Lecture 2 Flashcards
1
Q
Aspects of mealtime environment
A
- lighting
- noise
- meal layout
- meal assistance
- food/drink presentation
- presence of others
2
Q
What is penetration?
A
Enters level above vocal folds, cleared with coughing
3
Q
What is aspiration?
A
Goes below vocal folds, into lungs
4
Q
What is the Risk of aspiration
A
If any aspirated material is pathogenic, aspiration pneumonia can develop
5
Q
Risk factors influencing the development of aspiration pneumonia?
A
- Dependant for feeding/oral care
- number of decayed teeth
- tube feeding
- number of medications
- smoking
- having dementia
- stroke
- alcohol abuse
6
Q
Clinical bedside examination of swallowing (CBE)
A
- aims to provide an overview of the oral and pharyngeal phases of swallowing during eating and drinking tasks
- useful to be carried out when the client is having a meal
7
Q
Advantages of CBE
A
- easily incorporated into a clinic or ward visit
- non-invasive and no exposure to toxic substances
8
Q
Disadvantages of CBE
A
- does not necessarily tell you about the underlying impairment
- pharyngeal function is inferred
9
Q
What’s involved in a CBE?
A
- client is presented with trials of food and liquids of different consistencies and bolus sizes
- SLT observes swallow and aims to create a profile of areas of strengths and breakdowns
10
Q
What to determine in a CBE
A
- is the client safe on oral intake? If so what type?
- is the swallow efficient for meeting nutrition/hydration needs
- what factors are influencing the swallow, e.g. fatigue, cognition, caregiver approach
- is further objective assessment necessary
11
Q
Extra things to note in a CBE
A
- lip seal
- bolus control
- timing of swallow
- coughing (immediate or delayed)
- number of swallows per bolus
- drooling
12
Q
Laryngeal palpation of the swallow
A
- the SLT uses their fingers to palpate the swallow for timing, completion of laryngeal elevation and excursion and number of swallows
13
Q
Signs/symptoms of aspiration
A
- immediate cough/throat clear
- delayed cough/throat clear
- wet voice or voice change
- colour change
- ear tearing
- post prandial sleepiness
- drop >2% in 02 sats
14
Q
Adjuncts to the CBE; cervical auscultation
A
- listens to the sound of swallowing
- the bigger the bolus and the thicker the consistency, the longer the sound