallow
how will dysphagia in Huntington’s Disease present?
lingual chorea
incoordination of swallow
inability to stop respiration
what else do you need to consider when dealing with HD?
weight loss due to chorea
difficulty in feeding due to chorea
how would you manage dysphagia in HD?
modified diet
weighted cutlery (OT)
liaison with dietician
what is Myasthenia Gravis and how can it affect swallowing?
autoimmune neuromuscular disease that causes muscle weakness - muscles fatigue.
oral and pharyngeal phases will be affected
what should be considered when managing MG?
that fatigue will fluctuate. Can set in, in one meal or over the course of the day
how will dysphagia in MG be managed?
modified diet
planning diet choices around fluctuating fatigue
what kind of head an neck oncology would affect the physiological process of swallowing?
tumours may obstruct the passage of the bolus
once there has been surgical intervention there may be functional deficit if parts have been resected
radiotherapy can cause swelling and soreness
what is the SLT role in managing dysphagia in patients with cancer?
pre = giving information, exercises to preserve muscle strength post = modified diet and liaison with MDT
what kind of assessment will be given to patients with a tracheostomy to test for dysphagia?
modified Evans blue dye test (MEBDT)
what kind of things might you see in patients with mental health related dysphagia?
tachyphagia = eating too quickly
taking too large mouthfuls resulting in choking
how would you intervene in a mental health related dysphagia?
behavioural intervention techniques
