Lesson 1- Basic Principles Flashcards
Difficulty moving food and liquid from the mouth to the stomach
Occurs in all ages and can be a symptom of many disease and conditions.
Can be acute or progressive
3 Stages
dysphagia
The tongue initially forms the food bolus (green) with compression against the hard palate.
Oral Stage
Displacement of the food bolus into the pharynx by the tongue initiates deglutition.
Pharyngeal stage
Relaxation of the cricopharyngeal muscle (the physiological upper esophageal sphincter) permits movement of the food bolus into the proximal esophagus.
Esophageal stage
______concerns placement of food in the mouth/oral stage and stops at the pharyngeal stage.
feeding
Symptoms of Dysphagia
Weight loss with no other explanation
Gurgly voice quality
Secretions in the pharynx or chest following a meal
Pt. complaints
Inability to recognize food
Difficulty placing food in the mouth
Inability to control food/saliva
Coughing before, during or after the swallow
Coughing at the end or right after a meal
Recurrent pneumonia
Ways of Identifying and Assessing Patients with Dysphagia
Screening
Chair side or bedside evaluation
CED/BED
Modified Barium Swallow Study (MBSS)
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Modified Evans Blue Dye Assessment (MEBDT)**trach patients only
Cervical Auscultation
Why is dysphagia a concern?
aspiration, length of stay & cost in hospital, nutrition concerns
Complications of Dysphagia
Pneumonia Malnutrition Dehydration ----Constipation ----Decreased cognition
Multidisciplinary Approach
SLP MD Radiologist Dietition Nursing OT PT Pharmacist
Patient Safety
Always use small amount of food/liquid during any assessment until the patients swallow is well understood SILENT aspiration Secondary to sensory deficit No cough is elicited MBSS necessary for assessment Radiation
Ethics
Non compliance Living wills Quality of life issues Treating the disorder Vs treating the person Families
