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Dysphasia > lecture 4 > Flashcards

lecture 4 Flashcards

1
Q

HOw many, and what are the symptoms for oral dysphagia?

A

10:

  1. Cant hold food in the mouth
  2. Cant chew with closed mouth
  3. Cant chew cert. foods
  4. cant line up teeth
  5. Material goes all over mouth
  6. Cough chokes before swallow
  7. slow eating
  8. food sticks on the top of mouth
  9. food and drink comes out the nose
  10. slow eating that is worse with solids
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2
Q

When you suspect a client cant hold food in the mouth: what is the clinical sign?, what do you look for in the floro? and what is the disorder?

A

Clinical sign: Oral spillage
Floro results: Oral Spillage
Disorder: decreased lip closure/strenght

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3
Q

When a client cant chew with the mouth closed. what are the clinical signs, flouro results, and the disorders?

A

Clinical sign: Open mastication
Floro results: Open mastication
Disorder: Mouth breather/nasal insufficiency

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4
Q

WHen the client cant chew certain consistencies, during oral phase what are the clinical signs, fluoro results, and the disorders?

A

Clinical signs: Bolus stays on tongue and falls into sulci
Floro results: Bolus stays on the tongue and falls on the sulci
Disorder: Tongue immobility, decreased strength, decreased buccal and labial tension and strenght

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5
Q

When the client cant line up teeth, during oral phase what are the clinical signs, fluoro results, and disorders?

A

Clinical signs: mandible doesn’t align
Fluoro results: mandible doesn’t allow a-p view
Disorder:Inability to align dentition

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6
Q

When the clients bolus goes all over the mouth during oral phase what are the clinical signs?, Fluoro results, and the disorder?

A

Clinical sign:Bolus spreads in oral cavity
Fluoro result: Loss of bolus control (A-P) view
disorder: Decreased tongue coor/mvmt/strength and decreased oral sensation

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7
Q

When the client cough, chokes before swallow during oral phase what are the clinical signs, the fluoro results, and the disorder?

A

Clinical sign: Coughing choking before swallow
Fluoro: Pre spillage into valleculae or airway
Dx: less tongue coord/strength to hold

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8
Q

when the client displays slow eating during oral phase, what is the clinical sign, fluoro results and the disorder?

A

clinical sign: delayed oral transit
Fluoro results: delayed oral transit/tung pumpting/rolling and/or mid-tung residues
Disorder: Swallow aprxia (incoordination), decreased strength and scarring

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9
Q

when the client has food and drink coming out the nose during oral phase what are the clinical signs, fluoro results and disorder?

A

clinical signs: early nasal regurgitation
Fluoro results: Nasal regurgitation before swallow is comlete
disorder: decreased vp closure

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10
Q

When the food sticks to the top of the mouth during oral phase, what are the clinical signs, floro results, and the disorder?

A

Clinical signs: residues on hard palate
floro signs: Residues on hard palate
disorder: decreased tongue eleveation/strenght

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11
Q

If slow eating is worse with solids what is the clinical sign, fluoro results and the disorder?

A

CLinical signs: Deslayed oral transit
Fluoro results: Delayed oral transit, less tong elevation, and hard palate residues
Disorder” less tong elevation and tongue movement

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12
Q

HOw many and what are the symtoms for pharyngeal swallow disorder?

A

9:

  1. Food catches high in throat
  2. Food doesn’t go down; coughs & chokes
  3. Cough food up; coughs, chokes
  4. Sometimes food sticks high in throat
  5. Food catching in bottom of throat; coughs, chokes, regurgitates
  6. Coughs, chokes
  7. Hard to get food down, painful swallow /coughs (laryngectomy)
  8. Something stuck in throat, sometimes coughs or chokes
  9. Hoarse voice
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13
Q

Clinical sign, fluoro results and disorder when the client has a hoarse voice?

A

Clinical sign: harseness, breathiness
Fluoro result: normal swallow or decreased airway closure
disorder: normal or decreased larungeal closure

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14
Q

Clinical sign, fluoro results and disorder when the client has Something stuck in throat, sometimes coughs or chokes during pharyngeal swallow

A

Clinical sign: Occasional cough during swallow
fluoro results: Narrowed pharynx; occasional penetration
disorder: Cervical osteophytes

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15
Q

Clinical sign, fluoro results and disorder when the client has hard time getting food down (painful/coughing/laryngectomy) during pharyngeal stage

A

clinical sign:Delayed swallow, high effort / coughs during swallow
Fluoro:Delayed swallow, stricture / aspiration during swallow, assymetrical vf’s
diagnosis:

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16
Q

Clinical sign, fluoro results and disorder when the client has during pharyngeal stage

A

clinical sign:
Fluoro
diagnosis:Pseudoepiglottis; scar tissue; stricture; m. spasm / incompl gc (assymetry)

17
Q

Clinical sign, fluoro results and disorder when the client has Coughing and choking
during pharyngeal stage

A

clinical sign:Coughs, chokes during/after swallow, less elevation
Fluoro:Aspiration after/during swallow; ↓ hyo- laryngeal elevation; valleculae, pyriform, phary. wall residues, less airway closure from ant view
diagnosis:U or B pharyngeal paralysis; ↓ tongue base mvmt; ↓ hyo- laryngeal elevation, less laryngeal closure

18
Q

Clinical sign, fluoro results and disorder when the client has Food catching high in throat
during pharyngeal stage

A

clinical sign:Delayed hyolaryngeal elevation
Fluoro: Delayed vallecular pooling prior to pharyngeal initiation
diagnosisDelayed pharyngeal swallow

19
Q

Clinical sign, fluoro results and disorder when the client has Food that doesn’t go down; coughs & chokes
during pharyngeal stage

A

clinical sign:No hyolaryngeal elevation; delayed oral transit; aspiration before swallow
Fluoro: Delayed vallecular pooling w/ pre-spill into pyriforms/ airway, aspiration before swallow
diagnosis:Absent pharyngeal swallow

20
Q

Clinical sign, fluoro results and disorder when the client is Coughing food up; coughs, chokes during pharyngeal stage

A

clinical sign:Expectorates before & after pharyngeal swallow; coughs/ chokes before & after
Fluoro: Aspiration before swallow; valleculae & pyriform residues; expectoration
diagnosis:Delayed pharyngeal swallow; ↓ tongue base mvmt; ↓ hyo-laryngeal elevation

21
Q

Clinical sign, fluoro results and disorder when the client has food that sticks high in throat
during pharyngeal stage

A

clinical sign:Coughs/chokes after swallow
FluoroValleculae,pyriform, phary. wall residues; aspiration after swallow
diagnosisU or B pharyngeal paralysis/paresis;
↓ tongue base mvmt

22
Q

Clinical sign, fluoro results and disorder when the client has Food catching in bottom of throat; coughs, chokes, regurgitates during pharyngeal stage

A

clinical sign:Coughs/chokes after swallow; gurgly voice ↑ saliva
Fluoro: Aspiration after swallow; pyriform residues; prominent CP
diagnosis:↓ hyolaryngeal elevation; CP/CPG dysfunction; stricture

23
Q

Clinical sign, fluoro results and disorder when the client has Catching in lower throat; pain lower throat
during esophageal stage

A

CLinical:Points to lower throat
FluoroProminent CP; CP bar
Diagnosis:CP dysfunction

24
Q

Clinical sign, fluoro results and disorder when the client has Catching in upper chest; pain upper chest
during esophageal stage

A

CLinical:Points to upper chest; “beats” upper chest during/after swallow

FluoroEsophageal residues; prominent LES

Diagnosis↓ esophageal peristalsis; LES dysfunction

25
Q

Clinical sign, fluoro results and disorder when the client has Food coming back up; coughs/chokes
during esophageal stage

A

CLinical:Regurgitation; coughs/chokes after swallow

Fluoro: Esophageal retention/pocketing; backflow
DiagnosisEsophageal diverticulum; Zenker’s diverticulum

26
Q

Clinical sign, fluoro results and disorder when the client has Food coming back up; coughs/chokes
during esophageal stage

A

CLinical:Regurgitation; coughs/chokes after swallow

Fluoro: Aspiration after swallow
DiagnosisEsophageal obstruction; reflux

27
Q

Clinical sign, fluoro results and disorder when the client has Coughing/choking (laryngectomy w/ TEP); material leaking out stoma
during esophageal stage

A

CLinical:Coughs/chokes after swallow; stoma leakage

FluoroEsophagus>trachea leakage; stoma leakage
DiagnosisTEP fistula/misfit

28
Q

HOw many changes, and list the chages that occur past 80

A 
11:
Tongue muscle atrophy= less lingual propulsion
Hardening of cartilages (ossification)
laryngoptosis/presbylaryngeus
transit times increased=delayed
residue increased
UES reduced opening
Timing of swallow response/start delayed 
Frequent penetration into the airway 
Reduced sensations  
Reduced cough reflex
Piecemeal deglutition
29
Q

T/F: Aspiration is normal beyond the age of 80

A

Falso! Its NEVER ever normal

Dysphasia (12 decks)

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