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Dysphagia Comp > Treatment > Flashcards

Treatment Flashcards

1
Q

What do swallowing maneuvers do?

A 
Place specific aspects of swallow under volitional control.
Need:
   Intact cognition
   Muscle strength
   Muscle endurance
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2
Q

Chin down position effects

A

Protects airways
Widens vallecula
Narrows airway entrance
Protection mechanism to cover the airway

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3
Q

What do you use chin down position for?

A

Poor BOT control
Delayed pharyngeal swallow
Reduced closure of VF
Reduced laryngeal elevation

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4
Q

Change in bolus size and texture effects

A

Facilitates oral phase and initiates the swallow

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5
Q

What do you use change in bolus size and change in texture for

A

Poor BOT control and pressure
Reduced closure off VF
Mistiming of laryngeal elevation

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6
Q

Thermal tactile stimulation effects

A

Sensory stimulation to brain stem

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7
Q

When do you use thermal tactile stimulation, sour bolus, and three second prep for ?

A

Delayed pharyngeal swallow

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8
Q

Super supraglottic swallow effects

A

Protects before and during swallow
Tilts arytenoid forward
Improved larynx elevation
Improved BOT retraction

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9
Q

What to use super supraglottic swallow for

A

Reduced closure of VF
Mistiming of laryngeal elevation
Reduced laryngeal elevation and BOT pressure

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10
Q

Supraglottic swallow effects

A

Closes and protects airway

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11
Q

When to use supraglottic swallow

A

Reduced closure of the the truer VF

Delayed pharyngeal swallow

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12
Q

Head rotation towards WEAKER side effects

A

Aids in adduction of VF
Twists pharynx so food flows down stronger side
Moves damage to midline

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13
Q

When to use head rotation towards weaker side

A

Reduced VF closure and laryngeal elevation
Reduced BOT pressure and pharyngeal wall movement
Cricopharyngeal dysfunction

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14
Q

Mendelsohn maneuver effects

A

Increases duration of laryngeal elevation and width of CP opening
Increases coordination of swallow

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15
Q

When to use Mendelssohn maneuver

A

Mistiming/reduced laryngeal elevation

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16
Q

When to use multiple swallows

A

Reduced laryngeal elevation and BOT a pressure

Reduced posterior wall movement

17
Q

Effort full swallow effects

A

Improves tongue pressure
Increases BOT retraction
Clears vallecula residue

18
Q

When to use effortful swallow

A

Reduced BOT pressure and pharyngeal wall movement

19
Q

Head tilt to STRONGER side effects

A

Directs bolus down stronger side

Uses gravity to advantage

20
Q

When to use head tilt to stronger side

A

Oral/pharyngeal weakness on same side

When residue in the mouth/pharynx

21
Q

Head back chin up effects

A

Drains food from oral cavity
Takes advantage of gravity
Eliminates vallecular space

22
Q

When to use head back chin up

A

Reduced tongue control/oral transit time

Common with glossectomy

23
Q

Laying down on one side effects

A

Uses gravity to reside pharyngeal residue

24
Q

When to use laying down on one side

A

Reduced pharyngeal constriction

Residue in pharynx

25
Q

Neuromuscular electrical stimulation effects

A

Electrical stimulation on throat, activates muscles of intact peripheral motor nerves
Goal is to strengthen muscular system to control swallow

26
Q

When to use neuromuscular electrical stimulation

A

Decrease risk of penetration and aspiration
Reduced CP opening
Can lead to cortical reorganization

27
Q

Increases pressure on tongue effects

A

Helps initiatial chew stimulation

28
Q

Volitional hold and swallow effects

A

Reduced automaticity and reflexive components

Adds cognitive aspect to swallow

29
Q

When to use volitional hold and swallow

A

Delayed swallow initiation

Poor bolus control and transfer

30
Q

Food consistency changes

A

Most effect on quality of life - last option

Thin liquor, nectar thick, honey thick, purée/pudding, soft solid, hard solid, mixed consistencies

31
Q

Masako maneuver (tongue holding)

A

For decreased super pharyngeal constriction and PPW bulging

Decreases BOT retraction

32
Q

Shaker exercise

A

For decreased UES opening

33
Q

How does a tracheostomy cannula prevent ability to do some swallowing strategies

A

Restricted laryngeal elevation and sensitivity
Decreased glottal pressure
Interrupts cricopharyngeal
Causes difficulty in expelling air

34
Q

Limitations of electrical stimulation as a therapeutic approach

A

Gains made through stimulation must be sustained in functional use or else they can’t be maintained

If patient unable to participate in swallowing exercises, electrical stimulation will be ineffective

35
Q

The goal of treatment for dysphagia is

A

To establish the safest, most efficient oral nutrition

Determine if and how to fix the problem

Dysphagia Comp (5 decks)

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