O14 Swallowing PART I, FINAL Flashcards

1
Q

What is swallowing?

A

Moving food from mouth to stomach

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2
Q

T/F: Swallowing disorders occur in all age groups

A

True

  1. Can they protect the airway?
  2. Can they get their oral intake all the way to the stomach or does it get hung up somewhere along the way?
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3
Q

What is dysphagia?

A

Problems or difficulty swallowing;

Swallowing disorder

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4
Q

What are the 3 phases of swallowing?

A
  1. Oral phase
  2. Pharyngeal phase
  3. Esophageal phase (we don’t deal with this phase)
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5
Q

Talk about the oral phase of swallowing.

A

needs good closure, no leaking

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6
Q

Talk about the pharyngeal phase of swallowing.

A

o Negative air pressure helps to drive the bolus backwards.

o Many muscles for peristalsis must work together to drive the bolus into the esophagus…

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7
Q

What must happen for a successful swallow in the pharyngeal phase? (six things)

A
  • Tongue muscles- tongue lifts in front & bunches in back.
  • Larynx lifts and closes in a sphincteric action.
  • Epiglottis closes backwards over the vestibule.
  • False and true vocal folds close in.
  • True vocal folds close tightly.
  • Superior, middle, and pharyngeal constrictors work together to squeeze food into esophagus.
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8
Q

What happens during the esophageal phase?

A

Upper esophageal sphincter (cricopharyngeus) has relaxed to allow the food into the esophagus.

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9
Q

What are the extrinsic muscles that are used for swallow? (suprahyoids and infrahyoids)

A

a. Suprahyoids: laryngeal elevators critical for swallow, ELEVATE larynx
1. Digastricus - means 2 bellies, anterior and posterior belly.
2. Mylohyoid - this muscle forms the floor of the mouth.
3. Stylohyoid – originates from styloid process of temporal bone; a long and slender muscle that is lateral and superficial to the posterior belly of digastricus
4. Geniohyoid - it is located superiorly to mylohyoid.

b. Infrahyoids: critical for breathing - move the larynx down for panting; laryngeal depressors
1. Sternohyoid
2. Sternothyroid
3. Omohyoid
3. Thyrohyoid

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10
Q

What are the four structures that protect the larynx?

A

(from bottom to top)

a. True vocal folds
b. False vocal folds
c. Aryepiglottic folds
d. Epiglottis

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11
Q

What are the spaces and places of the larynx?

A
  1. valleculae
  2. pyraform sinuses
  3. aditus laryngeus/vestibule
  4. anterior commissure
  5. posterior commissure
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12
Q

What are the three pharyngeal constrictors?

A

a. superior
b. middle
c. inferior

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13
Q

What is the muscle of the upper esophageal sphincter?

A

Cricopharyngeus - peristaltic motion

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14
Q

What are the risks for dysphagia?

A

Lack of muscle function
Lack of sensation
Lack of cough/clear reflex

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15
Q

Define “aspiration”

A

food or liquid BELOW the level of the TRUE VOCAL FOLDS.

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16
Q

Define “penetration”

A

food or liquid in the vestibule (at the level of the true vocal folds)

17
Q

What is “Residue”?

A

Leftover food/liquid in the vestibule or the places and spaces of the larynx. This is a huge aspiration risk.

18
Q

What is “backflow”?

A

food or liquid that has gone into the esophagus and has come back up into the pharynx or nasal cavity.

19
Q

What are four signs and symptoms of aspiration?

A

Coughing after swallow

History of pneumonia

Laryngeal damage, stroke, neurological damage or disease (lead to lessened sensation)

Food squirting out the tracheostomy (duh)

20
Q

What is one physiological evaluation for swallow?

A

Modified barium swallow (MBS) - videoflouroscopic procedure

  • MBS looks at function of larynx
  • Two purposes:
    1. determine abnormalities causing the symptoms
    2. identify & evaluate treatment strategies
21
Q

What are six treatment strategies/swallowing maneuvers?

A
  1. Head positioning - chin lift or chin tuck
  2. Laryngeal manipulation
  3. Food alterations
  4. Multiple swallows
  5. Swallow, then cough
  6. Swallow food then sip of liquid to clear.