Feeding And Swallowing Flashcards
Oral motor system
Physical structures and neuromuscular functions
Dysphagia
Impairment in the ability to swallow
Oral motor functions
Strength and coordination
Oral motor muscular tone
Tension and posture of articulators
Oral motor sensation
Sensitivity to taste, movement, and textures
Deglutition
Ability to swallow
Odynophagia
Painful swallowing
Peristalsis
Wave like contraction in esophagus to move bolus
Involuntary
Aspiration
Bolus below the level of the vocal folds
Four stages of swallowing
Oral prep phase
Oral stage
Pharyngeal phase
Esophageal phase
Oral prep phase
Initial placement of bolus into the oral cavity
Begin to break down with release if saliva
Mastication and lateralization
Oral stage
Time it takes prepared bolus to move posteriorly in a cohesive fashion
Pharyngeal phase
Swallowing response triggered involuntarily when bolus reaches the anterior faucial pillars
Esophageal phase
Bolus passes through UES, LES, then into stomach in 8-20 seconds
Alternative feeding (2)
Enteral feeding tube- supplementing PO with other forms of nutrition PEG tube (gastrostomy tube)- directly delivers food into stomach
Areas where bolus can get caught
Vallaculae
Pyriform sinuses
Larynx (above and below vocal folds)
Pediatric feeding disorder red flags
Persistent failure to adequately feed for a period of at least a month
Unsafe/insufficient swallow
Growth delay affecting height and/or weight
Poor appetite regulation
Pediatric feeding behaviors
Food refusal Food selectivity Rumination Pica Limited food intake Excessive food intake Oral motor hypersensitivity Oral motor hypo sensitivity Chewing problems Sucking problems
Instrumental procedures
Modified barium swallow (video fluoroscopy)- X-ray of swallow, mix with barium, identify compensatory strategies
Fiberoptic endoscopy exam of swallowing (FEES)- scope through the nose to visualize bolus and where it is getting stuck
Reasons why not to send patient out for testing
- Medically fragile
- Level of alertness is diminished
- Procedure might cause additional problems
Bedside swallow examination
- Review current and past medical record
- Interview patient on awareness of swallowing complaint
- Elaborate oral motor exam
- Trial feeding or observes client during meal
Compensatory approaches to treatment
Diet modification
Altered positioning during swallow
Intake modification
Meal setup and environment
Restorative techniques to treatment
Thermal stimulation
Effortful swallow
Mendelssohn maneuver
Supraglottic swallow
Dysphasia diet
Thin
Nectar-like
Honey-like
Spoon-thick
AAC assessment process
Identification of participation patterns and communication needs
Identification of capabilities related to communication
Symbol assessment
Feature match
Recommendations
Purposes of communication
Expressing wants and needs Information transfer Social closeness Social etiquette Communicating with oneself
Types of symbols
Aided Unaided Acoustic Graphic Manual Tactile
