ch 1 Flashcards
what is dysphagia?
difficulty moving food from mouth to stomach
what causes swallowing disorders?
infection, structural malformations, conditions that weaken/damage muscles/nerves (CVA, PD, TBI)
consequences of dysphagia
malnutrition, dehydration, aspiration pneumonia, quality of life
what are the 4 types of dysphagia?
oral, pharyngeal, oropharyngeal, esophageal
what are feeding techniques?
those that describe procedures to improve the oral stages of the swallow; manipulation of food in the prep stage prior to swallowing and transport of food thru oral cavity
what is swallowing therapy?
techniques to improve the triggering of the swallow and the pharyngeal stage of the swallow, in addition to the prep stage of oral manipulation and the oral stage
therapy procedures designed to improve feeding attempt to improve:
positioning of food, manipulating food, chewing, organizing lingual action to propel food posteriorly
stages of dysphagia
oral-(time varies) mastication, bolus formation, bolus transport from oral cavity to pharynx
pharyngeal-(1 sec) epiglottis inverts over laryngeal vestibule, larynx and hyoid bone are pulled up and over to open pharynx, glottis closes, bolus transported to esophagus via pharyngeal constrictors
esophageal (10 seconds) bolus flows thru esophageal wall via peristaltic contractions, relaxation of LES allows bolus to flow into stomach
signs of oropharyngeal dysphagia
coughing, choking with swallowing
difficulty initiating swallowing
food sticking in throat
xerostomia, drooling, spillage, weight loss, penetration, recurrent pneumonia, wet gurgly voice quality
nasal regurgitation, tearing, nose running, sore throat
signs of esophageal dysphagia
sensation of food sticking in chest or throat
chest pain, vomit, recurrent pneumonia, reflux, aspiration
s/s of silent aspiration
no s/s. possible yawning, tearing, runny nose
what is the difference btw feeding and swallowing
feeding-placement of food in the mouth before initiation of swallow. oral prep stage
swallowing- transfer of bolus from mouth to stomach. oropharyngeal and esophageal stage
what do screening procedures identify?
signs and symptoms of dysphagia
what symptoms of oropharyngeal dysphagia are often observed during a dx assessment procedure?
- aspiration- entry of food into airway below true VF’s
- penetration-entry of food into larynx at some level down to but not below level of VF’s
- residue-food that is left behind in mouth or pharynx after swallow
- backflow-of food from the esophagus into pharynx and/or from pharynx to nasal cavity
what does a screening involve/not involve?
pre dx. 15 min observation of s/s (spillage, oral residue, long transit time, cough, throat clear, gurgly voice, tearing, runny nose). does not define a&p of oropharynx
bedside clinical assessment: medical hx, level of alertness, pt interview, oral motor exam, assess swallow w/ small bolus
