Intervention Flashcards
treatment that can improve TBR
lingual resistance
effortful swallow
tongue pull back
pretend to gargle
treatment that can improve laryngeal elevation
Mendelsohn effortful swallow effortful pitch glide supraglottic super-supraglottic Shaker/Head lift Chin tuck EMST
when is the effortful pitch glide used?
reduced laryngeal elevation, pharyngeal stripping wave & contraction
T/F: the Mendelsohn should be used if the patient has a neck injury
False - Mendelsohn should not be used if a patient has ANY neck injury
What physiologies can the Mendelsohn address?
reduced hyolaryngeal motion or excursion
decreased LVC (occurs in patients with reduced hyolaryngeal excursion)
reduced PES opening
What physiologies can the effortful swallow address?
- reduced TBR
- reduced pharyngeal contraction (including pharyngeal shortening & stripping wave)
- decreased epiglottic inversion
- decreased lingual pressures on hard palate
- decreased swallow duration (hyoid excursion, laryngeal closure, PES opening)
the difference between the supraglottic and super-supraglottic swallow?
effortful breath hold in super-supraglottic
cardiac patients or patients who have had a stroke should not be given this intervention
super-supraglottic, supraglottic swallow
physiologies that super-supraglottic address
delayed initiation of pharyngeal swallow
laryngeal elevation
laryngeal vestibule closure
what does supraglottic swallow address?
delayed initiation of the pharyngeal swallow
reduced/delayed laryngeal elevation & LVC
Shaker/head lift should not be used with what patients?
patients. w/cervical spine deficits, reduced movement of neck (head & neck cancer), cognitive limitation or other factors that lead to poor compliance
patients with reduced anterior hyoid excursion/movement and/or PES opening would benefit from
Head lift/Shaker
Masako/Tongue hold improves
the increased contraction of superior pharyngeal constrictor and anterior movement pulls pharyngeal wall forward
Masako/tongue hold targets
PPW by moving towards the BOT to help create pressure to push the bolus through the pharynx (keeping the tongue in place)
What would be the best treatment to use when using Bolus Control exercises?
Practice motor movement using food wrapped in gauze or use a chewy tube
(using gauze is better to use & is a natural reinforcement as food particles come out of the gauze as pt’s chew)
this treatment facilitates movement of the bolus from midline to the lateral portion of the oral cavity
bolus control exercises
strengthens lips & facilitates removal of food from utensils
lip protrusion - retraction
- facilitates strength for lips & cheeks
- strength in cheek reduces pocketing
- strength in lip to reduce anterior spillage
- lips: straw sucking against resistance, holding a screen behind lips against resistance
lips & cheek exercises
- exercises to improve movement of tongue from side to side
- helps w/ bolus manipulation to move bolus to molar
- facilitates bolus manipulation to molar table for chewing
tongue lateralization
- facilitates oral phase & containment of bolus in oral cavity
- helps with anterior oral containment
- strengthens tongue to facilitate clearing of bolus from oral cavity
tongue tip elevation
types of biofeedback
FEES EMST sEMG MDTP IOPI Tongueometer High-resolution monometry
bolus prep/manipulation targets what?
moving bolus around in the mouth (anterior, lateral, posterior)
bolus maintenance targets what?
keeping the bolus from falling over the tongue base, out of the front of the mouth or in the lateral sulci
bolus propulsion targets what?
moving the bolus posteriorly (towards the back)