Dysphagia - through the lifespan

Question 1

What is involved with swallowing and pre-natal infants?

Answer 1

Pharyngeal swallowing - 15 weeks
Suckling develops - 16-24 weeks

Question 2

What is the swallowing anatomy like in 0-6 month infants?

Answer 2

Large tongue relative to oral cavity
Cheeks have sucking pads
Very small mandible
No distinct oropharynx
Larynx - 1/3 size of an adult
Narrow trachea and oesphagus

Question 3

What are the swallowing functions like in 0-6 month infants?

Answer 3

0.2ml volume swallow
Rooting reflex - food searching behaviour
Suckling and sucking

Question 4

What is feeding development like at 0-36 months?

Answer 4

Infant develops volitional control
Chewing begins - munching first - develops into rotary lateral chewing
Independent self-feeding

Question 5

What is feeding development like at 36+ months?

Answer 5

Independent
Socially and culturally acceptable feeding is refined during childhood

Question 6

What is swallowing like in older adults at the oral preparatory and pre-oral stage?

Answer 6

Loss of teeth and reliance on dentures
Reduced salivation
Reduction in smell and taste
Loss of tongue muscle mass
Increased oral transmit time
Reduced oral clearance
Increased post-swallow oral residue

Question 7

What is swallowing like in older adults at the pharyngeal stage?

Answer 7

Change in swallow trigger timing
Loss of pharyngeal and laryngeal muscle mass
Increased pharyngeal transmit time
Reduced pharyngeal clearance
Increased apneoic period
Reduced cough sensivity and cough strength
Influence of postural changes