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Advanced MNT 1 > Dysphagia > Flashcards

Dysphagia Flashcards

1
Q

what is the definition of dysphasia

A

difficulty or inability to swallow properly

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2
Q

symptoms of dysphagia include ?

A

choking, coughing, drooling
multiple swallows for one bite
pocketing food
gurgle voice
frequent respiratory infections

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3
Q

what neurologic disorders can cause disphagia

A

stroke
dementia

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4
Q

what neuromuscular disorders can cause dysphagia

A

ALS
MS
parkinsons

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5
Q

trauma that can cause dysphagia

A

brain injury

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6
Q

cancer in which areas can cause dysphagia

A

oral cavatiy
pharynx
esophagus

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7
Q

medications that cause dysphagia

A

sedation
dry mouth

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8
Q

biological causes of dysphagia

A

advanced age and frailty

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9
Q

what are the three swallowing phases and are they voluntary?

A

oral phase - Voluntary
pharyngeal phase - Involuntary
Esophageal phase - Involuntary

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10
Q

In the oral phase food is introduced to the ______, then it is chewed and mixed with _______.

Tongue presses against ______ which forms a bolus of food and forces it toward the _________.

A

oral cavity
saliva

hard palate
pharynx

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11
Q

In the Pharangeal Phase the ______ raises and this causes the _______ to _________.

________ elevated causing ______ to move over the _____ and the _____ close to prevent food from entering the trachea

______ contracts while the _______________ relaxes allowing food to pass into the esophagus

A

soft palate
nasopharynx
seal off

Larynx
epiglottis
glottis
vocal cords

Pharynx
upper esophageal sphincter

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12
Q

In the esophageal phase the bolus moves through the ______ into the _______

A

esophagus
stomach

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13
Q

To identify Dysphagia, you should start with a _______, and provide _______________.

A

diet interview
observation during mealtime

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14
Q

If dysphagia is suspected, recommend a _______ consult for a swallowing evaluation. They will perform a clinical exam and a ___________

A

SLP

video fluoroscopy/modified barium swallow

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15
Q

Oral phase swallowing problems can include drooling and food spillage caused by the ____________. Food pocketing and difficulty forming a bolus can occur from ________

A

weakened lip muscles
weakened or poorly coordinated movements of the tongue

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16
Q

Pharyngeal phase complications can cause ________, _______, and _______.

A

nasal regurgitation
choking
aspiration

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17
Q

esophageal phase issues often are caused by _______ or _________

A

mechanical obstruction
neuromuscular disorder (achalasia)

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18
Q

Consequences of dysphagia include

inadequate _____, ________ and ______ leading to weight loss
Increased ______, _____, and increased risk of ________

A

intake, nutrient deficiencies, and malnutrition
frailty, dehydration, aspiration pneumonia

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19
Q

MNT for Dysphagia include proper ________
consistency modification as per ____
______,______ meals
minimize _______
Foods that are ______ or ____ help stimulate swallow reflex

A

positioning HOB above 30 degrees
SLP
small frequent
distractions
flavorful or cold

20
Q

MNT for dysphagia also includes avoiding _____, _____ the patient, including ____ if needed, and also including _______ if oral intake in inadequate

A

alcohol
educating
MVI with minerals
Enteral nutrition

21
Q

Textures that pose a choking risk include…

_____, ____ or ______ (nuts, raw carrots)
_____ or _______ (steak, pineapple)
_____, ______ or ______ (nut butter, cheese chunks)
________ (bacon)
_______ (dry cakes or cookies)
______, _____, and _____ (peas shells, grape skins)
_____ shaped foods
_________ (soup, bubble tea)

A

hard, dry, or crunchy
fibrous or tough
sticky, gummy, or chewy
crispy
crumbly
seeds, skins, and husks
round
mixed thin-thick textures

22
Q

Standardized diet released in 2017 by a multidisciplinary, multinational taskforce for dysphagia

A

International Dysphagia Diet Standardisation Initiative (IDDSI)

23
Q

The International Dysphagia Diet Standardisation Initiative (IDDSI) was developed to provide _______________ terminology &
definitions to describe texture modified food &
thickened liquids.

Also to Improve patient_______ by increasing consistent
communication & standards

A

standardized, international
safety

24
Q

What is IDDSI …
level 0 ?
level 1?
level 2?
level 3?
level 4?
level 5?
level 6?
level 7?

A
  1. Thin liquids
  2. Mildly thick liquids
  3. Moderately thick liquids/liquidized foods
  4. Extremely thick liquids
  5. minced and moist foods
  6. soft and bite sized
  7. easy to chew
25
Q

IDDSI level 0 Thin Liquids

flow like _____
flow test should be ___ ml residue remaining in syringe
include most _______
thin liquids are easily _________

A

water
<1 ml
liquids
aspirated

26
Q

other than most liquids, _______ is also a thin liquid

A

ice cream, frozen yogurt, sherbet, milk shakes, and gelatin

27
Q

IDDSI Flow test measures how thick a liquid is by how much flows through a ____ syringe in ____

A

10 ml
10 seconds

28
Q

Slightly thick liquids IDDSI level 1

should be thicker than _____, but thin enough to ______
used when thin drinks flow _____
flow test leaves _____ml

A

water, flow through a straw
too fast to be controlled safely
1-4 mL

29
Q

IDDSI level 2 mildly thick liquids

pours _____ from a spoon but slower than slightly thick
mild effort is needed to _________
indication when ________
flow test should be _____ mL

A

quickly
drink through straw
tongue control is slightly reduced
4-8 mL

30
Q

IDDSI level 3 Moderately thick liquid/liquidised food

_______ from fork with
_____ texture with _____
______ effort to drink out of straw
indications include ______________ and __________
flow test should be _____ mL

A

drips slowly
smooth texture with no lumps
moderate
difficulty controlling tongue and pain with swallowing
>8 mL

31
Q

IDDSI level 4 extremely thick liquids

________ when falls off a spoon
______ with a straw or cup
allow more time for ________-
indications include _________, _________, and __________

A

falls off in a single hold
cannot drink
oral control
significant loss of tongue control, pain when chewing and swelling, aspiration risk

32
Q

If thin liquids are not permitted Thickened liquids can meet the ___ requirements

A

fluid

33
Q

thickening agents include ?

A

cornstarch
flour
infant rice cereal
pureed fruits or veggies
commercial products

34
Q

commercial instant thickeners examples? (3)

A

thickenUp
simply thick
thick it

35
Q

Pre thickened products examples

A

juice, milk, water, coffee

36
Q

Adequate fluid intake can be difficult to achieve for people receiving thickened liquids

Provide _______
An alternative approach to using thickened liquids=> _________

A

education
Frazier Free Water Protocol

37
Q

Frazier Free Water Protocol

A

consume bacteria free water not at times of meal to prevent infection

38
Q

IDDSI Level 4: Pureed Foods

Indications=> _______________

Foods are pureed to a “_______” texture
Food are easy to swallow because they are smooth, lump-free, homogenous, cohesive, & not sticky

No _______required
Add gravy, sauce, vegetable juice, cooking water, fruit juice, milk, or half-and-half to pureed foods to prevent lumps and provide moisture

A

unable to bite or chew food, tongue control is significantly reduced, or aspiration

pudding-like

chewing

39
Q

There are ______ to make food resemble food it was and look more appetizing

A

molds

40
Q

IDDSI Level 5: Minced & Moist Foods

For patients who are unable to ______, have pain or difficulty chewing foods, or easily ______ when chewing foods

_________ all foods into pieces no larger than __mm width lump size

Soft & moist with no separate thin liquid

A

bite foods
tire

Mince or mash
4 mm

41
Q

IDDSI Level 6: Soft & Bite-sized

For patients who are unable to _______ but are able to _____

Indications: ________ with chewing, _________

Cut all foods into pieces no larger than _______

Add gravy & sauces to keep food moist

A

safely bite off pieces
chew the food into pieces that can be swallowed

pain or fatigue
missing teeth, poorly fitting dentures

1.5 cm x 1.5 cm

42
Q

IDDSI Level 7: Easy to Chew

Normal, everyday foods of _______

For people who find hard &/or chewy foods difficult or painful to chew and swallow

Avoid foods that are hard, tough, chewy, fibrous, stringy, crunchy, or crumbly

A

soft texture

43
Q

trigeminal nerve

A

chewing

44
Q

hypoglossal nerve

A

tongue

45
Q

glossopharangyl nerve

A

structures of swallowing

Advanced MNT 1 (20 decks)

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