Introduction to Dysphagia

Question 1

Dysphagia

Answer 1

problems swallowing safely

Question 2

Aphagia

Answer 2

Inability to swallow

Question 3

Penetration

Answer 3

Food residue left in the vestibule above the vocal folds

Question 4

Aspiration

Answer 4

When food falls into trachea/lungs due to reflux or ingesting

Question 5

Feeding

Answer 5

Happens before swallowing initiated and assumes that client can swallow safely. Just have to work on food reluctance/ fear/ aversion/ motivation to swallow

Question 6

Danger Signs of Dysphagia

Answer 6

Coughing, gurgly voice, weight loss, recurrent pnemonia, weakness, inability to recognize food( dementia), drooling, secretions, inability to control food in the mouth

Question 7

Aspiration pneumonia

Answer 7

infection of the lungs due to aspirating

Question 8

Effects of Dysphagia

Answer 8

Weight loss, aspiration pneumonia, weakness, depression, dehydration

Question 9

Dysphagia assessment gold standard

Answer 9

small amounts of food or liquid to prevent aspiration pneumonia/ do not feed the patient, instead observe naturally or give small sips of water.
40% of patients silent aspiration missed @ screening. Modified Barium Best

Question 10

Stages of Swallowing

Answer 10

Oral Preparatory, Oral, Pharyngeal, Esophageal

Question 11

Oral Preparatory Stage

Answer 11

Chewing(mastication), adding saliva, forming a bolus

Question 12

Mastication

Answer 12

Complicated process- chewing control center- in Pons/ Cortical controls make adjustments due to sensory feedback

Question 13

Tongue

Answer 13

Both intrinsic (originate/insert inside tongue)/extrinsic (originate/insert outside tongue)

Question 14

SILL

Answer 14

Intrinsic muscles: superior longitudinal, inferior longitudinal, Lingua transverse, Lingua verticales

Question 15

Superior Longitudinal

Answer 15

raises the tongue tip

Question 16

Inferior Longitudinal

Answer 16

lowers the tongue tip

Question 17

Lingua transverse

Answer 17

elongates the tonge

Question 18

Lingua verticalis

Answer 18

flattens the tongue

Question 19

Gen
Hyoga
Senku
Petrification

Answer 19

Extrinsic Muscles:
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus

Question 20

Extrinsic Muscles

Answer 20

Gen
Hyoga
Senku
Petrification

Question 21

Genioglossus

Answer 21

Most of tongue/protrusion&depression

Question 22

Hypoglossus

Answer 22

depress&retract tongue

Question 23

Styloglossus

Answer 23

retract the tongue

Question 24

Palatoglossus

Answer 24

depresses the soft palate and moves the faucial pillars toward midline

Question 25

Mastication Muscles

Answer 25

Primary-attach mandible to skull | Secondary- attach mandible to anything else like hyoid/thyroid

Question 26

Close the Mouth

Answer 26

Temporalis Masseter Medial pterygoid

Question 27

Open the mouth

Answer 27

gravity & lateral pterygoid

Question 28

anterior/ventral

Answer 28

front

Question 29

posterior/dorsal

Answer 29

back

Question 30

superior

Answer 30

top

Question 31

inferior

Answer 31

bottom

Question 32

Anterior Movement of the Jaw

Answer 32

* Masseter * Medial pterygoid * Lateral pterygoid

Question 33

Posterior Movement of the Jaw

Answer 33

Temporalis

Question 34

Oral Stage

Answer 34

Bolus starts to move from tongue through faucial pillars. Tongue lift to hard palate, Tongue peristaltic movement, Hyoid bone to lift and larynx lifts and tilts

Question 35

Epiglosttis

Answer 35

laryngeal cartilage/ falls down over larynx to prevent food from falling into trachea

Question 36

Cricopharyngeus>PE Segment> UES

Answer 36

upper part of the esophagus- muscle that allows food to go through to esophagus

Question 37

Pyriform Sinuses

Answer 37

pockets at the rear lateral edge of the larynx

Question 38

Larynx

Answer 38

upper portion of trachea, vocal box, contains vocal cords

Question 39

Pharynx

Answer 39

tube from behind faucial pillars to UES & Larynx (nasopharynx, oropharynx, laryngopharynx)

Question 40

Pharyngeal Stage

Answer 40

takes less than a second. Bolus travels from top of the pharynx to UES. Lift/tilt of larynx causes UES to stretch open, epiglottis to fall down ontop of larynx and aretynoids to move forward creating a seal over the trachea

Question 41

Pharyngeal Muscles

Answer 41

superior, medial, inferior constrictors

Question 42

Esophageal Stage

Answer 42

Eight to twenty seconds, movement of bolus through UES and down into lower sphincter and stomach. Involuntary

Question 43

Swallowing can be initiated

Answer 43

Pressure, liquid against pharynx, tactil stimulation

Question 44

Swallowing

Answer 44

respiration stopped, caused by stimulating pre-motor area, neurons needed for pharyngeal/esophageal stages in Brain stem

Question 45

Swallowing continued

Answer 45

Brainstem-neurons necessary | Cortex- initiation and neuromuscular activity

Question 46

Pons

Answer 46

when stimulated can activate swallowing and chewing