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Boards > Feeding > Flashcards

Feeding Flashcards

1
Q

Fiber endoscopic evaluation

A

An evaluation used to assess swallowing in which a flexible instrument is placed through the nostrils to view the pharynx, larynx, and trachea

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2
Q

Modified barium swallow

A

An evaluation using digital imaging to assess oral, pharyngeal, and upper esophageal function while ingesting various textures of food and liquids

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3
Q

Mendelsohn maneuver

A

Technique used to prolong the opening of the upper esophageal sphincter during a swallow, involves pushing the tongue into the upper palate while manually maintaining the Adam’s apple in an elevated position

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4
Q

Supraglottic swallow

A

Compensatory swallowing technique used to close the vocal cords before and during swallow
Steps:
- Take deep breath
- Hold breath while swallowing
- Cough to lear saliva or food

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5
Q

Pre-oral phase

A

Smell and visual appreciation of food
Stimulation of saliva
Mouth and UE motor movements to initiate the process of eating

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6
Q

Oral preparatory phase

A

Voluntary intake of food into mouth
Bolus formation with saliva
Chewing with molars and activation of buccal muscles to prevent pocketing
Bolus movement to the center of the tongue

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7
Q

Oral phase

A

Use of cheek and tongue muscles to retain bolus centrally
Posterior migration of bolus

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8
Q

Chin tuck

A

Compensatory swallowing maneuver that involves moving the chin towards the chest while swallowing, protects the airway and reduces the risk of aspiration

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9
Q

Advanced dysphagia diet

A

Dietary food texture modification described as soft consistency for safer swallowing that requires more advanced chewing ability
Examples:
- baked potato with skin
- moist pancackes
- thin sliced meat

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10
Q

Mechanically altered dysphagia diet

A

Dietary food texture modification described as moist, semi-solid consistency for safer swallowing that requires some chewing ability
Examples:
- cottage cheese
- ripe banana
- moist meat loaf
- scrambled eggs

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11
Q

Puree dysphagia diet

A

Dietary food texture modification described as smooth, uniform consistency for safer swallowing that requires very little chewing ability
Examples:
- pudding and plain yogurt
- smooth apple sauce
- whipped potatoes

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12
Q

Moderately thick dysphagia diet

A

Thickened liquid consistency so that it drips from a spoon for safer swallowing, progression from mildly thick that may be prepared with thickening gel or powder

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13
Q

Mildly thick dysphagia diet

A

Thickened liquid consistency for safer swallowing that is a progression from thin liquid
Examples:
- tomato juice
- fruit nectars
- egg nog

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14
Q

Thin dysphagia diet

A

Liquid consistency that requires an intact swallow
Examples:
- water
- ice chips
- broth
- coffee
- gelatin

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15
Q

Dysphagia diet levels

A
  1. Pureed foods
  2. Mechanical altered
  3. Dysphagia-advanced
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16
Q

Esophageal phase

A

Return of upper esophageal sphincter to tonic state
Passage of food through the esophagus to the stomach

17
Q

Pharyngeal phase

A

Soft palate elevation
Larynx and hyoid elevation and protraction
Cessation of airflow to prevent aspiration
Vocal cord closure when whole bolus is moved through the pharynx

18
Q

Dysphagia

A

Difficulty at any stage of the swallow- oral to esophageal

19
Q

Hypotonic feeding issues

A

Poor head, neck and trunk stability
- Fall over
- Elevation of shoulders
- Hyperext 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`

20
Q

Paralytic dysphagia

A

Lower motor neuron
Weakness or paralysis of oral structures
Swallowing reflex may be absent
Common in:
- CVA, TBI and Developmental disorders (MR)

21
Q

Pseudobulbar dysphagia

A

Upper motor neuron
Hyper or hypotonic oral structures
More common in pediatric population
Common in:
- CVA, CP, TBI

22
Q

Mechanical dysphagia

A

Loss of structure or weakness due to trauma or surgery
Common in:
- Cancer, MVA

23
Q

Put these in the order of which you would introduce them to a patient:
protein shake
water
diet coke
coffee with cream
black coffee

A

Protein shake
Coffee with cream
Diet coke
Black coffee
Water

24
Q

Texture progression for typical kids

A

Pureed - baby food
Mashed - potatoes, peas
Chopped
Full

25
Q

Dysphagia diet for adults or kids

A
  1. thick puree - pudding or apple sauce
  2. soft chewables - soft fruit (banana), cooked veggie
  3. drier chewable - bread, cookie
  4. foods that require biting - meat
  5. mixed textures - oatmeal with raisins
26
Q

Fluid progression

A
  1. None
  2. Spoon thick (commercial thicken)
  3. Texture of honey
  4. Nectar (pulp orange juice)
  5. Thin flavored fluids (coffee with cream, coke)
  6. Water
27
Q

Dysphagia level I diet

A

Pureed
Difficulty protecting airway
- Crush injury, trachs
Little or no jaw or tongue control
Delayed swallow
Homogenous food, no bumps or lumps, same consistency
Moves slower to allow the swallow reflex to kick in
Goal is for oral feeding, stepping stone, may not be enough for caloric intake alone

28
Q

Dysphagia level II diet

A

Soft food
Beginning rotary chew
Some tongue control
Minimally delayed swallow
Mild to moderate problems
Stick together
Good bolus, not fall apart
Provide good proprioceptive feedback

29
Q

Dysphagia level III diet

A

Advanced diet
Able to chew
Able to form a bolus from different textures
Minimal jaw or tongue issues
Swallow can be mildly delayed but intact bilaterally
Think things a kid can eat without supervision
- rice, cooked veggies
- no skins, tough or dry course food

30
Q

Dysphagia level IV diet

A

Regular diet

31
Q

How to initiate a swallow in pt with slow or delayed swallow

A

Frozen pacifier
Popsicle
Formula

32
Q

How to improve transit with feeding

A

Handling of head and jaw
Outside support
Thickened liquids
- Proprioception
- Easier control
Positioning

33
Q

How to increase strength or tone with feeding

A

Tongue exercises, jaw exercises-increase ROM and strength
Peanut butter, gum, tapping, vibration
Chin tuck and turning toward affected side

34
Q

How to effect poor tongue control with feeding

A

Exercises
Quick stretch

35
Q

Compensatory strategies for weakness with feeding

A

Manipulate food
Inspect after meals
Place food on strong side
Break meals up

36
Q

Compensatory strategies for abnormal reflexes with feeding

A

Avoid provoking them
Positioning
Exaggerate opening and closing of mouth

37
Q

Compensatory strategies for hyposensitivity with feeding

A

Temperature
Flavors

38
Q

Compensatory strategy for delayed swallow

A

Chin tuck

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