Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3rd year > Dysphagia Rehabilitation and Compensation > Flashcards

Dysphagia Rehabilitation and Compensation Flashcards

1
Q

What is neural plasticity?

A
  • The lifelong ability of the brain to change and rewire itself in response to the stimulation of learning and experience
  • Strengthen existing neural connections or make new ones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the four things needed to increase power and endurance in swallowing muscles?

A
  • overload (gradually increasing intensity/difficulty of intervention over time)
  • specificity of training
  • repetition
  • recruitment of additional motor units
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a supraglottic swallow and when is it used?

A
  • Used when timing of swallow is delayed
  • Aims to protect airway by closing it before swallow
  • Take bite of food/ sip of drink. With mouth closed, take a deep breath and hold it. Vocal cords will be consciously closed. Swallow. Cough immediately after to eliminate any residue.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a super supraglottic swallow and when is it used?

A
  • Used when airway protection is impaired and have additional pharyngeal weakness
  • Fill lungs with air. Hold breath tightly and bear down (like you’re having a bowel movement). Vocal cords consciously closed. Swallow. Cough to eliminate any residue.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mendelsohn Manoeuvre

A
  • Works on the UPWARDS and FORWARDS movement of the larynx
  • Improves airway closureand opens the UES
  • Swallow your saliva and use the muscles in your throat to hold the larynx UP at the top of the swallow
  • Hold for 3 seconds then release back down
  • Can palpate to feel this!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Effortful swallow

A
  • Strengthens muscles in the base of the tongue
  • During swallowing, your tongue acts as a pump and pushes the bolus to the back of your throat and down your esophagus
  • Swallow saliva or a small sip of water while squeezing the muscles in your throat as hard as you can

(If this is tricky, imagine you are swallowing a golf ball! Using a mirror, you may be able to see the exaggerated muscle effort as you swallow)

  • The increased drive of the bolus through the pharynx reduces residue in the valleculae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Masako manouevre (aka tongue hold)

A
  • During swallowing, the tongue acts as a pump to push bolus to back of throat and esophagus
  • Masako designed to strengthen base of tongue and reduce residue
  • Hold tip of tongue tongue between teeth and swallow
  • Should NOT be completed with food or fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Shaker exercise used for

sha-KEER

A
  • Used for patients with poor upper esophageal opening
  • Strengthens muscles in the throat to increase anterior hyolaryngeal excursion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hyolaryngeal excursion?

A
  • As the hyoid moves, the larynx is pulled along with it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Closure of the larynx is needed to form a seal to the entrance of the trachea to protect the airway.

How is this closure achieved?

A
  • Through hyolaryngeal excursion!

(As the hyoid moves, the larynx is pulled along with it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the shaker exercise

A
  • Lie flat on your back (shoulderblades and head touches floor). Lift and tuck your head, bringing it as close to your chin as you can. Look at your feet for UP TO one minute.
  • Only lift head and not shoulders!
  • Rest for one minute. Repeat twice.
  • (repetition) Lie flat on your back. Lift your head and look at your feet 30 times. (can work up repetitions gradually)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is CTAR?

Why do we use it?

A
  • Chin tuck against resistance
  • Sit upright.

-Place a resistance object (eg large rubber ball or rolled up towel) underneath chin, then lower chin as close to chest as possible slowly and steadily, squeezing the ball/object as hard as possible.

  • hold for up to 60 seconds
  • then lift head and relax for one minute
  • Alternatively can do repetitions of this by pushing your chin down firmly and releasing. Do this 30 times in a row
  • for clients who cannot tolerate the Shaker exercise
  • strengthens muscles under chin to improve strength of swallow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is LSVT?

A
  • Lee Silverman Voice Treatment
  • Designed to improve voice intensity (loudness) in Parkinson’s Disease
  • Used in patients with dysphagia to improve neuromuscular control, respiratory flow and overall motility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is EMST?

A
  • Expiratory muscle strength training
  • Aims to improve effectiveness of cough (protects airway and its closure during swallowing)
  • Can use nose clips or pinch your nose to stop air from escaping
  • Take a deep breath and blow into tube as hard and fast as you can in a SHORT SHARP breath… lips need to be sealed tightly!
  • You should be able to hear a rush of air (whoosh!) through the device which indicates you have blown hard enough
  • Designed to strengthen the expiratory and submental muscles (under middle of chin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thermotactile stimulation

A
  • Chilled dentist’s mirror is stroked along the faucial pillars to stimulate the swallowing reflex
  • (Less commonly used, effectiveness remains under question)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe compensation strategies in EDS management

A
  • Accommodates dysphagia rather than changing it
  • Aims to achieve safe and efficient swallow
  • COMPENSATE for dysphagia
17
Q

Describe rehabilitation strategies in EDS management

A
  • targets specific aspects of function to be changed by treatment
  • takes into account neural plasticity
18
Q

Name 5 motor rehabilitation strategies WITH swallow

A
  1. supraglottic swallow
  2. super supraglottic swallow
  3. Mendehlson manoeuvre
  4. effortful swallow
  5. Masako manoeuvre
19
Q

Name 4 motor rehabilitation strategies WITHOUT swallow

A
  1. CTAR
  2. Shaker exercise
  3. LSVT
  4. EMST (expiratory muscle strength training)
20
Q

Name 4 types of compensation in EDS management

A
  1. postural change
  2. techniques to increase control of bolus
  3. diet modification (volume/thickness)
  4. changes to the environment
21
Q

Describe why using chin tuck when swallowing is effective in dysphagia compensation

A

Because it narrows the diameter of the airway

22
Q

Chin tuck

A

With food in mouth, just before swallow, tuck your head down with your chin close to chest (give yourself a double chin ha ha)

Swallow hard and fast, keeping head down

This closes off airway and protects it!

23
Q

Head turn

A
  • This can help with one sided weakness (eg stroke)
  • With food in mouth, just before swallow, turn your head to the affected/weaker side
  • Then swallow
  • This cuts off the weakened side of the airway and protects it… food will only go down the strong side
24
Q

3 second prep

A

After chewing and forming the bolus, get ready to swallow but hold it in your mouth and count to 3 before oral transfer

Then swallow

Aids bolus control and formation

This is a compensatory strategy

25
Q

Alternate solids and liquids

A

After a mouthful of food, swallow, then take a drink and swallow

This clears any residue from the oral cavity and valleculae

This is a compensatory strategy

26
Q

Rate of intake

A

This is keeping a steady rate of feeding yourself / person with dysphagia and allowing plenty of time within mouthfuls

This allows time to clear residue of the oral cavity

27
Q

Cued swallow

A

Take a mouthful, chew / form the bolus and then you will be instructed by another person when to swallow

This can be effective in overriding any physiological processes which may be causing dysphagia

this is compensatory

28
Q

Chin tuck

A

compensatory

When bolus is formed, lower your chin to your chest and then swallow with your chin tucked

This helps to close off the airway to prevent aspiration and opens the UES

Also helps movement of the tongue base

29
Q

Head tilt/turn

A

compensatory

Can be used in unilateral weakness, head turns towards the weaker side to close off the airway in that side

Stronger side swallows sucesssfully and reduces risk of aspiration

30
Q

Neck extension

A

compensatory

can only be used if patient has good airway closure

helps move the bolus from oral cavity into the pharynx

31
Q

Double swallow

A

swallow twice

helps to clear oral residue and vallecular residue

compensatory

32
Q

effortful swallow

A

swallow hard

imagine swallowing a golf ball

can use a mirror to see the muscles

compensatory

increases pressure in the pharynx

33
Q

suck swallow

A

form bolus, use muscles in the mouth to suck and then initiate swallow

this helps to clear oral and vallecular residue

compensatory

34
Q

dump and swallow

A

used for patients with very little tongue movement at all

another person will put the bolus at the back of the oral cavity

then you swallow

reduces oral residue and improves formation of bolus

35
Q

Supraglottic swallow

A

take a deep breath and hold it, but a small mouthful of food/liquid in, form the bolus, swallow and then immediately cough

this helps with consciously closing over the vocal folds (and entrance to the trachea), reducing residue in oral cavity and valleculae

used when airway is impaired

36
Q

Super supraglottic swallow

A

same as supraglottic but when holding your breath, bear down (as if having a bowel movement)

this engages the muscles in the pharynx

used for airway impairment and pharyngeal weakness

37
Q

me

A

3rd year (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions