Intro to Dysphagia Flashcards
What is dysphagia?
A chronic swallowing problem. It can be in either manipulation of the bolus or difficulty in swallowing itself.
True or False: Dysphagia is age-specific.
False: Dysphagia can occur amongst any age, from the newborn to the elderly.
True or False: Dysphagia is always secondary to another problem.
True.
What are the etiologies of dysphagia?
Infections, structural malformations, surgery, nerve damage, muscle weakness
What are the consequences of dysphagia?
Dehydration, malnutrition, aspiration pneumonia, and a decreased quality of life.
What are the types of dysphagia?
Oral, oropharyngeal, pharyngeal and esophageal.
What might lead to oral dysphagia?
Difficulty in tongue movement, lip closure, pocketing and transport.
What might lead to pharyngeal dysphagia?
Incomplete airway closure, residues, motility issues, and UES issues.
What is oropharyngeal dysphagia?
When there are deficits in both the oral phase and the pharyngeal phase.
What might lead to esophageal dysphagia?
Issues with motility, LES, a fistula, a diverticulum, reflux, or an ulcer
What is the most important dysphagia and why? Is it very common?
Pharyngeal dysphagia is the most important because of airway protection; it is very common.
What does the oral stage consist of?
Mastication, bolus formation, and bolus transport from the oral cavity to the pharynx; basically everything from the lips to the back of the tongue.
What does the pharyngeal stage consist of?
The epiglottis inverts over the laryngeal vestibule, the larynx and the hyoid bone are pulled anteriorly and superiorly to open the pharynx, the cricopharyngeus relaxes allowing the bolus to enter the esophagus. Pharyngeal constrictor muscles propel the bolus into the esophagus.
What does the esophageal stage consist of?
The bolus is moved down the esophagus via peristaltic waves and the LES relaxes allowing the bolus to move into the stomach.
What are signs or symptoms of oral or pharyngeal dysphagia?
- Coughing or choking while swallowing
- difficulty initiating swallow
- food sticking in the throat
- sialorrhea or xerostomia (excessively salivated or dry mouth)
- drooling or spillage
- unexplained weight loss
- change in dietary habits
- penetration
- aspiration
- recurrent pneumonia
- change in voice (wet, gurgly voice)
- nasal regurgitation
What signs does silent aspiration have?
None.
Explain the difference in penetration and aspiration.
Penetration is when the residue from the bolus sits at or just above the level of the vocal folds. Aspiration is when residue enters the trachea.
What are signs/symptoms of esophageal dysphagia?
- Sensation of food sticking in the chest or throat
- oral or pharyngeal regurgitation
- change in dietary habits
- recurrent pneumonia
- reflux
- aspiration
Describe the difference in feeding vs. swallowing.
Feeding is the oral prep stage (placement of food before swallow). Swallowing is the transfer of food/drink to the stomach (the three stages.)
