Swallowing Flashcards
Which issue during swallowing is associated with a problem during the pharyngeal phase of swallowing?
reduced movement of the tongue
What is cervical auscultation?
a swallowing assessment technique in which a stethoscope is placed over the thyroid cartilage to make sounds louder during swallowing
What is scintigraphy?
a swallowing assessment technique in which a person drinks radioactive material and then is scanned so that an image is produced
What is videofluroscopy?
a swallowing assessment technique in which a patient drinks a tiny bit of liquid barium and the SLP records the swallow
What is fiberoptic endoscopic evaluation of swallowing?
a swallowing assessment technique in which a tube is passed through a patient’s nose to examine their swallow
What are the goals of oral motor exercises?
increase tongue movement; increase range of tongue movements; increase the range of lateral movements of the jaw
What is used to quantify the time and frequency of gastroesophageal reflux into the esophagus?
a pH probe or intraluminal pH monitoring study
What are the four phases of swallowing?
oral prep phase, oral phase, pharyngeal phase, and esophageal phase
What part of the brain is responsible for swallowing?
medulla oblongata which has the central pattern generator
What is the oral phase of swallowing?
moving bolus from the front to the back of the mouth
What is an option to provide a client with a weak pharyngeal swallow and minimal laryngeal elevation and excursion following stimulation?
gastrostomy tube
The disorders of the pharyngeal phase of swallowing include
delayed or absent swallowing reflex
What treatment technique results in the widening of the vallecula space?
head down (chin tuck)
What is known about medically fragile babies with feeding difficulties?
They have issues with oral-motor development; they often need to be fed through nasogastric tubes; to be fed orally, they must be at least 35 weeks old; it’s hard to breastfeed them
What is cricopharyngeal myotomy?
split the cricopharyngeal muscle to create a sphincter for swallowing
What is esophagotomy?
put a feeding tube into the esophagus and stomach through a stoma; this is for people who cannot tolerate oral feeding
Why do you select a pureed diet?
no mastication involved
What should an SLP do for a patient who has tongue weakness and cannot properly form a bolus?
tilt their head down as food is placed in their mouth and then tilt it back
If a patient had a hemilaryngectomy, delayed triggering of swallowing reflext, and inadequate laryngeal closure, then what should an SLP do?
Have the patient tilt their head downward to hold the food in the valleculae until the reflex is triggered
What is the supraglottic swallow used for?
to address delayed onset of swallow; delayed closure of vocal folds and delayed closure of larygneal vestibule
What is the super-supraglottic swallow used for?
to address the laryngeal vestibule not closing as much
What is the effortful swallow used for? How is it used?
to address the pharynx not constricting as much and lack of tongue base moving posteriorly; this is used to help the tongue base move posteriorly
What is the difference between direct treatment and indirect treatment of swallowing?
direct treatment involves food and drink and indirect treatment does not
For direct treatment of the oral phase of swallowing, an SLP can use
teach patient to use their tongue to sweep food from the lateral sulci; increase tongue to palate contact or use a palatal obdurator to do that; place food at the back of the oral cavity or back of the tongue
For direct treatment of the pharyngeal phase of swallowing, an SLP can use
teach patient to use a chin tuck; tilt their head towards the weak side if their pharyngeal constriction is weak on one side; tilt their head towards the stronger side if the have unilateral paralysis of laryngeal function, decreased laryngeal elevation
To stimulate the swallow reflex, the following exercises can be used,
liquid swallow after stimulation; use thermal stimulation; tell them to swallow after stimulation without food
What indirect treatment of swallowing targets the UES?
The Shakur method
What indirect treatment of swallowing increases tongue base strength?
the Masako maneuver
What is the difference between a hemiglossectomy and a subtotal glossectomy?
hemiglossectomy: 50% of the oral tongue and some of the tongue base is removed
subtotal glossectomy: at least 50 to 100% of the oral tongue and tongue base is removed
What is the difference between esophagotomy and a gastrostomy?
For an esophagotomy, a feeding tube is inserted into the esophagus and stomach through the hole. For an gastrostomy, the feeding tube is inserted into the stomach through the stoma.
What is nasogastric feeding?
another method for individuals who cannot tolerate oral feeding. A tube is inserted through the nose, pharynx, and esophagus into the stomach, and feeds the patient
