intro to dysphagia Flashcards
What is dysphagia
difficulty swallowing or difficulty moving bolus from the mouth to the stomach
is dysphagia age specific
no
what are etiologies of dysphagia
- infection
- structural malformations
- surgery (thryoid/RLN/cervical)
- conditions that weaken/damage muscles/nerves (CVA,PD,TBI)
what are the consequences of dysphagia
- dehydration
- malnutrition
- aspiration pneumonia
- quality of life
what are the different types of dysphagia
- oral
- pharyngeal
- *oraopharyngeal
- esophageal
what does oral dysphagia include
- tongue mvmt
- lip closure
- pocketing
- transport
what does pharyngeal dysphagia include
- airway closure
- residues
- motility
- UES
what does esophageal dysphagia include
- motility
- LES
- fistula
- diverticulum
- HCI: reflux, ulcer
how many stages of dysphagia are there
3 per carmichael
- oral
- pharyngeal
- esophageal
logemann puts oral prep as stage 1 putting a total of 4 stages
what is involved in the oral prep/oral stage
- mastication
- bolus formation
- bolus transport from the oral cavity to the -pharynx
how long is the oral prep/oral stage
time varies with bolus consistency
how long is the pharyngeal stage
~1 second
what is involved in the pharyngeal stage
- epiglottis inverts over the laryngeal vestibule
- larynx and hyoid bone are pulled anteriorly and superiorly to open the pharynx
- relax the cricopharyngeus (UES) muscle
- assist VFs in closing off the glottis
- bolus is propelled through the pharynx toward the esophagus by action of pharyngeal constrictors
how long is the esophageal stage
~10 seconds
what is involved in the esophageal stage
- bolus flow through the esophagus via peristalic contractions of striated and smooth muscle along the esophageal wall
- relaxation of LES allows bolus to flow into the stomach
what are the signs and symptoms for the oral or pharyngeal dysphagia
- coughing or choking with swallowing
- difficulty initiating swallowing
- food sticking in the throat
- sialorrhea/xerostomia
- drooling/ spillage
- unexplained weight loss
- change in dietary habits
- penetration
- aspiration
- recurrent pneumonia
- change in voice or speech (wet voice)
- nasal regurgitation
- wet, gurgly voice quality
what are the signs and 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
what are the signs and symptoms of silent aspiration
NO s/s
-possible signs: tearing, runny nose
what is feeding
-placement of food in the mouth before initiation of swallow
what stage involves feeding
-oral prep stage (salivation, presentation)
what is swallowing
transfer of food/drink from mouth to stomach
what stages involve swallowing
- oral
- pharyngeal
- esophageal
how long does a swallow screen take
10-15 mins administration/observation of a small bolus
what is included in a swallow screening
- administration/observation of a small bolus
- bedside clinical assessment
- look for signs and symptoms
- cannot assess A&P
- Pre-diagnostic
