Feeding Flashcards
Aspiration
Food or liquid entering airway before, during, or after swallow
GERD
gastroesophageal reflux disease
Swallowing phases
Oral preparatory, oral, pharyngeal, esophageal
MBSS
Upright modified barium swallow (Videofluroscopic swallow study) assesses oral, pharyngeal, and upper esophageal anatomy and function during feeding and swallowing
Feeding
(Self-feeding) the process of setting up, arranging, and bringing food from the table, plate, or cup to mouth
Eating
the ability to keep and manipulate food or fluid in mouth and swallow it
Swallowing
Complex act in which food, fluid, medication, or saliva is moved from the mouth through the pharynx and esophagus into the stomach
Oral preparatory phase
Oral manipulation of food occurs using jaw, lips, tongue, teeth, cheeks, and palate to form food bolus
Oral phase
The tongue elevates against the alveolar ridge of the hard palate, moving the bolus posteriorly, and ends with onset of pharyngeal swallow
Pharyngeal phase
(Primarily reflexive) swallowing is triggered at the anterior faucial arches. Hyoid and larynx move upward and anteriorly, and epiglottis retroflexes to project the opening of the airway. Opening of upper esophageal sphincter.
Esophageal phase
(Not voluntary) relaxation of cricopharyngeus muscle to open the upper esophageal sphincter and ends with relaxation of the lower esophageal sphincter at the distal end.
Laryngeal penetration
The flow of food or liquid underneath the epiglottis into the laryngeal vestibule, but not into the airway
GI endoscopy
Uses a flexible endoscope with a light and camera that is inserted into a nostril and down the throat. Child then chews and swallows. diagnose inflammation or structural abnormalities
Upper GI series
Fill with liquid barium, x-ray test used to define the anatomy of the upper digestive tract.
Esophageal pH probe
Probe inserted into esophagus through nose to monitor abnormal acid levels over 24 hours to discover presence or severity of GER
Dysphagia
Difficulty or discomfort swallowing
FEES
Fiberoptic Endoscopic Evaluation of Swallowing.
Analyze the swallow mechanism, r/o aspiration, ID safe food and liquid consistencies, visualize anatomic structures during swallowing
Environmental adaptations for feeding
Mealtime routines—location of meals, length of meal periods, sensory stimulation within the environment, changes to the order of mealtime activities (solid before liquid, preferred b/f nonpreffered)
Positioning adaptations for feeding
Aims to provide stability in the trunk and support the child in a midline orientation with the head and neck aligned in neutral or slight flexion during oral feeding
Oral reflexes: Sucking
8 to 10 months
Suckling (forward and backward movement of the tongue) - predominates up to 4 months
Sucking (upward and downward movement of the tongue)
Oral reflexes: Phasic bite reflex
Automatic - 3 to 4 months
Munching - 6 to 9 months
jaw bites down-need to open up jaw to release whatever has been bit
Oral reflexes: Gag
From stimulus to tongue
Oral reflex: Cough
From stimulus to larynx
Oral reflex: Swallowing
From bolus in pharynx
