lecture 8 Flashcards
4 mina functions pg GIT
Motility
secreation
digestion
absorption
made up of upper/lower/ accesory organs
Common Disorders Affecting the Oral Cavity
Xerostomia
• Mucositis (stomatitis)
Dysgeusia
Dysphagia
Xerostomia
– Decreased saliva production and dry mouth
• Mucositis (stomatitis)
– Inflammation of the membrane of the mouth
– Thrush*: mucositis with candida infection (fungal)
• Dysgeusia
– Altered sense of taste
Dysphagia
– Definition: difficulty swallowing solids and/or liquids
Phases of the Normal Adult Swallowing Process
- Oral preparatory phase: chewing, mixing saliva into bolus
- Oral transition phase: tongue pushes food to back
- pharyngeal phase: food enters upper throat, soft palatable elevates, epiglottis off tranchea
- Esophagela Phase: food enters esophagus and propelles to stomac
Common Causes of Dysphagia
Neurological diseases (stroke) – Chronic – Acute • Muscle disorders • GI disease- gerd • Malignancy • Other
Diagnosing Dysphagia: RD Scope of Practice
• RD dysphagia assessment (diagnosis) and management:
– Falls within the dietetic scope of practice in provincial legislation in all
jurisdictions in Canada.
– The Quebec, Ontario, Alberta, and British Columbia governments within
Canada identify specific activities that pose a substantial risk of harm if
not performed competently. Health professionals in those provinces
require authorization to perform the activities referred to as either
controlled acts, restricted activities or reserved activities.
• Speech language pathologist (SLP)
dIAGNOSTIC methods
- Bedside swallowing assessment
Modified barium swalloing assessment
fiberoptic endoscopic evaluation of swallowing
Dysphagia Outcome & Severity Scale (7-point scale)
o Level 1: Severe dysphagia: NPO: Unable to tolerate and PO safely
o Level 2: Moderately severe dysphagia: Maximum assistance or use of strategies with
partial PO only (tolerates at least one consistency safely with total use of strategies)
o Level 3: Moderate dysphagia: Total assist, supervision, or strategies, two or more diet
consistencies restricted
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o Level 4: Mild-moderate dysphagia: Intermittent supervision/cueing, one or two
consistencies restricted
o Level 5: Mild dysphagia: Distant supervision, may need one diet consistency restricted
o Level 6: Within functional limits/modified independence
o Level 7: Normal in all situations
Consequences of Dysphagia
In hospitalized patients dysphagia associated with increased hospital stay and increase mortality
higher prevalence in older patients
independant risk factors of malnutrition
Thickening Agents
Different types ØStarch ØGuar gum ØLocust bean gum ØXanthan gum ØCarageenan
Esophagus
Straight hollow muscular ”tube” – ~25 cm long, 2 cm diameter – 2 sphincters • Pharyngoesophageal sphincter • Lower esophageal sphincter (LES) – Controls passage of food into stomac h • Longitudinal & circular musculature – Coordinate movement of food by alternating contractions (”peristalsis”) • Chief function = motility
Esophageal Related Conditions
Esophageal dysphagia
• Gastroesophageal reflux disease (GERD)
• Esophagitis
• Barrett’s esophagus (precursor to cancer)
• Esophageal varicies (blood vessels burst)
• Strictures (narrowing)
• Achalasia (lower sphicter doesnt relax - nothing goes to stomac
