dysphagia

Question 1

what does dysphagia mean?

Answer 1

“difficulty eating”–> aka: disruption of swallowing process (bolus transfer from oral cavity to stomach)

Question 2

what are the 2 classifications of dysphagia?

Answer 2

1. oropharyngeal (transfer dysphagia)

2. esophageal

Question 3

oropharyngeal dysphagia involves difficulty during what period of swallow? what is happening to the bolus at this time?

Answer 3

before/at initiation of swallow when bolus is transferring from oral cavity to upper esophagus

Question 4

what are the 4 stages of swallowing + short description of each?

Answer 4

1. oral preparatory (making bolus soft enough to swallow)
2. oral propulsion(pushing bolus back to oropharynx)
3. **pharyngeal (where the magic happens and epiglottis moves, tongue pushes bolus down, sphincters relax)
4. esophageal(peristalsis moves bolus down)

Question 5

what is the BEST therapy for dysphagia?

Answer 5

rehab- practicing swallowing

Question 6

how can MNT help dysphagia patients during rehab of swallowing?

Answer 6

change consistency of food to allow for rehab

Question 7

what levels of dysphagia severity merit a normal diet with possible modified independence while eating?

Answer 7

7(all normal) and 6(within f(x)al limits)

Question 8

at what severity level may some modification of consistency be necessary?

Answer 8

5–> usually only aspirate thin liquids, can still clear bolus

Question 9

what is the difference between levels 3 and 4 of dysphagia severity?

Answer 9

level 4 needs only intermittent supervision(cues to clear) while level 3 requires total eating assistance

Question 10

t/f: level 2 severity dysphagia should be NPO

Answer 10

false- can be partial PO but modified consistency and maximum eating assistance to prevent aspiration

Question 11

why should level 1 dysphagia patients be NPO?

Answer 11

they will silently aspirate

Question 12

what severity levels can be on the NDD level 4?

Answer 12

5-7

Question 13

NDD level 1 is described as “________” consistency and includes what type of foods?

Answer 13

pureed

**foods that are pudding-like and have NO lumps: mashed potatoes, pureed chicken, applesauce, chocolate puddign

Question 14

NDD level 2 is described as “____________” and includes what types of foods?

Answer 14

mechanically altered

**foods that are moist and soft-textured: diced meats, soft-cooked veg, soft ripe/canned foods, moistened cereals

Question 15

NDD level 3 is described as “______________” . what kinds of foods are included?

Answer 15

advanced–> most feeds except very hard, sticky, or crunchy items: bread, rice, cake, shredded lettuce, tender meats, etc. (NOT hard fruits/veg, nuts, seeds)

Question 16

what are the 4 levels of liquid consistency?

Answer 16

spoon thick (pudding), honey-like, nectar-like, thin liquids(water, ice, milk, juice, coffee, tea, carbonated bevs all allowed)