Ch.1 Flashcards
T/F
Dysphagia is age- specific to elderly adults
False
Dysphagia is not an age- specific disorder
What’s dysphagia?
Difficulty swallowing
Difficulty moving bolus from mouth to the stomach
Name 4 Dysphagia etiologies
Infection
Structural malformation
Surgery
Conditions that weaken/ damage muscle/nerves like TBI, CVA, PD
T/ F
Dysphagis is always secondary to something else
True
Name the 4 consequences of dysphagia
Dehydration
Malnutrition
Aspiration pneumonia
Quality of Life
What are the types of dysphagia?
Oral
Pharyngeal
Oropharyngeal
EsophageAl
What are 5 signs and symptoms of Oral or Pharyngeal dysphagia?
Cough or choking with swallowing Have difficulty initiating swallowing Food sticking in the throat Sialorrhea-Excessive saliva/ xerostomia- dry mouth Drooling or spillage Unexplained weight loss Change in dietary habits Penetration Aspiration Recurrent pneumonia Change of voice, speech Nasal regurgitation Wet, gurgly voice
What are 5 signs and symptoms of Esophagial dysphagia?
Sensation of food sticking in the chest or throat Oral or pharyngeal regurgitation Change in dietary habits Recurrent pneumonia Reflux Aspiration
What are some possible signs of silent aspiration?
Tearing
Running nose
What happens during the oral stage of swallowing?
Mastication
Bolus formation
Bolus transport from oral cavity to the pharynx
What happens during the pharyngeal stage of swallowing?
Tongue retracts
VP closes
Epiglottis inverts over laryngeal vestibules
Larynx and hyoid bone are pulled anteriorly and superiorly to open pharynx, which also relaxes the cricopharyngeus (UES) muscle, and assist the VFs in closing off the glottis
Bolus is propelled through the pharynx toward the esophagus by action of pharyngeal constrictors
What happens during the esophageal stage of swallowing?
Bolus flow through the esophagus VIA PERISTALTIC CONTRACTIONS OF STRIATED AND SMOOTH MUSCLE along esophageal wall
Relaxation of LES allows bolus to flow into the stomach
What is the difference between feeding and swallowing?
Feeding= PLACEMENT OF FOOD in the mouth before initiation of swallow
- oral prep stage
Swallowing= TRANSFER FOOD/ DRINK from mouth to stomach
- oral, pharyngeal, esophageal stages
How long does a swallow screening last?
10-15 mints.
What are some clinical assessments that you do when doing a swallow screening?
Medical history Level of alertness Pt. interview Oral mech exam Assess swallow with small bolus
What are some sounds and symptoms that you can see/ hear during a screening?
Spillage Oral residue Long transit time Cough Throat clear Gurgly voice Tearing Runny nose Wrong sound thru a stethoscope
T/F
A Swallow screen is a diagnostic tool
False
It’s a pre-diagnostic tool
You cannot asses A&P
What are some diagnostic procedures?
Etiologies- ID symptoms to explain abnormalities
Examine physiology
Timming, tongue base motion, epiglottic dysfunction, laryngeal excursion, UES dysfunction, peristalsis, paralysis, sensitivity
Examines immediate effects of Tx
Imaging:
- FEES/FEESST, videofluoroscopy, ultrasound, videoendoscopy, scintigraphy
Nonimaging:
- EMG, EGG, Acoustic (accelerometer or esthethoscope), pharyngeal manometry
T/F
Videoflouroscopy= modified barium swallow
True
Name 5 possible dysphagia treatments
Diet modification- volume, viscosity, NG tube…
Compensatory strategies- positional: posture, chin tuck, head rotation, multiple swallows
Maneuver- supraglottic, super- supraglottic, mendelsohn, effortful
Exercise- oral m. Strenghtening, shaker, masako
Stimulation- thermal/ tactile stim
Experimental- neuromuscular electrical stimulation, vitalstim…
Prothetic
Surgery
Name 5 professionals that take part in the multidisciplinary dysphagia team
SLP Physician Nursing Dietician Ot Pt Radiologist Pharmacist Social worker Psychologist
