chapter 8 Flashcards
Define neurogenic dysphagia
Any swallowing deficits secondary to a neurological disorder including TBI, stroke, & other acquired disorders
Incidence rate for adult clients with TBI
60% have some form of neurogenic dysphagia
Incidence rate for pediatric clients with TBI
68% have some form of neurogenic dysphagia
Risk factors for developing dysphagia
-severity of head injury on initial brain scan
-lower scores on Glasgow Come Scale & Pancho Los Amigos upon admission
-abnormal tongue control
-presence of tracheostomy, feeding tubes, & mechanical ventilation for more than 2 weeks
Physiological features contributing to dysphagia
-impaired oral reflexes
-reduced tongue coordination and/or range of motion
-increased oral muscle tone
-reduced lip strength
-delayed swallow responses
-reduced velopharyngeal closure
-reduced strength of tongue base
-reduced tongue control
define aspiration
entry of food into the airway below the level of the VFs
define silent aspiration
-episodes of aspiration without a cough of other signs of distress or difficulties
-approx. 50% of people who aspirate may not demonstrate any clinical signs or symptoms of swallowing difficulties
define penetration
entry of food material into the airway above the level of the VFs
define aspiration pneuomonia
entry of aspirate food into the lungs creating respiratory infections or pneumonia
Oral stage deficits
-poor lip closure
-difficulties in mastication
Pharyngeal stage deficits
-lack of initiation of swallow
-pooling
esophageal stage deficits
-difficulties with peristalsis
-delayed transit of the bolus past the esophageal sphincter
Assessment medical history
-underlying cause of TBI
-extent of injuries
-feeding deficits
-change in weight
-episodes of coughing/chocking during and/or after eating, feeding, tube, weight loss, recurrent episodes of pneuomonia, drooling & need for suction
Assessment clinical interview
-talk to patient and/or family members or healthcare professionals working closely w/patient
