Final Review Flashcards

1
Q

What the most common use of the chin tuck?

A

Increases oral control and premature spillage

Also:
Reduces premature spillage 
Increases Vallecular space
Bring base of tongue closer to pharyngeal wall
Improves airway protection
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2
Q

what is the most common use of the effortful swallow?

A

Assists with strength of transit in bolus

Also:
Helps with weak transit of food in pharyngeal and oral cavity

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3
Q

Which compensatory maneuvers are multipurpose?

A

Chin tuck
Head turn
Effortful swallow

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4
Q

Which maneuver do you use specifically for hyolaryngeal elevation?

A

Mendelson maneuver

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5
Q

Which maneuver is specifically used for airway protection?

A

Supraglottic swallow

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6
Q

Name 3 swallow treatments that may be used for adults?

A

Diet modifications
Tactile stimulation
Oral motor exercises

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7
Q

When evaluating infants what should we rely on?

A

The behavior of the infant

Most importantly the infants respiratory breathing

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8
Q

What is the main difference between treatment in adults and treatment in infants?

A

The treatment is centered around the infants parent/caregiver

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9
Q

Name the 5 treatment strategies used when treating children

A
Scheduling
Good quantities 
Environment 
Posture 
Oral stimulation
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10
Q

Why is posture important when treating children?

A

Because of gravity and airway protection;

It gives cues to engage in feeding behaviors

Allows the infant to maintain control of the bolus

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11
Q

Why is environment important when treating children?

A

It relates to the infants state:

State improves feeding

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12
Q

Basic anatomy of children

A

Oral cavity is proportionally smaller compared to size of their tongue
Larynx sits higher thus tongue is more forward
Tongue ONLY has oral portion
Epiglottis and soft palate are contacted at rest
Children have reflexes
Tongue and larynx relationship is more curved

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13
Q

What is the most common use of the head turn?

A

For unilateral weakness

Also:
For airway protection
Good for hyolaryngeal elevation 
Directs bolus to strong side 
Opening the UES
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14
Q

What makes the oral cavity smaller in infants?

A

The reduced size of the mandible

Therefore the ORAL tongue takes up much of the space

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15
Q

What two structures are in direct contact in infants?

A

The soft palate and epiglottis

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16
Q

The structures are elevated in infants?

A

The larynx and hyoid

17
Q

At what age does the larynx drop?

A

At age 2-4 years

18
Q

What is the difference in the pharynx in an infant compared to an adult?

A

Infants- gentle curve from nasopharynx to hypopharynx. No distinct oropharynx

Adults- curve is at a 90 degree angle.

19
Q

Name four important feeding reflexes

A
Tongue protrusion (see other flashcards)
Rooting (see other flashcards)
Suckling
- place nipple inside mouth
- stroke tongue or touch hard palate
- movement is rhythmical
- nutritive-nutritional intake vs. nonnutritive-oral gratification
Sucking 
- same only w/lip seal
20
Q

Describe the tongue protrusion reflex

A
  • touch ant. tongue and it protrudes from mouth
  • to prepare infant to eat
  • important to diminish to introduce spoon feeding
21
Q

Describe the rooting reflex

A
  • stroking infant’s cheek/mouth

- May be present longer in breastfed infants

22
Q

Swallowing and feeding are dependent on WHAT in infants?

A

Normal motor development

23
Q

Why is postural control important?

A

It affects feeding success/control and airway protection

24
Q

During the first 6 months, how do infants breathe?

A

Infants have belly breath

After 6 months, breathing becomes thoracic

25
Q

What can I see with normal breathing patterns?

A

Problems with muscle tone or coordination

26
Q

True/False: infants swallow and breathe at the same time

A

False!

27
Q

What effects does respiration have on sucking?

A

Continuous sucking may affect oxygenation level

Feeding can be disrupted due to respiratory tract issues

28
Q

How do you know a child is ready to feed?

A

If they can produce a normal non-nutritive sucking

29
Q

Name 3 advantages of NNS (non-nutritive sucking)

A
Calming/ better at regulating state
Increases feeding behaviors
Improves O2 
Faster gastric emptying 
Gain weight faster
Leave NICU sooner
30
Q

How do we assess infants swallowing?

A

Bedside swallow
FEES
MBSS

31
Q

What are some symptoms that infants are having swallowing problems? (Hint: 6 reasons)

A

Failure to thrive (gain weight, grow etc.)
Sudden change in feeding
Behavioral changes (before/after feed)
Weak suck
Cough/choking during feeding
Unexpected physiological changes after meals

32
Q

Name the motor related stress cues

A

Grimacing
Twitching
Hypertension of limbs

33
Q

Name the automatic stress cues

A
Gasp
Sigh 
Sneeze
Cough
Gag 
Respiratory changes
34
Q

Name 3 ways to assess postural control in infants

A

Muscle tone/posture/movement abnormalities
Evaluate head/neck/trunk alignment
Evaluate head support
Note abnormal compensatory Bx

35
Q

How can we supplement food for children with dysphasia?

A

Provide small frequent meals
Add calories to feeds (polyjoule, heavy cream, better etc.)
Vitamin or mineral supplements
NGT/PEG

36
Q

What do you look at during oral-motor/CN eval?

A
  • oral primitive reflexes that may interfere w/feeding (tongue protrusion)
  • oral structures and function - including dentition
  • CN screening (mostly observe this)
37
Q

What do you look at during feed/swallowing eval?

A
  • bottle feeding - NS vs NNS
  • note position on nipple
  • initiation of suckle/suck
  • mandibular excursion
  • feeding endurance
38
Q

What is the order of feed/swallowing eval for young children?

A
  • cup drinking
  • straw drinking
  • spoon feeding
  • biting/chewing solids (soft and hard)