Swallowing Postures

Question 1

4 most common swallowing postures

Answer 1

1. Head back
2. Chin down
3. Head rotation
4. Head tilt

Question 2

Head Back Posture (what is it)

Answer 2

Position that relies on gravity to move the bolus out of the oral cavity

Question 3

When to use head back posture

Answer 3

Inefficient oral transit (reduced posterior propulsion of bolus by tongue)
–> effective for patients with tongue paralysis or partial or total removal or the tongue

Question 4

Chin down (what does it do)

Answer 4

also known as chin tuck
- improves airway protection by moving the tongue base and epiglottis posterior toward the posterior pharyngeal wall
- makes the airway entrance narrower and thus increases airway protection

Question 5

Chin down (how to do it)

Answer 5

tilt your chin down toward the chest and hold that position until the bolus is swallowed
–> effective for patients with neurologic and neuromuscular diseases and in patients following pharyngectomy surgery

Question 6

When to use chin down posture

Answer 6

• reduced posterior motion of tongue base (residue in velleculae)
• delay in triggering the pharyngeal swallow (bolus past ramus of mandible b ut pharyngeal swallow is not triggered)

Question 7

Head Rotation (what does it do)

Answer 7

promotes flow of the bolus to the more normal side of the pharynx or larynx

Question 8

Head rotation (how to do it)

Answer 8

rotate the head toward the weak or damaged side to attempt to close off that side
–> effective in patients with unilateral pharyngeal or vocal fold weakness or impairment

Question 9

Head rotation (when to use it)

Answer 9

• unilateral vocal fold paralysis or surgical removal (aspiration during the swallow)
• reduced closure of laryngeal entrance and vocal folds (aspiration during the swallow)(PAIR THIS WITH CHIN TUCK)
• reduced pharyngeal contraction (residue speed throughout pharynx) (LYING DOWN ON ONE SIDE)
• unilateral pharyngeal paresis (residue on one side of pharynx)

Question 10

Head tilt posture (what does it do)

Answer 10

also called lateral head tilt
gravity carries the bolus in the direction of the stronger side

Question 11

head tilt (how to do it)

Answer 11

tilt head to the stronger side

Question 12

Head tilt (when to use)

Answer 12

unilateral oral and pharyngeal weakness on same side (residue in mouth and pharynx on same side)