Chapter 8

Question 1

Mastication

Answer 1

The process of the oral motor preparation of food for swallowing (chewing)

Question 2

Deglutition

Answer 2

The process of swallowing

Question 3

Bolus

Answer 3

A ball of food or liquid to be swallowed

Question 4

Videofluoroscopic Swallow Study (VFSS)

Answer 4

Recording of swallowing different consistencies of food (liquid, puree, crunchy) with barium (aka modified barium swallow)

Question 5

Fiberoptic Evaluation of Swallowing (FEES)

Answer 5

Use of fiberoptic camera in nose to view swallowing structures (and if leftover residue) while giving different consistencies of things to swallow

Question 6

Swallowing patterns in year 1 of infancy

Answer 6

There are rapid developments particularly with sucking-swallowing reflex

Question 7

What is the feeding cycle?

Answer 7

Suck, swallow, breath

Question 8

0-6 mo

Answer 8

Rooting reflex (brush cheek and move towards you), sucking reflex (when something touches lips they will start the sucking motion), suckling pattern

Question 9

6 mo +

Answer 9

Sucking action (more control and more voluntary)

Question 10

10 mo +

Answer 10

Teeth erupt and the sucking action changes again

Question 11

How is infant anatomy different for swallowing?

Answer 11

Tongue fills oral cavity, fat pads in cheeks narrow the oral cavity, hyoid and larynx are much higher, velum hangs lower, ulva rests inside epiglorris forming a pocket velleculae

Question 12

How is infant physiology different for swallowing?

Answer 12

They go through an oral phases which they can only eat liquids and they go through a pharyngeal phases where there is less elevation and more wall movement

Question 13

What are the main changes in anatomy from infancy to adulthood?

Answer 13

jaw grows down and forward, tongue descends, pharynx enlarges, larynx and hyoid drop, and most enlargement happens during puberty

Question 14

The infant swallow pattern

Answer 14

suck-swallow-breathe

Question 15

What are the main points about the infant swallow?

Answer 15

It is reflexive, begins in utero, and it is an apneic period where they don’t breathe, it should be rhythmic

Question 16

Laryngomalacia

Answer 16

Floppy airway where the arytenoid cartilage flops into the airway and creates a squeak sound

Question 17

Why are textures important?

Answer 17

Because kids learns so much through texture feed

Question 18

Birth

Answer 18

Suck-swallow

Question 19

4-6 mo

Answer 19

Begin puree

Question 20

8 mo

Answer 20

Finger food

Question 21

12 mo

Answer 21

chopped food, small bites

Question 22

2-3 yr

Answer 22

adult food cut up

Question 23

What are the 4 stages of the swallow?

Answer 23

Oral prep, Oral transit, Pharyngeal stage, Esophageal Stage

Question 24

1. oral preparation

Answer 24

Chewing food into a soft ball ready for transport, tongue pushes food onto the molar surfaces, collects food mixes it with saliva and forms the bolus (voluntary)

Question 25

2. oral transit

Answer 25

breathing stops as the bolus is moved to the oropharynx to initiate a swallow, begins when the bolus is formed and is propelled toward the facial pillars, the tongue is elevating and pulling posteriorly, anterior tongue elevates to hard palate (voluntary or involuntary)

Question 26

3. pharyngeal stage

Answer 26

Begins at the facial pillars and is squeezing the bolus through the pharynx, moves from facial pillars to the cricopharyngeus, it is fast and rhythmic, central pattern generators control this phase (reflexive)

Question 27

4. Esophageal stage

Answer 27

Peristalsis moved the bolus from the cricopharygeas through the stomach, gravity assists and this is about 10-20 seconds of transit time, the peristaltic muscles contract(reflexive)

Question 28

What else impact deglutition?

Answer 28

Gustation/taste, olfaction, temp receptors, salivation, interest in eating, tactical sense, pain receptors, muscle tone

Question 29

What happens to the VB when you swallow?

Answer 29

Voice box moves up and forwards

Question 30

What are all of the reflexes

Answer 30

chewing, rooting, sucking, gag, vomit, cough, pain withdrawl, apneic, respiration, swallowing

Question 31

What are some changes to anatomy as we age?

Answer 31

teeth loss/decay, muscle deterioration, weakness in VB and tongue

Question 32

What are some changes to physiology as we age?

Answer 32

Oral: more/longer chewing, dentures
Pharyngeal: larynx and hyoid don’t elevate well to protect the airway
Esophageal: delayed emptying of esophagus, feeling full