Dysphagia and Nutrition Flashcards
Achalasia definition
Aperistalsis and incomplete LES relaxation
Globus pharyngeus definition
Sensation of lump in throat but swallowing is unaffected
Esophageal dysphagia
Dysphagia is localized to chest or neck, have food impaction
Oropharyngeal dysphagia
Dysphagia is localized to neck, nasal regurgitation, aspiration, and has associated ENT symptoms
When would you order a modified barium swallow?
To determine cause for and evaluate severity of tracheal aspiration. Consider when pt has sx suggestive of dysphagia or aspiration, or neurologic findings suggesting dysfunction affecting swallowing
Uses thin liquid, thick liquid, etc to mimic different food consistencies
What should a patient condition be for a bedside swallow assessment?
Alert and coherent Upright posture Able to breathe through the nose Clear speech, normal voice - if not cough to clear Oral mechanism exam
Oral trials
Start with water Observe swallowing Palpate thyroid notch for rise and fall Have pt speak Advance to crackers and repeat Check for food retained in oropharynx
What are the muscles of mastication?
Lateral pterygoid
Temporal muscle
Medial pterygoid
Masseter muscle
Esophagram
Barium swallow
Evaluate pharyngeal and esophageal mucosa
Video capture fluroscopy
Use air contrast to make mucosal surface distinct
What is the sensorimotor control of swallowing?
Afferent sensory fibers in CNs Cerebral and midbrain fibers synapse w brainstem swallowing centers Paired swallowing centers in brain stem Efferent motor fibers in CNS Muscle and end organs
Disease appropriate hospital diet
Clear liquid Full liquid Regular Low residue Low sodium (2g, 3g, 4g) No sodium Cardiac - low sodium and low cholesterol
Pureed dysphagia diet
All foods pureed and thickened to pudding-like consistency
Mechanically altered dysphagia diet
Moist, soft-textured, easily chewed. Ground meat w gravy or sauce
Dysphagia advanced
Excludes hard, dry, sticky, or crunchy foods
