Chapter 1 powerpoints Flashcards
Dysphagia– What is it, and who can it effect?
Its difficulty swallowing (moving the bolus from the mouth to the stomach)
Can effect anyone at any age
How many, and list the etiologies– and some examples
4 (with 6 examples):
- infection
- structural malformations
- surgery (ex: thyroid/RLN/Cervical)
- Conditions that weaken or damage muscles/nerves (ex: CVA/PD/TBI)
What are the consequences of dysphagia (how many)?
4:
- Dehydration
- Malnutrition
- Aspiration pneumonia
- Quality of life
What are the types of dysphagia? How many types are there?
4:
- Oral
- Pharyngeal
- Oropharyngeal
- Esophageal
What is effected during oral dysphagia? How many things?
4:
- Tongue movement
- Lip Closure
- Pocketing
- Transport
What is effected during Pharyngeal dysphagia? How many?
4:
- Airway closure
- Residues
- Motility
- UES
What is effected during Esophageal dysphagia?
6:
- Motility
- LES
- Fistula
- Diverticulum
- HCI - reflux
- Ulcer
How many stages of swalling are there, list them
3:
- Oral prep/oral
- Pharyngeal
- esophageal
How long does one swallow aprox. take? Break up the time by stages!
Aprox 11 secs (unless extensive oral prep is nessisary)
- Oral Prep/Oral stage = varied
- pharyngeal (~1 sec)
- esophageal (~10 secs)
How many things occur during oral prep/oral stage? List
3:
- Mastication
- bolus formation
- Oral transit (move bolus from oral cavity to the pharynx
How many and what actions occur during the pharyngeal stage?
3:
- Epiglottis inverts covering the laryngeal vesitbule
- Larynx and hyoid and pulled anterior and superior
- Bolus is propelled through the pharynx to the esophagus by action of the pharyngeal constrictors
Why is the hyoid (and larynx) lifted and pulled forward?
when this happens it opens the pharynx, relaxes the UES and helps the VFs to close the glottis
How is the bolus transported to the LES?
Peristaltic constractions (like squeezing a tube) of striated and smooth muscle along the esophageal wall
What happens when the bolus is transported to the LES?
This constrictor relaxes, allowing bolus to enter the stomach
How many, and what are the signs and symptoms of Oral and Pharygneal dysphagia?
13:
- Coughing/choking while swallowing
- difficulty initiation of swallow
- Food sticks to the throat
- Sialorrhea/xerostomia
- Drooling/spillage
- Unexplained weightloss
- Change in dietary habits
- Penetration
- Aspiration
- Recurrent pneumonia
- change in voice/speech (wet)
- Nasal regurgitation
- Wet/gurgly voice
What are (and how many) signs and symptoms are there for esophageal dysphagia?
6: 1. Sensation of food sticking in the chest/throat 2. Oral or pharyngeal regurgitation 3 Change in dietary habits 4 recurrent pneumonia 5 Reflux 6 Aspiration
T/F There are never any signs or symptoms of silent aspiration
Falso! Sometimes you will see teaing or runny nose
Define Feeding
Placement of food in the mouth before initiation of swallow
What stage does feeding fall under?
Oral Prep Stage
What physiolgic reactions occurs during the oral stage?
Salivation during presentation of food
Define swallowing
Transfer of food/drink from mouth to stomach
How many stages are there of swallowing?
3-
oral
pharyngeal
Esophageal
How long does a bedside take?
10-15 min
What does a bedside consist of?
5 things:
- medical hx
- Level of alertness
- Px interview
- Oral motor exam
- Assess swallow with a SMALL bolus
What are you looking for (and how many things) during a bedside?
9: 1. spillage 2 oral residue 3 long transit time 4 cough 5 throat clear 6 gurgly voice 7 tearing 8 Runny nose 9 Wrong sound with a stethoscope
What is the bedside limited in?
Assessing a and p
T/F you usually do a bedside after a BSS
Falso! its a prediagnostic
Purpose of a dx is to:
Identify symptoms to explain abnormalities in anatomy or physiology causing dysphagia (the etiology)
What are you looking for in a Dx– Define the things you are looking for
Physiology: 8 factors 1 Timing 2 tongue base motion 3 epiglottic dysfunction 4 laryngeal excursion 5 UES dysfunction 6 peristalsis 7 Paralysis 8 sensitivity ***ALso the immediate effects of Txs!!!!***
What types (and how many) imigaing tools do we use during a Dx?
5 -Fees/Feesst Videofluoroscopy ultrasound Videoendoscopy scintigraphy
What are some non imaging tools we can use to dx swallowing (how many)?
4 EMG EGG Acousitic *accelerometer or stethoscope pharyngeal manometery
