Swallowing Disorders

Question 1

4 phases of swallowing

Answer 1

1) Oral preparatory phase
2) Oral phase
3) Pharyngeal phase
4) Esophageal phase

Question 2

Oral preparatory phase

Answer 2

Begins when food or liquid is consumed through diet and enters the oral cavity
When drinking liquids, the posterior tongue rises to meet the soft palate to ensure a proper seal, preventing leakage of liquid oral cavity contents
Processing of the bolus to render it “swallowable”

Question 3

Oral phase

Answer 3

Refers to the propelling of food from the oral cavity into the oropharynx

Question 4

Pharyngeal phase

Answer 4

Rapid sequence of overlapping events
Soft palate elevates, hyoid bone and larynx move upward and forward, vocal folds move to the midline, epiglottis folds backward to protect the airway

Question 5

Esophageal phase

Answer 5

Tongue pushes backward and downward into the pharynx to propel the bolus down
Assisted by the pharyngeal walls, which move inward with a progressive wave of contraction from top to bottom
Upper esophageal sphincter relaxes during the pharyngeal phase of swallowing and is pulled open by the forward movement of the hyoid bone and larynx

Question 6

Aspiration

Answer 6

Breathing fluid, food, vomit, or an object into the lungs

Question 7

Silent aspiration

Answer 7

Aspirating food or fluids without coughing or choking and later developing pneumonia or other conditions

Question 8

Penetration

Answer 8

Occurs when food or liquids enters the top of the airway

Question 9

Residue/Stasis

Answer 9

Leftover material in the throat

Question 10

What causes dysphagia?

Answer 10

Usually caused by another health condition
Conditions that affect the nervous system such as: stroke, head injury, or dementia
Cancer (mouth cancer, esophageal cancer)
Gastroesophageal reflux disease

Question 11

Does everyone aspirate?

Answer 11

Everyone has the ability to aspirate
Normal to happen from time to time

Question 12

Does everyone who aspirates get pneumonia?

Answer 12

No

Question 13

Compensatory strategies for dysphagia

Answer 13

Chin tuck, head tilt, head turn, food hardening/softening

Question 14

Restorative exercises for dysphagia

Answer 14

Take a deep breath and keep holding your breath as you place a small bite of food in your mouth and swallow
Then, cough to clear any remnants of saliva or food which may have gone down past your vocal cords
Lastly, exhale

Question 15

Do people with normal swallowing occasionally penetration or aspirate?

Answer 15

Yes

Question 16

Instrumental swallowing assessment

Answer 16

Looks at functional and structural aspects of swallowing that aren’t visible upon physical examination

Question 17

Modified barium swallow study

Answer 17

Analyzes the way you swallow in three phases: oral, pharyngeal, upper esophagus

Question 18

Barium swallow

Answer 18

Looks at the way liquid propels through the esophagus and down into the stomach

Question 19

Advantages of the modified barium swallow study

Answer 19

Coats the esophagus, stomach, or intestine with a material that is not absorbed into the body so diseased or damaged areas can be clearly seen by x-ray examination or CT scan

Question 20

Fiberoptic endoscopic evaluation of swallowing

Answer 20

Test used to assess how you swallow
During the test, a SLP passes a thin, flexible instrument through your nose
Then, SLP views parts of your throat as you swallow

Question 21

Advantages to the fiberoptic endoscopic evaluation of swallowing

Answer 21

Easy to perform, can be repeated, bedside examination if needed, economic