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Dysphagia Test 1 > Chapter 1 > Flashcards

Chapter 1 Flashcards

1
Q

What is Dysphagia?

A

difficulty swallowing and/or difficulty moving bolus from mouth to stomach

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2
Q

Is dysphagia age specific?

A

no, ages can range from newborn to elderly

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3
Q

What are some etiologies of Dysphagia?

A

infection, structural malformations, surgery, conditions that weaken/damage muscle/nerves

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4
Q

What are some examples of the types of surgeries that can lead to Dysphagia?

A

thyroid, RLN, cervical

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5
Q

What are some examples of the types of conditions that weaken/damage muscle/nerves?

A

CVA, parkinson’s, TBI

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6
Q

What are some consequences of Dysphagia?

A

Dehydration, malnutrition, aspiration pneumonia and overall quality of life

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7
Q

What is the leading cause of death in Parkinson’s?

A

Aspiration pneumonia

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8
Q

What are the types of dysphagia?

A

Oral, pharyngeal and esophageal

although oropharyngeal can also be mentioned when its a combination of oral and pharyngeal

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9
Q

The types of dysphagia correlate with the __

A

phases of dysphagia

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10
Q

What are some of examples of oral dysphagia?

A

tongue movement, lip closure, pocketing and transport

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11
Q

What are some examples of pharyngeal dysphagia?

A

airway closure, residues, motility and UES

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12
Q

What are some examples of esophageal dysphagia?

A

motility, LES, fistula, diverticulum, HCI-reflux, ulcer

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13
Q

Patients who report oropharyngeal swallowing are able to describe symptoms accurately. T/F

A

True

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14
Q

Patients with esophageal disorders may be highly inaccurate in describing their symptoms. T/F

A

True

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15
Q

Literature on deglutition or swallowing falls into three categories: _

A

Physiology of normal swallow, changes in physiology if swallowing as a result of a variety of medical conditions and methodologies for screening/diagnosis and management of patients with dysphagia

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16
Q

What is diverticulum?

A

pockets in esophagus

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17
Q

What are the stages of dysphagia?

A

oral, pharyngeal and esophageal

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18
Q

Describe the oral stage.

A

mastication, bolus formation, and bolus transport from the oral cavity to pharynx.
This stage begins when lips close after food enters mouth.

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19
Q

How long does the oral stage last?

A

It is dependent on the bolus

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20
Q

Describe the pharyngeal stage.

A

The epiglottis inverts over the laryngeal vestibule. The larynx and hyoid bone are pulled anteriorly and superiorly to open the pharynx, relax the cricopharyngeus (UES) muscle, and assist the vocal folds in closing off the glottis. The bolus is propelled through the pharynx toward the esophagus by action of pharyngeal constrictors.

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21
Q

How long is the pharyngeal phase?

A

about 1 second

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22
Q

When does the pharyngeal phase begin?

A

when the head of the bolus gets past the posterior faucial pillar

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23
Q

The majority of disorders are found in what phase of the swallow?

A

pharyngeal

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24
Q

Describe the esophageal stage.

A

The bolus flows through the esophagus via peristaltic contractions of striated and smooth muscle along the esophageal wall. Relaxation of the LES allows bolus to flow into stomach, then closes to prevent food from coming back up

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25
Q

The stage before lips close is called __

A

feeding

26
Q

When doing therapy with swallowing, it is important to remember what about the oral stage?

A

keep it to a “normal” time limit

27
Q

How long does the esophageal stage last?

A

8-20 seconds depending on bolus

28
Q

What are some signs and symptoms of oral or pharyngeal dysphagia?

A 
coughing or choking with swallowing
difficulty initiating swallowing
food sticking to the throat
sialorrhea/xerostomia
drooling or spillage
unexplained weight loss
change in dietary habits
penetration
aspiration
recurrent pneumonia
change in voice (wet gurgly voice)
Nasal regurgitation 
tearing and/or nose running
Sore throat
29
Q

Spillage is defined as

A

premature spillage over tongue base

they will cough

30
Q

What is penetration?

A

food or drink into laryngeal vestibule, past epiglottis

31
Q

What is aspiration?

A

food or drink past vocal folds and into trachea

32
Q

What does a wet gurgly voice indicate?

A

bolus on the vocal folds

33
Q

Why is nasal regurgitation a symptom of oral or pharyngeal dysphagia?

A

VP not closing or extreme reflux

34
Q

Tearing and/or runny nose can indicate

A

silent aspiration

35
Q

What are some signs and symptoms of esophageal dysphagia?

A 
sensation of food sticking in the chest or throat
chest pain
oral or pharyngeal regurgitation
change in dietary habits
recurrent pneumonia
reflux
aspiration
36
Q

Head, neck and chest radiation cause the esophagus to __

A

narrow

37
Q

Silent aspiration occurs in what stage?

A

pharyngeal mostly but can be have esophageal problems too

38
Q

What is feeding?

A

placement of food in the mouth before initiation of swallow

39
Q

Feeding is also called __

A

Oral prep stage

40
Q

What is swallowing?

A

transfer of food/drink from mouth to stomach

41
Q

What is a swallow screening?

A

10-15 minute administration/observation of a small bolus. It is a pre-diagnostic tool

42
Q

What are the parts of a bedside clinical assessment?

A

medical history, level of alertness, patient interview, oral motor exam, assess swallow with small bolus

43
Q

What signs and symptoms are you looking for in a screening or bedside assessment?

A

spillage, oral reside, long transit time, cough, throat clear, gurgly voice, tearing, runny nose, wrong auscultation

44
Q

What is auscultation?

A

listening to the internal sounds of the body, usually using a stethoscope

45
Q

ID symptoms to explain

A

abnormalities in anatomy or physiology causing dysphagia (etiology)

46
Q

Diagnostic Procedures examine the physiology through looking at

A

timing, tongue base motion, epiglottic dysfunction, laryngeal excursion, UES dysfunction, peristalsis, paralysis and sensitivity

47
Q

Diagnostic procedures examines the immediate effects of

A

treatment

48
Q

What are some imaging diagnostic procedures?

A 
FEES/FEESST
videofluoroscopy
ultrasound
videoendoscopy
Scintigraphy
49
Q

What are some nonimaging diagnostic procedures?

A

EMG, EEG, acoustic (accelerometer or stethoscope), pharyngeal manometry

50
Q

What are some treatments for dysphagia?

A 
diet modification- last resort
compensatory strategies
maneuver
exercise
stimulation
experimental
prosthetic
surgery
51
Q

Describe diet modification as a treatment for dysphagia.

A 
change volume, viscosity, texture, temperature of food/drink
NPO-NG tube
G tube
PEG tube
J tube
TPN
52
Q

Describe compensatory strategies as a treatment for dysphagia.

A

Mostly positional like posture
chin tuck
head rotation
multiple swallows

53
Q

What are some maneuver strategies as a treatment for dysphagia.

A

Supraglottic, Super-glottic, Mendelsohn, Effortful swallow

54
Q

What are some exercise strategies as a treatment for dysphagia.

A

shaker, masako, oral muscle strengthening

55
Q

What are some stimulation strategies as a treatment for dysphagia.

A

thermal/tactile stim

56
Q

What are some experimental strategies as a treatment for dysphagia.

A

neuromuscular electrical stimulation, deep pharyngeal neuromuscular stimulation, myofascial release, botox

57
Q

Who is part of the team for a patient with dysphagia?

A 
SLP
physician/ neurologist/ ENT
nursing
dietician
OT
PT
Radiologist
Pharmacist
social worker
psychologist
58
Q

Why is keeping a good relationship with the pharmacist important?

A

because many drugs cause dysphagia

59
Q

What are some examples of prosthetic treatment?

A

palatal lift or obturator

60
Q

What are some examples of surgery treatment?

A

CP myotomy, diverticulectomy, dilation

Dysphagia Test 1 (5 decks)

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