Lecutre 8 Flashcards
List all the basic dysphagia txs
Diet modification Positional Oral sensory Maneuver Exercises Prosthetic Surgery Experimental Other
List some diet modifications
(volume, viscosity, texture, temperature, NPO diet - NG tube, G tube, PEG, J tube, etc.)
List some positional txs
(posture, chin tuck, head rotation, head tilt)
Oral sensory treatments
(tactile/taste/thermal-tactile stimulation
Maneuver
(Supraglottic, Super-supraglottic, Mendelsohn, Effortful)
Exercise
(Shaker, Masako, oral muscle strengthening)
Prosthetic
(Palatal lift or obturator)
Surgery
(CP myotomy, diverticulectomy, dilation, palatopexy, VF medialization-augmentation/thyroplasty)
Experimental
Experimental (Neuromuscular electrical stimulation-NMES: “VitalStim”, Deep pharyngeal neuromuscular stimulation-DPNS, myofascial release-MFR, Botox)
Other
Other (multiple swallows, food presentation, liquid wash, throat clearing, adduction techniques*, EMST)
What are the compensatory techniques designed to do?
eliminate the symtoms
Why are the compensatory techniques therapeutic?
They change the timing of the swallow
List the compensatory techniques
Diet, positional, oral sensory, and prosthetics
T/F diet modification is usually the first things you do.
Falso! its a last resort
When do you do diet modication?
If other compensatory strategies or therapies fail If too cognitively impaired If a “building block” Neurom. control/strength ROM ex’s
what do you change in diet modications?
Bolus volume (size)
Bolus viscosity (consistency)
Temperature
Taste
List the diet consistencies
Liquids -Thin -Nectar -Honey Solids -Pudding -Puree -Mechanical soft -Chopped -Regular
List the positional txs
Sitting upright at 90° Lying on side Chin tuck Head rotation Head tilt Head back
why do you do Sitting upright at 90°
Contributes to gravity to direct bolus down
why do lying on side?
Eliminates gravitational effect on pharyngeal residue
why do chin tuck?
Widens valleculae (to prevent penetration)
Narrows airway entrance & ↑ laryngeal elevation & vf closure
Pushes tongue base backward toward pharyngeal wall
Puts epiglottis in a more protective position
Why do head rotation?
To weaker side: closes off damaged side & directs bolus down stronger side