Dysphagia Disorders Flashcards
Patient Symptom:
Can’t hold food in mouth
Clinical sign - Oral spillage
Fluoro results - Oral spillage
Disorder - Decreased lip closure/strength
Patient Symptom:
Cant chew with mouth closed
Clinical sign - Open mastication
Fluoro results - Open mastication
Disorder - Mouth breather/nasal insufficiency
Patient Symptom:
Can’t chew-avoid food types
Clinical sign - Bolus stays on tongue; falls into sulci
Fluoro results - Bolus stays on tongue; falls into sulci
Disorder - Tongue immobility/decreased strength; Decreased buccal/labial tension/strength
Patient symptom:
Can’t “line up” teeth
Clinical sign: Mandible doesn’t align
Fluoro results: Mandible doesn’t align (A-P view)
Disorder: Inability to align dentition
Patient symptom:
Material goes all over mouth
Clinical sign: Bolus spreads in oral cavity
Fluoro results: Loss of bolus control (A-P view)
Disorder: Decrease tongue coordination/ movement/ strength; decreased oral sensation
Patient symptom:
Coughs, chokes before swallow
Clinical sign: Coughing, choking before swallow
Fluoro results: Pre-spillage into valleculae or airway
Disorder: Decreased tongue coordination/ strength to hold
Patient symptom:
Slow eating
Clinical sign: Delayed oral transit
Fluoro results: Delayed oral transit; tongue pumping/rolling
Disorder: Swallow apraxia (incoordination)
OR
Clinical sign: Delayed oral transit
Fluoro results: Delayed oral transit; mid-tongue residues
Disorder: Decreased tongue coordination/ strength; scarring
Patient symptom:
Slow eating, worse with solids
Clinical sign: Delayed oral transit
Fluoro results: Delayed oral transit; decreased tongue elevation; hard palate residues
Disorder: decreased tongue elevation/decreased tongue movements
Patient symptom:
Foods sticks on top of mouth
Clinical sign: Residues on hard palate
Fluoro results: Residues on hard palate
Disorder: Decreased tongue elevation/strength
Patient symptom:
Food & drink comes out of my nose
Clinical sign: Early nasal regurgitation
Fluoro results: Nasal regurgitation before swallow is complete
Disorder: decreased VP closure
Patient symptom:
Food catches high in throat
Clinical sign: Delayed hyolaryngeal elevation
Fluoro results: Delayed vallecular pooling prior to pharyngeal initiation
Disorder: Delayed pharyngeal swallow
Food doesn’t go down; coughs & chokes
Clinical sign: No hyolaryngeal elevation; delayed oral transit; aspiration before swallow
Fluoro results: Delayed vallecular pooling with pre-spill into pyriforms/airway, aspiration before swallow
Disorder: Absent pharyngeal swallow
Cough food up; coughs, chokes
Clinical sign: Expectorates before and after pharyngeal swallow; coughs/chokes before and after
Fluoro results: Aspiration before swallow; valleculae & pyriform residues; expectoration
Disorder: Delayed pharyngeal swallow; decreased tongue base movement, decreased hyolaryngeal elevation
Sometimes food sticks high in throat
Clinical sign: Coughs/chokes after swallow
Fluoro results: Valleculae, pyriform, phary. wall residues; aspiration after swallow
Disorder: U or B pharyngeal paralysis/paresis; tongue base movement
Food catching in bottom of throat; coughs, chokes, regurgitates
Clinical sign: Cough/chokes after swallow; gurgle voice; increased saliva
Fluoro results: Aspirationafter swallow; pyriform residues; prominent CP/bar
Disorder: hyolaryngeal elevation; CP dysfunction- achalasia, stricture
Coughs/chokes
Clinical sign: coughs/chokes after swallow, decreased hyolaryngeal elevation
Fluoro results: Aspiration after swallow; decreased hyolaryngeal elevation; valleculae, pyriform, phary. wall residues
Disorder: U or B pharyngeal paralysis: decreased tongue base movement, decreased hyolaryngeal elevation
OR
Clinical sign: Coughs, chokes during swallow
Fluoro results: Aspiration during swallow, decreased airway closure
Disorder: decreased laryngeal closure
Hard to get food down, painful swallow/coughs (laryngectomy)
Clinical sign: Delayed swallow, high effort/coughs during swallow
Fluoro results: Delayed swallow, stricture/aspiration during swallow, asymmetrical VFs
Disorder: Psuedoepiglottis, scar tissue, stricture, muscle spas,, incomplete GC (asymmetry)
Something stuck in throat, sometimes coughs or chokes
Clinical sign: Occasional cough during swallow
Fluoro results: Narrowed pharynx; occasional penetration
Disorder: Cervical osteophytes
Hoarse voice
Clinical sign: Hoarseness, breathiness
Fluoro results: normal swallow or decreased airway closure
Disorder: normal or decreased laryngeal closure
Catches in lower throat; pain lower throat
Clinical sign: points to lower throat
Fluoro results: Prominent CP/CP bar
Disorder: CP dysfunction- achalasia
Catches in upper chest; pain upper chest
Clinical sign: points to upper chest; “beats” upper chest during/after swallow
Fluoro results: Esophageal residues; prominent LES
Disorder: Decreased esophageal peristalsis LES dysfunction
Food comes back up; coughs/chokes
Clinical sign: Regurgitation; coughs/chokes after swallow
Fluoro results: Esophageal retention/pocketing; backflow
Disorder: Esophageal diverticulum
OR
Clinical sign: Regurgitation; coughs/chokes after swallow
Fluoro results: Aspiration after swallow
Disorder: Esophageal obstruction; reflux
Coughs, chokes, material leaks out of some (laryngectomy with TEP)
Clinical sign: Coughs/chokes after swallow; stoma, leakage
Fluoro results: Esophagus -> trachea leakage, stoma leakage
Disorder: TEP fistula/misfit
