Postural Techniques

Question 1

Inefficient oral transit

Reduced posterior propulsion of bolus by tongue

Answer 1

Posture: Head back

Rationale:
Utilizes gravity to clear oral cavity

Question 2

Delay in triggering the pharyngeal swallow

Bolus past the ramus of the mandible, but pharyngeal swallow not triggered

Answer 2

Posture: Chin Down

Rationale:

• Widens the valleculae to prevent bolus from entering airway;
• Narrows airway entrance;
• Pushes epiglottis posteriorly.

Question 3

Reduced posterior motion of the tongue base

(Residue in valleculae)

Answer 3

Posture: Chin down

Rationale:
Pushes tongue base backward toward pharyngeal wall

Question 4

Unilateral laryngeal dysfunction

Aspiration during swallow

Answer 4

Posture: Head rotated to damaged side; chin down

Rationale:
Places extrinsic pressur on thyroid cartilage, increasing adduction

Question 5

Reduced laryngeal closure

Aspiration during the swallow

Answer 5

Posture: Chin down; head rotated to the damaged side

Rationale:

• Puts epiglottis in more protective position;
• Narrows laryngeal entrance;
• Increase vocal fold closure by applying extrinsic pressure

Question 6

Reduced pharyngeal contraction

Residue spreads throughout pharynx

Answer 6

Posture: Lying down on one side

Rationale:
Eliminates gravitation effect on pharyngeal residue

Question 7

Unilateral pharyngeal paresis

Residue on one side of the pharynx

Answer 7

Posture: Head rotated to damaged side

Rationale:
Eliminated damaged side from bolus path

Question 8

Unilateral oral and pharyngeal weakness on the same side

Residue in mouth and pharynx on same side

Answer 8

Posture: Head tilt to stronger side

Rationale:
Direct bolus down stronger side

Question 9

Cricopharyngeal dysfunction
(Residue in pyriform sinuses)

Answer 9

Posture: Head rotated

Rationale:
Pulls cricoid cartilage away from posterior pharyngeal wall, reducing resting pressure in cricophyngeal sphincter