feeding and eating

Question 1

eating

Answer 1

the ability to keep and manipulate food or fluid in the mouth and swallow it.

Question 2

Feeding

Answer 2

the process of setting up, arranging, and bringing food (or fluid) to the mouth

Question 3

Oral-motor skills

Answer 3

motor skills of the oral structures, including the jaw, tongue, lips, and cheeks.

Question 4

swallowing

Answer 4

a complex process that involved numerous muscles and nerves and consists of both voluntary and reflexive components

Question 5

stages of the normal swallow

Answer 5

Pre-oral phase- moves food or liquid to the mouth

Oral preparatory phase- the oral structures form the bolus by tasting, chewing, manipulation and containment

Oral phase- begins when the bolus is in the mouth and ends when the bolus enters the pharynx

Pharyngeal phase- Begins when the bolus enters the pharynx and ends when the bolus enters the esophagus

Esophageal phase- Begins when the bolus enters the esophagus and ends when the bolus enters the stomach.

Question 6

Pre-oral phase

Answer 6

• Cognitive and physical orientation to eating or feeding occurs.
• self feeding takes place in this phase as the food or liquid is brought to the mouth
• Primarily voluntary

Question 7

Oral phase of swallowing

Answer 7

transport of food

• involves processing food
• during bottle-feeding or breastfeeding, this stage involved extacting the liquid from the nipple
• Soft palate is in a lowered position, helping to prevent the bolus from entering the pharynx
• Generally under voluntary neural control with airway open.

Question 8

pharyngeal phase

Answer 8

Begins with the initiation of the swallow and ends with the food going into the esophagus
-cessation of breathing occurs during this phase

Question 9

Esophageal phase

Answer 9

Begins as the bolus moves through the esophagus and ends as the bolus moves into the stomach.

• this phase is entirely under involuntary neural control
• Breathing can occur during this phase of the swallow.

Question 10

cranial nerves involved in swallowing

Answer 10

V-trigeminal- sensory and motor
VII- facial- sensory and motor
IX- glossopharyngeal- sensory and motor
X- Vagus- sensory
XI- Spinal accessory- sensory
XII- Hypoglossal- motor

Question 11

Dysphagia

Answer 11

Difficulty in swallowing, may lead to aspiration, which is a misdirection of food, liquid or gastric contents into the lungs,
-can lead to aspiration pneumonia.

Question 12

3 possible causes of dysphagia in acute care

Answer 12

1) acute dysphagia- symptoms of current diagnosis
2) Chronic dysphagia
3) Dysphagia due to prolonged hospitalization

Question 13

interventions: anticipatory and pre-oral phase

Answer 13

Gaining shoulder ROM to bring spoon or cup from table to mouth.

• increased strength to grasp a variety of utensils for improved independence.
• energy conservation techniques
• alternatives for eating out in favored restaurants-
• how to prevent altered diet foods in appetizing ways.

Question 14

Interventions: oral preparatory phase

Answer 14

• provide cheek and jaw support to facilitate movement for efficiency with breakdown of food.
• to address weakness, decreased ROM
• remember postural stability- supporting trunk and pelvis before starting feeding.

Question 15

Interventions: oral phase

Answer 15

• use cold or sour bolus for clients with slow oral transit times.
• try thermal stim (cold) to encourage swallow
• utilize postural changes for swallowing such as chin tuck or turning head toward weaker side.
• consider swallowing techniques

Question 16

Pharyngeal phase

Answer 16

interventions require additional training and referral to a specialist with dysphagia

Question 17

Esophageal phase

Answer 17

consider team decisions focused on safety and comfort of client.