Neurological (degenerative) Discorder Flashcards
Name 7 neurological/degenerative disorders associated with dysphagia
- Cerebrovascular Accident (CVA)
- Progressive diseases (i.e. Parkinson disease)
- Multiple Sclerosis (MS)
- (Amyotrophic lateral sclerosis (ALS)
- Myashtenia Gravis (MG)
- Traumatic Brain injury (TBI)
- Dementia
Name 2 surgical/medical causes of dysphagia
- Anterior cervical spinal surgery
2. Head and Neck cancer
What are the risks associated with anterior cervical spine surgeries?
Immediate dysphasia followed by quick recovery.
Mechanical interference from hardware
Swelling of post. pharyngeal wall
What are the risks associated with head and neck cancer?
It depends on the area resected or removed.
- tongue removed = oral stages affected (consequently affecting all stages that follow)
What are the risks associated with CVA?
Depends on the size of lesion and the location.
Brainstem CVA results in significant dysphagia.
RH strokes - longer pharyngeal tranist, more aspiration, and last longer
What are the risks associated with Parkinson’s disease?
Impaired lingual movement, minimal jaw opening, abnormal head and neck posture, and impulsive eating behavior
• Delayed oral transit time (lots of tongue pumping)
• Delayed pharyngeal swallow
• Reduced pharyngeal contraction
Ridgidity and bradykinesia (slowness of initiation movement)
What are the risks associated with Amyotrophic Lateral Sclerosis (progressive disease)?
ALS- Swallowing pxs occur in pts w/bulbar involvement
• Swallowing problems are secondary to spastic/flaccid problems from UMN/LMN damage
• Prophylactic use of PEG has been shown to increase length of life
• If symptom starts in head and neck, we need to be aggressive. Put in a feeding tube soon to help maintain their weight (continue mouth feeding as well)
What are the risks associated with Multiple Sclerosis (progressive disease)?
- Spasticity and incoordination of oropharyngeal and respiratory muscles creates functional problems w/ swallowing
- Examine delay and incoordination of laryngeal movements and pharyngeal constrictor dismotility
What are the risks associated with Myasthenia Gravis (auto immune disorder)?
Neurons that accept acetylcholine get damaged and therefore…
- Presents with LMN signs
- Oral and pharyngeal stage progressively weakens as Pt cont. to eat
- Give client swallowing examine, have them eat (in order to fatigue them, then give another examine in 10 min.)
What are the risks associated with TBI?
- Often see poor oral control of boluses, a delay triggering the swallowing, and weak pharyngeal transit
- Often, cognitive issues affect swallow safety
- Usually problem during pharyngeal stage
- mostly UMN signs, but CN LMN damage may also occur due to skull fractures
- Impulsively eat
What are the risks associated with Dementia?
Cortical dementia (e.g. Alzheimer’s disease) typically affect the oral stage of swallowing (forget what to do with food)
Dementia from Huntington’s disease/Parkinson’s
• Affect both stages of the swallow
In late stages, patients stop eating - don’t know what food is
Name the esophageal dysphasias
GERD: gastroesophageal reflux disease → can lead to a globus sensation due to tissues being irritated by having acid coming back up
LPRD: laryngopharyngeal reflux disease → can present as c/o hoarseness, throat clearing, and coughing
Barrett esophagus: NOT on test, but it’s precancerous
What is GERD?
Can lead to globus sensation (something stuck in your throat)
Pain when swallowing
What is LPRD?
laryngopharyngeal reflux disease
Can present with hoarseness, throat clearing and coughing
What is Zenker’s diverticulum? How is it treated?
When a pocket is created in the pharyngeal wall superior to the UES
Treatment: staple the pouch closed
