Feeding Flashcards

Question

Biting

Answer 1

To tear and hold onto something

Answer 2

Happens from birth to 4-12 months because they haven’t gained that sitting posture yet 1 month - 1 suck, 1 swallow then - 2-3 sucks to swallow and breathe the whole time - Cough-lost this coordination - Breathing slows, within or between sucks 3-4 months - 20 sucks then swallow 9 months - Stop to swallow or breath 12months-should not be coughing - Suck followed by swallow and breathing

Answer 3

Aspiration is uncommon before 4 months of age, rapid change between 4 and 12 months The entrance of food into the larynx below the vocal cords Laryngeal Penetration - Entrance of food into the larynx above the vocal cords Auditory - Coughing or choking Silent - No swallow response - Pooling or wet sounds on auscultation - Change in voice - Change in patient color, vitals, or decreased O2 level

Answer 4

Combined with grasp Comes in around 32 weeks gestation When you stroke side of cheek, turn head toward that sensation

Answer 5

This is the most taxing and difficulty activity a baby undertakes, so problems often pop up 20-30 min Rooting and suck reflex decrease as child is full “When can I stop with bottle or breast”? - Biologically and physiologically 6 months can eat anything mashed - Varies from doc to doc - Culture and society driven - Mother’s preference

Answer 6

Birth-1year: suckling 3 months: suck develops 5-6 months: suck is stronger, primitive bite reflex to "munch", lip and tongue control improving 9 months: munching is voluntary, starting to move food around, lips are active 12 months: move to a cup, may lose liquids - rotary chew starts 18 months: jaw is stable, can drink from a cup - chews with lips closed 24 months: adult like patterns for suck and chew, swallows with lips closed, good tongue control - all table food

Answer 7

3-5 months - Reflexive munching - Can handle purred foods (suck it off spoon) 6 months - Some tongue lateralization - Control of the tongue 7-8 months - Diagonal patterns begin - Bite to hold only 9 months - Munching continues - Adds diagonal patterns - Voluntarily bites on objects - Lips are active rakers 12 months - Rotary chewing begins - Jaw stability - Controlled mobility - Coordination of tongue- moves food easily in mouth - Easily chews food, including meat 18 months - Meat and raw veggies - Bite to cut - Tongue can move food - Packing - No food loss 24 months - All food - Graded bite - Mature, circular bite - Good tongue movement - Good lip closure

Answer 8

6-8 months try to hold bottle - Radial digital (thumb and pointer) grasp on cookie 9-13 months - Develop posture that allows for self feeding - Good finger feeders - Older children may refuse to be fed (like doing it themselves) 15-18 months - Good with a spoon - pronated grasp, good with sticky food - May poke at spoon feeding at 12 months 24 months - Spoon with out spillage - Spoon feeding requires: - Posture - Midline head support - Hand to mouth skills - Disassociation of lip and tongue 30-36 months - Uses a fork Straws - 2 years - Sippy cups - spillage initially - Straws - require lip closure and strong suck - Also, cognitive skills - No spillage - By 2 there should be no backwash

Answer 9

In children - “Children have no sense of taste” LIE - Develops in utero - varying amniotic fluid - Breast babies are less likely to be picky eaters, why? - Whatever mom eats, baby will taste What about adults?

Answer 10

Connection to performance components Medical and developmental history Feeding observation

Answer 11

Instrumental Evaluations - use technology Electromyography: surface electrodes to determine if swallowing is occurring Barium swallow or Scintigraphy: pictured; barium is placed in bottle or cup, x-ray is taken and shows if there is any aspiration Videoflouroscopic study: moving x-ray Fiberoptic laryngoscope: camera is introduced Diagnostic ultrasound: anterior throat Manometry: catheter is introduced to the esophagus to measure force, timing, and sequence of swallow

Answer 12

Disorders of appetite Anatomic disorders - Oropharynx - Esophagus - Trachea Disorders affecting suck, swallow, breath - Usually CNS, ABI, CVA, CP - Have trouble with automatic and volitional aspects of feeding Coordination disorders - CP Infections/Inflammation Behavior/Experience/Many others

Answer 13

Difficulty with any stage of swallowing Not sensory related Not developmental Typically the result of: - Neuro insult - Structure

Answer 14

Nondegenerative - CVA (most common reason), Head Injury, Degenerative - Alzheimer's, dementia, general aging Remediation is often not an option Others: - Medication induced - Context - money, place, depression

Answer 15

Drooling Decreased mastication (chewing) Clearing throat Choking Nasal regurgitation Residual food in oral cavity Weight loss, dehydration, respiratory problems

Answer 16

Medical care Non use Neurological May see - Tongue thrust - Bite reflex - Gag reflex - Poor jaw grading - Tongue retraction - Inadequate suck - Inadequate chew - Drooling

Answer 17

Spasticity Hypotonic May not show up until solid food Problems - Head and neck control - Jaw excursion - Over or under active tongue - Postural instability - Hypotonic cheeks - Elevation of shoulder - Hypertonic bite * Tonic bite * Tongue thrust * Lip retraction, pursing

Answer 18

Poor head, neck and trunk stability - Fall over - Elevation of shoulders - Hyperextension of neck Open mouth-drooling Wide excursion Difficulty grading - Open or closed Difficulty in mid ranges - Not hard enough or wears self out Loss of food Tongue may be inactive - Or extreme in range Lips may not seal or be active - Spoon drag Cheeks - Packing

Answer 19

1. Paralytic - Lower motor neuron - Weakness or paralysis of oral structures - Swallowing reflex may be absent - Common in: CVA, TBI and Developmental disorders (MR) 2. Pseudobulbar - Upper motor neuron - Hyper or hypotonic oral structures - Common in: CVA, CP, TBI 3. Mechanical - Loss of structure or weakness due to trauma or surgery Common in: cancer, car accident

Answer 20

Pt history, diagnosis, surgeries etc. - Allergies!!!!!!!!!!!!!!!!!!!! - Who usually feeds and how - Where do they eat, what do they eat Current Nutritional source - NG tube - G tube (PEG) - Special diet Length of time a pt has been NPO Respiration Status Make sure you have ok for by mouth - Videofluorscopy, electromygraphy, endoscope, manometry, scinctigraphy, ultrasonography

Answer 21

Assess cognitive, perceptual and physical abilities (as appropriate) Level of arousal, ability to follow directions Ability to position self, move tongue, open mouth Ability to localize and recognize temp Desire to feed

Answer 22

Remember safety and exposure (you and client) Check ROM< strength of tongue lips and jaws Head control Vision Look at any reflexes, appropriate or not

Answer 23

Do a feeding trial - Do you have clearance - Try easy foods first and work up * Start where they’re at and take a step back - Make sure the client likes it - Watch, feel and listen To feel for swallow (both sides) - Index finger under chin - Middle finger at base of tongue - Ring finger over thyroid cartilage - Small finger above jugular notch

Answer 24

Remedial (rehabilitation) or compensatory Where and what can we impact? - Posture - Altering Food * Levels 1-3 to normal OT/SLP Treatment - Oral prep - Oral - Pharyngeal - Esophogeal-nope!

Answer 25

Pureed-baby food Mashed-potatoes, peas (what you can do with a fork) Chopped- broccoli, meats, carrots Full

Answer 26

smell, sight, salivation

Answer 27

Chew Form bolus

Answer 28

Bolus pushed toward back of throat

Answer 29

Soft palate elevates to close the nasopharynx Breathing stops

Answer 30

Things return to normal Food passes to stomach

Answer 31

* Types: NasoGastric (NG): short periods of time, for those that are immobile; or Gastrostomy (GT) or PEG (pericutaneous entergastric): fed through gut tube, surgical >With PEG you have continuous and bolus feeding. >Continuous – a drip all day everyday; they never get hungry >Bolus: 3-4 meals a day