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Swallowing > L9 Treatment Part 1 > Flashcards

L9 Treatment Part 1 Flashcards

1
Q

List the 6 types of dysphagia therapy

A

1) compensatory
2) swallow maneuvers
3) supplemental dimensions
4) active exercises
5) surgical
6) pharmacological

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2
Q

Of the 6 types of therapy, SLPs are responsible for which ones?

A

1-4

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3
Q

T or F: compensatory therapy improves underlying physiology

A

False

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4
Q

T or F: swallow manœuvres can be compensatory or rehabilitative?

A

true

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5
Q

List the types of compensatory interventions

A
  • posture
  • increased sensory awareness
  • controlled intake
  • intraoral prosthesis
  • pharyngeal clearance
  • adaptive utensils
  • environment
  • food consistency
  • alternative feeding mode
  • oral hygiene
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6
Q

describe tilt head forward (chin tuck)

A
  • increases airway closure
  • moves base of tongue towards PPW
  • can make it worse in people who have pyriform sinus reside
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7
Q

Describe tilt head backward

A
  • gravity helps overcome oral transport issues
  • we need to know that their pharyngeal swallow is prompt and reliable
  • use preparatory breath hold
  • **wouldn’t want to do this for someone who has difficulty following directions
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8
Q

Describe turn head to impaired side

A
  • used with one sided weakness
  • blocks of weak side, taking it out of the equation
  • aids with UES opening
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9
Q

Describe tilt or lean head to stronger side

A

-helps direct bolus to good side preventing oral spillage

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10
Q

Describe lie down on side

A

-more intense version of tilt head to good side, not used often

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11
Q

How might you implement these strategies for someone who has cognitive deficits?

A

-sit where you want their head to turn or bring spoon a bit lower so they have to chin tuck

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12
Q

Compensatory posture strategies are very effective in people who are _________

A

cognitively intact

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13
Q

T or F: compensatory postures can be used in combination

A

true

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14
Q

What food properties are used to increase sensory awareness

A
  • hot/cold
  • fine/course
  • sweet/bitter/sour
  • carbonation
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15
Q

What are 3 ways that we can control intake

A
  • rate
  • amount
  • placement of food
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16
Q

Intraoral prostheses are used to compensate for ________ deficits

A

structural

17
Q

What are two common compensatory strategies to aid in pharyngeal clearance

A
  • multiple swallows

- liquid/puree wash

18
Q

What are some compensatory interventions about modifying the environment

A
  • increase external cues
  • decrease distractions
  • strategic placement at table
19
Q

List the different food consistencies from thin to solid

A 
thin liquids
nectar thick liquids
honey thick 
pureed solid
ground/minced
chopped
soft solid
regular solid
20
Q

Jello is considered a _________ food

A

transitional

21
Q

What are the reasons we eat?

A
  • nutrition/hydration
  • pleasure
  • social reasons
  • emotional reasons
  • practice (if they have dysphagia)
22
Q

What are two systems that quantify different textures/ viscosities?

A
  • national dysphagia diet

- International dysphagia diet standardization initiative (IDDSI)

23
Q

When considering alternative feeding interventions must what we consider?

A
  • what is their likelihood of aspiration
  • can they tolerate aspiration
  • is their swallowing efficient/
  • fatigue
  • nutritional intake
  • QOL and patient preferences
24
Q

What are the 2 types of tube feeding?

A
  • enteral - NG, G tube, PEG, J tube

- Parenteral - TPN

25
Q

What are complications of enteral feeding?

A
  • infection at site of insertion

- tube dislodgement can lead to aspiration

26
Q

T or F: parenteral feeding is common in treatment of dysphagia

A

False

27
Q

Why is oral hygiene so important?

A

-the bacteria in our mouth can be aspirated and lead to aspiration pneumonia

28
Q

What are the benefits of oral care?

A
  • reduce unfavourable oral bacteria
  • reduce risk of aspiration pneumonia
  • increases desire to eat
  • increases ability to swallow
29
Q

List the 4 swallow maneuvers discussed in class

A
  • supraglottic swallow
  • super-supraglottic swallow
  • effortful swallow
  • Mendelsohn maneuver
30
Q

What is the purpose of the supraglottic swallow

A

to close the airway entrance before and during the swallow

31
Q

What is the purpose of the super-supraglottic swallow

A

to FORCEFULLY close the airway entrance before and during the swallow

32
Q

What is the purpose of the effortful swallow

A

to increase posterior motion of the tongue base during the pharyngeal swallow and thus improve bolus clearance form the valleculae

33
Q

What is the purpose of the Mendelssohn maneuver

A

To increase the extent and duration of laryngeal elevation and thereby increase the duration and width of cricopharyngeal opening. It also increases the overall coordination of the swallow.

34
Q

what are the two factors of supplemental interventions/

A
  • intensity

- timing

35
Q

What were the general results of the free water protocol question?

A

low quality evidence that there is no significant increase in odds of having lung complications in rehab setting

  • low quality evidence of increase in fluid intake
  • increased QOL and satisfaction scores
36
Q

What were the results from the General Dysphagia Program,?

A
  • trend in favour of swallowing treatment > usually care
  • increased recovery of functional swallow, and decrease in chest infection in high intensity > low intensity > usual care
37
Q

What are the evidence based compensatory & supplemental therapies?

A
  • intensity
  • decontamination
  • timing (early identification from screening)
  • posture, texture, taste, Temperature, controlled intake, maneuvers
38
Q

T or F: Earlier screening for dysphagia leads to changes in health outcomes of pneumonia, malnutrition, dehydration and mortality

A

True - earlier screening leads to earlier diagnostic work up and then treatment

Swallowing (15 decks)

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