Postural Changes

Question 1

Chin Tuck

Answer 1

Use when:

• there is spillage prior to swallow due to a pharyngeal delay
• reduced BOT retraction –> PPW
• aspiration before or during swallow

Question 2

Head Back

Answer 2

Use when:
-person cannot move food to back of mouth (poor A–>P transit)

Assumes that gravity will help clear the oral cavity

Question 3

Head Turn to Weak Side

Answer 3

Use when:

• unilateral pharyngeal/laryngeal weakness
• cricopharyngeal dysfunction (resulting in residue in pyriforms)

Rationale:

• Blocks bolus from traveling down weak side closes off weak side)
• Applies pressure to VF to increase approximation

Question 4

Head Turn to Strong Side

Answer 4

Use when:

• unilateral oral weakness
• unilateral pharyngeal weakness

Question 5

Chin Tuck with Head Turn

Answer 5

Use when:

-unilateral laryngeal dysfunction (which results in reduced closure –> aspiration during the swallow)

Question 6

If pt has unilateral VF immobility, (paralyzed V) due to laryngeal valving what would you do?

Answer 6

Compensatory; turn head to damaged side to bring VF together to midline so they close

Rehab: laryngeal excursion, tight breath hold for increase VF adduction
SUPER SUPRAGLOTTIC SWALLOW