Dysfunction in swallowing anatomy Flashcards

1
Q

Impaired palatopharyngeal muscle could cause?

A

-Regurgitation
-nasal voice (hypernasality)
-Aspiration

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2
Q

Outcomes of reduced saliva?

A

-Poor oral hygiene
-Bacteria in mouth
-Tooth decay
-Lack of saliva breaking down food
-Lack of oral moisture
-Lack of food lubrication

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3
Q

Dysfunction leading to aspiration AFTER swallow

A

-Lack of sensation (SLN and RLN damage)
-Residue in pharynx or larynx
-Upper esophageal sphincter remaining open

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4
Q

Pharyngeal residue sites?

A

-Pyriform sinuses
-Base of tongue
-Posterior pharyngeal wall (along nasopharynx, oropharynx, or hypopharynx)
-Valeculla

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5
Q

Larynx residue sites?

A

-True vocal folds
-False vocal folds
-Supraglottic or subglottic space
-epiglottis

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6
Q

Dysfunction in oral cavity that could cause aspiration BEFORE swallowing?

A

-impaired anterior facial pillars (lack of posterior seal of oral cavity)
-Impaired sensation (lack of awareness of bolus location)

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7
Q

Residue sites in the oral cavity

A

-Lips
-tongue
-Floor of mouth
-Facial pillars
-Anterior and lateral sulci

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8
Q

Define aspiration

A

Entry of food or liquid into the airway BELOW true vocal folds

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9
Q

Define penetration

A

Entry of food or liquid into the larynx at some level down, but ABOVE true vocal folds

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10
Q

Define residue

A

Food left behind in the mouth or pharynx after the swallow

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11
Q

Define regurgitation (backflow )

A

Food from the esophagus flowing back up into the pharynx and/or from the pharynx into the nasal cavity

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12
Q

Continued presence of aspiration can lead to?

A

Aspiration pneumonia

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13
Q

define silent aspiration

A

Pt sensitivity is reduced, so when they aspirate (food goes below true vocal folds) they don’t cough or demonstrate other visible or audible signs

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14
Q

Possible causes of difficulty swallowing liquids

A

-Suggestive of a neurological disorder
-Age related swallowing difficulties (presbyphagia)

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15
Q

Possible causes of difficulty swallowing solid foods

A

-structural abnormality
-sign of neuromuscular disease affecting the pharyngeal muscles

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16
Q

Possible causes of regurgitation

A

-a pharyngeal pouch (zenker’s disease)

17
Q

Possible cause of progressive dysphagia

A

-neuromuscular disease
-tumor

18
Q

Possible causes of of hoarseness

A

-laryngeal tumor
-neck masses caused by enlarged thyroid, compressing the esophagus

19
Q

Possible cause of dysphagia related weight loss

A

-pain or discomfort during eating
-if progression is rapid, may indicate something serious, requiring urgent investigation

20
Q

Oropharyngeal dysphagia is prevalent within which populations?

A
  1. nursing home residents
  2. hospital inpatients
  3. dementia
  4. normal elderly population
  5. head and neck oncology
21
Q

Why is dysphagia prevalent within the normal elderly population?

A

-weight loss
-decreased thrist sense
-decreased appetitie
-sarcopenia (muscle deterioration/loss)

22
Q

Individuals within hospital inpatient settings have increased risk of developing dysphagia due to?

A

-intubations
-enteral tubes
-tracheotomy
-sedation
-mental status
-debilitated status

23
Q

Possible causes of dysphagia?

A
  1. foreign bodies
  2. cricopharyngeal achalasia
  3. zenker’s diverticulum
  4. lateral pharyngeal pouches and diverticula
  5. cervical spine disease
  6. esophageal webs
  7. esophageal ring (schatzki’s ring)
  8. tracheostomy
  9. strictures
  10. achalasia
  11. diffuse esophgeal spasm
  12. GERD
  13. Larynx or pharynx cancer
  14. Esophagus cancer
  15. Amyotrophic lateral sclerosis (ALS)
  16. parkinson’s disease
  17. muscular dystrophy
  18. myasthenia gravis
  19. autoimmune disorder
  20. aging
  21. globus hystericus
  22. stroke
  23. laryngeal nerve injury
24
Q

The presence of residue patterns indicates there could be…

A
  1. weakness in tongue, pharyngeal muscles, or paralysis
  2. Fibrosis s/p chemorad
  3. Upper esophageal sphincter dysfunction (spasm or stricture)
  4. Sensory deficit
  5. Neurological disorder