Dysphagia Flashcards
Phases of swallowing
Oropharyngeal (voluntary)
Pharyngeal
Cricopharyngeal
Esophageal
Esophageal sections
Cervical initiates @ upper esophageal sphincter (UES)
Thoracic
Small abdominal portion @ lower es
Sensory neurological control
Trigeminal
Glossopharyngeal
Vagus
Motor neurological control
Facial, trigeminal, glossopharyngeal, vagus, hypoglossol nerve
Oropharyngeal phase
Prehension of food
Formation of bolus
Aboral movement to base of tongue
Initiates coordinated series of reflexes in pharynx
Pharyngeal phase
Peristalsis of pharynx
Bolus transported into laryngopharynx
Epiglottis closed
Cricopharyngeal phase
UES relaxation
Bolus passes into cranial esophagus
What is the cricopharyngeal muscle tone linked to?
With the respiratory center and deglutition
Esophageal phase
Swallow followed by movement of bolus by esophageal peristalsis
Bolus paused in proximal esophagus
Secondary peristalsis (bolus moves to stomach)
Dysphagia clinical signs
Anorexia
Hypersalivation (ptyalism)
Halitosis
Inability to open mouth
Regurgitation
Esophageal dysphagia diagnostics
Cervical neck and thoracic rads
Swallow study
Endoscopy
ACh Ab study
Thyroid profile
Baseline cortisol/ ACTH stimulation test
Ptyalism causes
Stomatitis
Oral ulcers
Oral neoplasia
Oropharyngeal foreign body
Tonsilitis
Pharyngitis
Pseudoptyalism
Foreign body
Neoplasia
Oropharyngeal dysphagia
Facial nerve paralysis
Halitosis (bad mouth odor) differentials
Stomatitis
Oral ulcers and burns
Foreign body, abscess, neoplasia
Complications of dysphagia
Coughing
Nasal discharge
Aspiration
Pneumonia
Gag reflex
Evaluates cranial nerves X, V, XII → medulla
Short rapid elevation of soft palate and constriction of pharyngeal constrictor muscles
Oropharyngeal dysphagia
Difficulty prehending food and creating food bolus
Formed food bolus falls from mouth
Cricopharyngeal dysphagia
Able to prehend food
Multiple attempts to swallow without success
Formed food bolus regurgitated
Esophageal dysphagia
Able to prehend food
Better success at swallowing food
Undigested and digested food regurgitated
Supportive treatment
Change consistency of food and water
Gravity helps (elevate food, bailey chair)
Assisted feeding gastrostomy tube
