Swallowing Disorders Flashcards
how is a moderate swallowing disorder defined?
reduced pharyngeal propulsion
how is a mild oral stage dysphagia characterized?
reduced oral preparation and delayed transport
pharyngeal swallow delay
a delay in initiating the pharyngeal swallow after oral transport have moved bolus into the pharynx
(very common)
in a pharyngeal swallow delay, material often piles up in the __________
valleculae (the space between the tongue base and the epiglottis)
laryngeal penetration
material falls into the larynx, but remains above VFs
nasal regurgitation
material is pushed into the nasal cavity due to incomplete nasal closure
subglottic aspiration
material falls below the VFs into the trachea and potentially into lungs
residue
material that remains in the pharynx after the swallow is completed
aspiration
usually classified by amount
-trace, mild, moderate, severe
aspiration before the swallow is associated with…
delayed pharyngeal swallow
aspiration during the swallow is associated with…
reduced laryngeal elevation and closure
aspiration after the swallow is associated with…
poor pharyngeal propulsion and residue in the pharynx after the swallow
or is laryngeal elevation is poor
most prevalent consequences of dysphagia
- reduced quality of life
- difficulty eating
- altered diet textures
- embarrassment
- lack of social contact during eating
physical consequences of dysphagia
- reduced nutrition/dehydration
- can effect cognitive and motor function
aspiration pneumonia
- problem with thicker textures
- occurs when client cannot clear aspirated material
- develops because of multiple factors (not just aspiration)
airway obstruction/choking
- results from improper feeding, rather than the swallowing disorder
- texture is not a problem
stroke victims w/ dysphagia have most problems with…..
pharyngeal stage
progressive neurological conditions and dysphagia…
-often oral stage is affect first, and may be quite severe before pharyngeal problems emerge
head/neck cancer and dysphagia
often most severe as mouth and/or larynx are reconstructed after surgey
what can be used to assess dysphagia?
- clinical or bedside eval
- modified barium swallow
- videoendoscopy
modified barium swallow
- assess what’s wrong with swallow
- try rehabilitation strategies to see their effects on the swallow
- tilt head/turn to side
three strategies to rehab
1 improve basic function
2 compensatory strategies that work around swallowing problem (head tuck etc)
3 modified diet texture
compensatory strategies
- chin tuck
- head turn
- supraglottic swallow (cough swallow exhale)
- mendlsohn maneuver
mendlsohn maneuver
- freeze mid swallow
- keeps larynx in middle so it doesn’t go down
