Dysphagia-AnatomyPhysiology Flashcards by Amanda P.

Dysphagia

Medical term for swallowing disorders. “Any difficulty moving food from mouth to stomach” per Dr. Jerilyn Logemann

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Deglutition

Medical term for swallowing

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Penetration

Material that has entered the Laryngeal Vestibule, but has not spilled below the level of the true vocal folds. OR, Entrance of anything ingested by mouth, secretions (saliva, mucus) or refluxed or regurgitated stomach contents into the laryngeal vestibule (bounded superiorly by the epiglottis; laterally by the aryepiglottic folds; inferiorly by the true vocal folds)

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Aspiration

passage of material below the level of the vocal folds. Materials enter the Laryngeal Vestibule AND Below the Level of the True Vocal Folds (entrance of anything ingested by mouth, secretions–saliva/ mucus, or refluxed/ regurgitated stomach contents.

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Mastication

Chewing (medical term)

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Bolus

Cohesive mass of food or liquid to be swallowed

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What happens when a muscle contracts?

The structure at the point of INSERTION moves closer to the structure at point of ORIGIN (e.g. Cricothyroid. Point of Origin= Cricoid Cartilage. Point of Insertion= Thyroid. So, when the muscle contracts, the thyroid (insertion) moves toward the cricoid (origin)

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Muscle ORIGIN is where the muscle is…

coming from

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Muscle INSERTION is where the muscle is ….

inserting to

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Lip Closure- What happens? What nerve?

Part of Oral Phase (#1 on Martin-Harris MBSImP); CN VII. Lips Close to Keep Food In Mouth; Orbicularis Oris & Zygomaticus seal the lips for anterior oral containment

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Tongue Control – Bolus Hold: What happens? What Nerves?

Part of Oral Phase (#2 on Martin-Harris MBSImP); CNXII (intrinsic tongue muscles-long, trans,vert); CNV (tensor veli palatine–stiffins soft palate); Tip of tongue elevates to close the anterior/ front of mouth. Sides of tongue elevate to meet the molars to close the sides of the mouth; Back of tongue elevates to meet the soft palate to close the back of the mouth

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Bolus Prep - Mastication

Part of Oral Phase (#3 on Martin-Harris MBSImP)

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Bolus Transport – Lingual Motion

Part of Oral Phase (#4 on Martin-Harris MBSImP)

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Oral Residue

Part of Oral Phase (#5 on Martin-Harris MBSImP)

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Initiation of Pharyngeal Swallow

Part of Oral Phase (#6 on Martin-Harris MBSImP)

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Soft Palate Elevation

Part of Oral Phase (#7 on Martin-Harris MBSImP)

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Laryngeal Elevation

Part of Pharyngeal Phase (#8 on Martin-Harris MBSImP)

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Anterior Hyoid Excursion

Part of Pharyngeal Phase (#9 on Martin-Harris MBSImP)

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Epiglottic Movement

Part of Pharyngeal Phase (#10 on Martin-Harris MBSImP)

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Laryngeal Vestibular Closure

Part of Pharyngeal Phase (#11 on Martin-Harris MBSImP)

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Pharyngeal Stripping Wave

Part of Pharyngeal Phase (#12 on Martin-Harris MBSImP)

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Pharyngeal Contraction

Part of Pharyngeal Phase (#13 on Martin-Harris MBSImP)

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Pharyngoesophageal Segment Opening

Part of Pharyngeal Phase (#14 on Martin-Harris MBSImP)

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Tongue Base Retraction

Part of Pharyngeal Phase (#15 on Martin-Harris MBSImP)

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Pharyngeal Residue

Part of Pharyngeal Phase (#16 on Martin-Harris MBSImP)

Esophageal Clearance

Esophageal Phase (#17 on Martin-Harris MBSImP)

Main Phases of swallowing (4)

1. Oral Preparatory Phase, 2. Oral Phase, 3. Pharyngeal Phase, 4. Esophageal Phase

Events of Swallowing--STEP (Dr. Humbert)

``` Posterior Lingual Propulsion Swallow Trigger Velar Elevation Laryngeal Vestibule Closure Pharyngeal Constriction & Elevation Upper Esophageal Opening ```

______ ______ is moving the bolus in a timely way without significant residue, effort, or repeat swallows

Bolus Efficiency –

______ ______ means: preventing ingested materials from entering the larynx and/or trachea

Airway Protection –

What does FEES stand for?

fiberoptic endoscopic evaluation of swallowing

What does VFSS stand for?

Videofluoroscopic Swallow Study

The ____ _____ refers to the immediate care of newborn infant at 1 minute and 5 minutes-check heart rate, respiratory effort, muscle tone, reflex irritability, color; scale of 0-1-2 for each = max score of 10

Apgar Score

The ____ _____ is the groove in the mouth between the gums and lips where food can get stuck

Anterior sulci

A-P View (A & P stands for?)

Anterior-Posterior view

the airway closure period when there is no respiration & usually corresponds to the closure of the airway during the pharyngeal stage

Apneic period

Collapsed alveoli is known as __________

Atelectasis-(at-uh-LEK-tuh-sis) is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid. Atelectasis is one of the most common breathing (respiratory) complications after surgery.

BSE-

bedside swallow evaluation

a material that can be added to food or liquid to assist in seeing these on X-ray

Barium-

Buccal

of or relating to the cheeks

COPD stands for what?

COPD-chronic obstructive pulmonary disease, any chronic lung disease that results in obstruction of the airways

CSE-

Clinical Swallow Evaluation

a dense type of tissue

Cartilage -

modifications or behavioral strategies designed to bypass persistent impairment

Compensatory strategies-

this muscle must relax for the UES to open during swallowing

Cricopharyngeus muscle-UES- (Crikey, you need to relax!)

the teeth that are used to cut food

Cuspids -

bolus head enters the pharynx; delayed to the valleculae; delayed to the pyriform (This is called..)

Delayed Initiation of Swallow

tongue tip down during swallow is called ______.

Dipper-

the identification and/or determination of the nature and cause of a problem is called _________.

Diagnosis

Eating Disorder is ...

any of a range of psychological disorders characterized by abnormal eating habits (e.g., anorexia nervosa)

_____ is the action of vomiting; caustic to aspirate

Emesis-

_____ refers to being fed through the stomach or duodenum via a tube

Enteral-

cartilage in your pharynx that is involved in the swallowing process

Epiglottis -

the natural tube that leads from the pharynx to the stomach

Esophagus -

of or relating to the esophagus

Esophageal -

Which phase of swallowing begins when the bolus passes through the UES to the esophagus?

Esophageal stage/phase-begins when the bolus passes through the UES to the esophagus and ends when the bolus passes through the LES into the stomach.

____ means having its origin some distance from the part that it moves

Extrinsic –

-refusal to eat certain food groups, textures, solids or liquids for a period of at least one month, which causes an infant or child to not gain enough weight, grow naturally, develop normally.

Feeding Disorder

FOIS stands for...

FOIS-Functional Oral Intake Scale

GERD stands for...

gastroesophageal reflux disease

Having or showing abnormally high sensitivity to stimuli is ___________.

Hyperreactive –

– lower threshold for sensory information

Hypersensitive –

high muscle tone is called _______

Hypertonicity –

_____ is also known as the laryngopharynx; the inferior, or lower, part of the pharynx behind the larynx

Hypopharynx –

having or showing abnormally low sensitivity to stimuli

Hyporeactive –

not processing enough sensory information

Hyposensitive –

low muscle tone

Hypotonicity –

U-shaped bone in the neck that supports the tongue—anchoring structure for the tongue

Hyoid bone

of or relating to illness caused by medical examination or treatment

Iatrogenic-

relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown

Idiopathic-

the teeth that are used to tear food

Incisors -

– low or lower in position

Inferior

in the alveoli and airways; infiltration of something

Infiltrates-

contained wholly within the organ on which it acts

Intrinsic -

1st initiation of the pharyngeal swallow represented by...

the 1st movement of the brisk superior-anterior hyoid trajectory

Lateral Sulci

the grooves that you find between the gums and the cheeks

LES—Lower esophageal sphincter –

LES-the muscle separating the esophagus and stomach

Ligament –

tough band of connective tissues (fibrous) that connect various structures, such as bones

LPR is

-laryngopharyngeal reflux

MASA stands for:

MASA-Mann Assessment of Swallowing Ability

a thin layer of tissue that covers a surface, lines a cavity, or divides a space or organ

Membrane –

MNA

MNA-Mini Nutritional Assessment

MISA-

McGill Ingestive Skills Assessment

Mastication-

chewing-the process by which food is crushed or ground by the teeth

MBS or MBSS

Modified Barium Swallow Study (MBS or MBSS

the teeth that are used to grind food

Molars

a large air-filled space above and behind the nose in the middle of the face;

Nasal Cavity – a large air-filled space above and behind the nose in the middle of the face; ; each cavity is the continuation of one of the two nostrils

the upper part of the pharynx, connecting with the nasal cavity above the soft palate

Nasopharynx –

NPO-

nil per os-Latin for “nothing by mouth”

process by which living organisms obtain nutrients to sustain life, growth, and development

Nutrition-

painful swallowing

Odynophagia -

Oral Cavity –

mouth or mouth cavity

begins when food enters the mouth & ends when anterior to posterior propulsion of the bolus begins in the oral cavity

Oral Preparatory Phase -

begins when the tongue tip elevates and propels the bolus back to toward the pharynx and ends when the bolus leaves the oral cavity

Oral Phase -

– middle part of the pharynx behind the mouth

Oropharynx

OTT –

Oral Transit Time – the amount of time it takes to push the bolus back in the oral cavity

PES -

PES - pharyngoesophageal segment

Pharyngeal phase - begins when

Pharyngeal phase - begins when bolus arrives at valleculae and ends when bolus passes through the UES/PES

the throat

Pharynx -

lung inflammation caused by a disease producing microorganism

Pneumonia - lung inflammation caused by a disease producing microorganism—pneumonitis + infectious process

Lung inflammation

Pneumonitis -

PO - per os-Latin for “by mouth”

Material entering the valleculae or pyriform sinuses before the swallow is triggered is called _______.

Pooling -Pooling -

The posterior wall of the pharynx

Posterior Pharyngeal Wall (PPW) – the posterior wall of the pharynx – you can see the PPW when you open your mouth and look straight back

the amount of time it takes the bolus to pass through the pharynx

PTT – Pharyngeal Transit Time –

a cavity or depression in the pharynx where food or liquid may collect

Pyriform sinus -

SaO2; taken on the finger; red and infrared light; want 90-100%

Pulse oximetry: SaO2; taken on the finger; red and infrared light; want 90-100%

An involuntary or automatic action or response

Reflex - a

Expulsion of material from the pharynx, or esophagus, usually characterized by the presence of undigested food or blood.

Regurgitation -

materials remaining in the valleculae or pyriform sinuses after the swallow

Residue -

soften and help pass food to the stomach

Secretions -

Sign-

Sign- something we observe; objective finding

sEMG

surface electromyography

Velum; fleshy, flexible part toward the back of the roof of the mouth

Soft Palate

Stasis

Stasis - residue-materials left in the pharynx following the swallow

- subjective indication of a disease that is perceived by the patient or caregivers

Symptom

fibrous cord of connective tissue continuous with the fibers of a muscle and attaching the muscle to bone or cartilage

Tendon

The natural tube that leads from the pharynx to the lungs

Trachea

UES-Upper esophageal sphincter -

the muscle separating the pharynx and esophagus

the small mass (or “bell”) that hangs from the rear portion of the roof of the mouth

Uvula

- a cavity or depression in the pharynx where food or liquid may collect

Valleculae or Vallecular sinus - a cavity or depression in the pharynx where food or liquid may collect

Valsalva maneuver -

moderately forceful attempted exhalation against a closed airway

Space between the false and true vocal folds

Ventricle/ventricular space – space between the false and true vocal folds

false vocal folds

Ventricular folds – false vocal folds

VFSS -

Videofluoroscopic Swallow Study

the tissue covered muscles in your larynx whose vibration helps to create your voice

Vocal folds - the tissue covered muscles in your larynx whose vibration helps to create your voice

Inability to process some information received through the senses

Sensory integration dysfunction. (may result in inability to process some information received through the senses or inability to appropriately respond to sensory stimuli, affecting actions & behavior) Implicated in some forms of dysphagia, particularly in pediatric patients.

Neurologic process of organizing the sensory information we receive from the environment

Sensory Integration

Stroke patients may exhibit tongue pumping preceding oral transport, indicating ...

disruption of upper motor neuron (UMN) Pathways

The tongue is a ______ ______

Muscular Hydrostat- deformed by intrinsic muscles oriented longitudinally & in the perpendicular plane, vertically & horizontally

Superior longitudinal, Inferior longitudinal, transverse & | Vertical are the _______ muscles

Intrinsic

3 Types of Intrinsic Muscles & Cranial Nerve?

CN XII (12) Hypoglossal Nerve: Longitudinal (superior & inferior), transverse, vertical

3 Extrinsic Muscles & CN?

CN XII (12) Hypoglossal. Genioglossus (moves tongue laterally), Hyoglossus (depresses tongue), Styloglossus (posterior containment)