Lecture 1: What is Dysphagia?

Question 1

What is Dysphagia? (2)

Answer 1

• Difficulty swallowing

- Difficulty moving bolus from mouth to stomach

Question 2

Is Dysphagia age specific?

Answer 2

No, it can affect newborns-geriatrics

Question 3

What are some consequences of Dysphagia? (4)

Answer 3

• Dehydration
• Malnutrition
• Aspiration pneumonia
• Quality of life

Question 4

What are some etiologies of Dysphagia? (4)

Answer 4

• Infection
• Structural malformations
• Surgery (thyroid, RLN, cervical)
• Conditions that weaken/damage muscles or nerves (CVA, PD, TBI)

Question 5

What are the types of Dysphagia? (4)

Answer 5

• Oral
• Pharygeal
• Oropharyngeal
• Esophageal

Question 6

What are the signs and symptoms of oral/pharyngeal dysphagia? (14)

Answer 6

1. Coughing or choking when swallowing
2. Difficulty initiating swallow
3. Food sticking in the throat
4. Sialorrhea/xerostomia
5. Drooling or spillage
6. Unexplained weight loss
7. Change in dietary habits
8. Penetration
9. Aspiration
10. Recurrent pneumonia
11. Change in voice (wet, gurgly voice quality)
12. Nasal regurgitation
13. Tearing and/or nose running
14. Sore throat

Question 7

What are the signs and symptoms of esophageal dysphagia? (7)

Answer 7

1. Sensation of food sticking in the chest
2. Chest pain
3. Oral or pharyngeal regurgitation
4. Change in dietary habits
5. Recurrent pnemonia
6. Reflux
7. Aspiration

Question 8

What are the signs and symptoms of silent aspiration? (2)

Answer 8

1. No cough reflux

2. Usually no other symptoms

Question 9

What is feeding?

Answer 9

Placement of food in the mouth before initiation of swallow

Question 10

What is swallowing? And what 3 stages incorporate it?

Answer 10

Transfer of food and drink from mouth to stomach (oral, pharyngeal and esophageal)

Question 11

How long does it take to administer a bedside swallow?

Answer 11

10-15 minutes for small bolus

Question 12

What is included bedside clinical assessment?

Answer 12

1. Medical history
2. Level of alertness
3. Patient interview
4. Oral motor exam
5. Assess swallow with small bolus

Question 13

What are signs and symptoms you look for in a bedside evaluation?

Answer 13

1. Spillage
2. Oral residue
3. Long treatment time
4. Cough
5. Throat clear
6. Gurgly voice
7. Tearing
8. Runny nose
9. Wrong sound

Question 14

What do you do in the diagnostic procedure? (5)

Answer 14

1. ID symptoms to find etiology
2. Examines physiology
3. Examines immediate effects of tx’s
4. Imaging
5. Nonimaging

Question 15

What physiology do you examine for a diagnostic procedure? (8)

Answer 15

1. Time
2. Tongue base motions
3. Epiglottic dysfunction
4. Laryngeal excursion
5. UES dysfunction
6. Peristalsis
7. Paralysis
8. Sensitivity

Question 16

What imaging is included in the diagnostic procedure? (5)

Answer 16

1. FEES
2. Videofluroscopy
3. Ultrasound
4. Videoendoscopy
5. Scintigraphy

Question 17

What are some non-imaging procedures for the diagnostic procedure? (4)

Answer 17

1. EMG
2. EGG
3. Acoustic
4. Pharyngeal manometry

Question 18

What are some treatments for dysphagia? (8)

Answer 18

1. Diet Modification
2. Compensatory strategies
3. Maneuver
4. Exercise
5. Stimulation
6. Experimental
7. Prosthetic
8. Surgery