Dysphagia

Question 1

What test is considered the gold standard for diagnosing swallowing problems?

Answer 1

Modified Barium Swallow

Question 2

Name the three phases of a swallow.

Answer 2

Oral Preparatory Stage- don’t think he is counting this as a phase though

Oral Phase: begins when tongue initiates posterior movement of the bolus toward the pharynx; voluntary, requiring the person to be alert and involved in the process

Pharyngeal Phase: marks the beginning of the involuntary portion of the swallowing process; begins when bolus passes any point between the anterior faucial arches and where the tongue base crosses the lower rim of the mandible into the pharynx

Esophageal Phase: starts when the bolus enters the esophagus through the cricopharyngeal juncture or upper esophageal sphincter (UES); as food enters the esophagus, the epiglottis returns to relaxed position and the airway opens

Question 3

Name several conditions that may lead to dysphagia.

Answer 3

Esophageal dysphagia: esophageal tumors, foreign bodies, GERD, eosinophilic esophagitis, scleroderma, radiation therapy
Oropharyngeal dysphagia: MS, muscular dystrophy, Parkinson’s disease, stroke, brain injury, spinal cord injury, cancer, pharyngeal diverticula

Question 4

What is the most commonly recommended compensatory strategy to improve a swallow?

Answer 4

1: Postural techniques (I am thinking this)

But also:
Techniques to improve oral sensory awareness
Modification of bolus volume and speed of presentation
Texture modifications
Sit upright with the hips flexed to 90 degrees
Tilting the patient’s chin down when swallowing

Question 5

A person with hemiplegia may swallow more safely by performing what compensatory maneuver?

Answer 5

Turning the head to the left or the right when swallowing.
Turn to the weak side when swallowing if weakness or paralysis on pharynx.
Turn to the stronger side when swallowing if lingual or pharyngeal weakness

Question 6

A person with hemi-sensory deficits may swallow more safely by performing what two compensatory maneuvers?

Answer 6

Tongue sweep

Finger sweep

Question 7

How long should a person sit up after eating?

Answer 7

30-60 minutes

Question 8

List three other strategies that can help a person swallow more safely.

Answer 8

Tilt the chin down about 45 degrees to help trigger the pharyngeal swallow, laryngeal closure, or to help the tongue move correctly

Thicken the consistency of the liquids they are consuming because this tends to travel through the oral cavity and pharynx at a slower rate to allow more time for the pharyngeal swallow to trigger

Reduce the size of the bolus

Swallow twice per bite and alternate solids with liquids

Question 9

What is the great risk that accompanies swallowing difficulties?

Answer 9

Aspiration