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dysphagia > chapter 1 > Flashcards

chapter 1 Flashcards

1
Q

what is dysphagia?

A
  • difficulty swallowing

- difficulty moving bolus from the mouth to stomach

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2
Q

Is dysphagia age specific?

A

No can range from elderly to newborns

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3
Q

what are the etiologies of dysphagia?

A 
infection
structural malformation
surgery (thyroid, RLN, cervical)
conditions that weaken/damage the nerves
CVA
Parkinson's dz
TBI
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4
Q

What are the consequences of dysphagia?

A

dehydration
malnutrition
aspiration pneumonia
quality of life

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5
Q

What are the types of dysphagia?

A

oral
oralpharyngeal
pharyngeal
esophageal

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6
Q

What can be the problems with oral dysphagia?

A 
trouble with:
tongue movement 
lip closure
pocketing
transport
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7
Q

What can be the problems with pharyngeal dysphagia?

A

airway closure
residues
motility
ues

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8
Q

What can be the problems with esophageal dysphagia?

A 
motility
LES
fistula
diverticulum
HCI
reflux
Ulcer
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9
Q

how long does the oral phase last?

A

depends on the bolus consistency

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10
Q

How long does the pharyngeal phase last

A

less than I second

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11
Q

explain the oral phase?

A

mastication of the food
the bolus is formed and mixed with saliva
and the bolus is transported from the oral cavity to the pharynx

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12
Q

Explain the pharyngeal phase?

A

velum elevates and retracts for VP closure
bolus transport w/tongue base retraction and pharyngeal wall contraction
epiglottis inverts over the laryngeal vestibule
larynx & hyoid bone are pulled anteriorly and superiorly to open pharynx, relax UES/CP

assist the vocal folds in closing of the glottis

bolus is propelled through the pharynx toward the esophagus by action of pharyngeal constrictors

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13
Q

Explain the esophageal phase?

A

bolus flow through the esophagus via peristaltic contractions of striated and smooth muscle along the esophageal wall
-relaxation of LES allows bolus to flow into the stomach

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14
Q

what are the signs and symptoms of oral or pharyngeal dysphagia?

A

13

  • coughing or choking with swallowing
  • difficulty initiating swallowing
  • food stuck in throat
  • sialorrhea/xerostomia
  • drooling or spillage
  • unexplained weight loss
  • change in dietary habits
  • penetration
  • aspiration
  • recurrent pneumonia
  • change in voice or speech (wet voice)
  • nasal regurgitation
  • wet, gurgly voice quality
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15
Q

What are the signs and symptoms of esophageal dysphagia?

A

6

  • sensation of food sticking in chest or throat
  • oral or pharyngeal regurgitation
  • change in dietary habits
  • recurrent pneumonia
  • reflux
  • aspiration
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16
Q

what are the signs and symptoms of silent aspiration?

A

NONE!

-possible tearing/runny nose

17
Q

T or F. everything after feeding is swallowing

18
Q

what is feeding?

A

placement of the food in the mouth before the initiation of swallow (outside the lips)

19
Q

What is swallowing?

A

the transfer of feed/drink from mouth to stomach with the 3 stages (oral/pharyngeal/esophageal)

20
Q

what is involved in a swallowing screening?

A

10-15 minute admin/observation of a small bolus bedside clinical assessment

  • med hx
  • level of alertness
  • ptnt interview
  • oral motor exam
  • assess swallow with small bolus
  • -look at signs and symptoms ((((spillage? oral residue? long transit time? cough? throat clear? gurgly voice?)))
  • -cannot assess A& P
  • -pre-diagnostic
21
Q

What are some imaging tools that you would use to look at swallowing?

A 
FEES/ FEESST
Videofluoroscopy ( MBS) 
ultrasound
videoendoscopy
scintigraphy (don't use anymore)
22
Q

What are the non-imaging tools that you can look at swallowing with?

A

EMG
EGG
Acoustic (accelerometer or stethoscope (cervical asculation)
pharyngeal manometry (measures pressure)

23
Q

What are some treatments?

A
  • Diet modification–( volume, viscosity, texture, temp NPO (tubes)
  • compensatory– ( positional, posture, chin tuck , head rotation, multiple swallows)
  • maneuver–supraglottic, super-supraglottic, Mendelsohn, effortful
  • exercise–shaker, Masako, oral muscle strengthening
  • stimulation–thermal/tactile stim
  • experimental–(neuromuscular electrical stim (vital stim) deep pharyngeal neuromuscular stim) Myofacial release, botox)
  • prosthetic–palatal lift or obturator ( to stop vp closure)
  • surgery–CP myotomy, diverticulectomy, dialation
24
Q

Name some people who will/can be part of the multidisciplinary team?

A
  • SLP
  • Physician/ Neurologist/ ENT
  • Nursing
  • Dietician
  • OT
  • PT
  • Radiologist
  • Pharmacist
  • Social worker
  • Psychologist

dysphagia (4 decks)

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