Swallowing Disorders/Dx/Ax

Question 1

UMN= Inhibition

Answer 1

Damage = spasticity (weak, slow, limited ROM, hypertonia, hypereflxia, primitive & protective reflexes) (+ distractibility, poor judgment, reduced potential to learn)
typically more difficulty with liquids (poor coordination and timing of swallow)
-often takes multiple or bilateral strokes to cause lasting dysphagia

Question 2

LMN = Flaccidity

Answer 2

Damage= flaccid (weakness, atrophy, hypotonia, reduced/absent reflexes, loss of protective reflexes, fatigue) (+aphonia)
severe dysphagia for liquids and solids

Question 3

*Oral swallow problems:

Answer 3

Delayed transit : oral residue, pocketing, spillage

Delayed initiation : premature entry of bolus into pharynx

Poor TBR : vallecular residue

Question 4

Aspiration before the swallow

Answer 4

Reduced tongue action and loss of control of the bolus

Delayed or absent triggering of pharyngeal swallow (lack of sensation)

Question 5

Aspiration during the swallow

Answer 5

Reduced laryngeal elevation
inefficient valving of larynx

Delayed or absent triggering of pharyngeal swallow (lack of sensation)

Question 6

Aspiration after the swallow

Answer 6

Residue in vallecula/pyriforms that spills into open airway

Backflow from open PES