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Dysphagia > Week 1 - Intro To Swallowing > Flashcards

Week 1 - Intro To Swallowing Flashcards

1
Q

Dysphagia

A

Impairment in emotional, cognitive, sensory, and or motor acts transferring food from mouth to stomach.

Swallowing disorder

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2
Q

Aspiration

A

Anything below the TVFs

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3
Q

FTT

A

Failure to thrive

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4
Q

Bolus

A

Food or liquid ball

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5
Q

Odynophagia

A

Pain when swallowing

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6
Q

Peristalsis

A

Muscle contraction

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7
Q

GERD

A

Gastroesophageal reflux disease

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8
Q

Normal swallow

A

Response that triggers a sequence of muscle contractions that propels prepared food to the stomach.

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9
Q

Swallowing requires

A

Large area of brain stem (swallowing center)

6 paired cranial nerves (5, 7, 9, 10, 12)

Numerous receptors (sense of taste and cough reflex)

31 pairs of muscles

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10
Q

Reflexive swallow

A

Involuntary swallow (not part of voluntary deglutition) evoked by stimulation to several regions of the brain.

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11
Q

Reflexive swallow occurs ___________

A

600-1000 times a day
OR
1 time a minute or so.

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12
Q

Reflexive swallow occurs at its highest ________

A

During meals.

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13
Q

Reflexive swallow occurs at its lowest ___________

A

While we sleep.

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14
Q

How much saliva do adults produce?

A

About 0.5 ml per minute.

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15
Q

Mew cases of dysphagia caused by stroke per year

A

160,000 to 573,000

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16
Q

About a __________ of stoke patients suffer from dysphagia.

A

25-50%

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17
Q

Overall incidence of dysphagia

A

6-10 million

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18
Q

About a ______ of all patients hospitalized in major medical centers have dysphagia.

A

13-14%

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19
Q

About __________ of patients in rehab centers have dysphagia.

A

30-35%

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20
Q

Up to __________ of patients in skilled nursing facilities have dysphagia.

A

59%

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21
Q

Acute care

A

ICU, step down unit, floor.

Shorter stay

Medically involved, notable medical complications.

13-33% prevalence within the hospital.

CVA, TBI, SCI, brain tumor patients.

22
Q

Inpatient Rehab Center

A

14-21 days - typical length of stay

3 hours or more of treatment per day.

23
Q

Levels of care

A

Acute care

Inpatient rehab setting

Long-term care/SNF

Home health/Outpatient

24
Q

Dysphagia team

A

Pt/family

Dietician

OT/PT

Nurses

CNA

MDs (primary care physician, GI, otoralyngologist, neurologist)

Radiologist

Respiratory therapist

25
Etiologies of dysphagia
Neurologic disorders Pulmonary disorders Infectious diseases Muscular disorders Structural impairments Latrogenic (caused by treatment or diagnostic procedures) Psychiatric or behavioral Normal aging
26
Neurologic etiologies of dysphagia
CVA Motor Neuron Diseases (ALS) Parkinson's Alzheimer's / Dementia MS
27
Structural etiologies of dysphagia
Tumors Traumatic injuries Webs Diverticulum Cleft lip/palate Micrognathia (Pierre-Robin syndrome)
28
Psychiatric etiologies of dysphagia
Bulimia related Paychogenic dysphagia (phagophobia: fear swallowing)
29
Negative outcomes of dysphagia
Malnutrition Dehydration Pulmonary complication Non-oral feeding Increased dependence, cost, and time consuming care
30
Malnutrition
Inadequate dietary intake Involuntary weight change Decreasing functional status Dizziness Fatigue Decreased immune response.
31
Dehydration
Dryness of lips Dryness or thickened oral secretions Sunken eyeballs Elevated temperature Hypotension Decreased urine output and UTI Constipation Decreased cognitive status and confusion Nausea and vomiting
32
Dysphagia pulmonary complications
Choking episodes Asphyxia Laryngospasm Bronchospasm: a sudden constriction of the muscles in the walls of the bronchioles Chronic bronchitis Aspiration pneumonia
33
Anatomic structures of swallowing
Oral cavity Pharynx Larynx Esophagus
34
Anatomical structures of the oral cavity
Lips Teeth Hard/soft palate Mandible Uvula Floor of mouth (FOM) Tongue, base of tongue
35
Anatomical structures of the Pharynx
Pharyngeal constrictor muscles (superior, medial, inferior) Vallecula Pyriform sinuses
36
Vallecula
A wedge-shaped space formed between the Base of tongue and the epiglottis.
37
Pyriform sinuses
The space formed by the attachment of the fibers of the inferior pharyngeal constrictor to sides of thyroid cartilage.
38
Anatomical structure of the larynx
Begins at BOT Designed to keep food out of the airway Components: epiglottis, aeryepiglottic folds, laryngeal vestibule, FVF, TVF, subglottiv space.
39
Anatomical structure of the esophagus
~22 cm long Flaccid collapsed tube Bounded by 2 tonically contracted muscles (UES - 1" long- & LES- 1.5" long) Parts: cricopharyngeus muscle, cervical portion, thiracic portion, and abdominal portion. Layers: epithelium, laminae propria, muscularic mucosae + esophageal muscles (1/3 smooth, 1/3 striated & 1/3 striated and smooth)
40
Cricopharyngeus muscle
UES, PE segment, CP segment Most inferior structure of the pharynx Pyriform sinuses are here Valve at the top of the esophagus Designed to keep air from entering esophagus Prevents material from refluxing into pharynx
41
Cervical esophagus
Runs from suprasternal notch to thoracic intlet
42
Thoracic esophagus
Runs from thoracic inlet around aortic notch to level of 8th thoracic vertebrae
43
Abdominal esophagus
Mainly the LES
44
Feeding
Placement of food in mouth through the oral stage of swallowing when food is propelled posteriorly
45
Therapy for feeding
Positioning of food Tongue manipulation exercises Chewing varying consistencies Organizing lingual peristalsis
46
Therapy for swallowing
Stimulation of swallowing response Improving pharyngeal trasit of material Airway protection Strengthening swallowing musculature All feeding techniques
47
Gag
Noxious stimulus ot motorically triggered. Reflex with the purpose of eliminating substances anteriorly.
48
Volume of saliva
1 ml
49
Colume of cup drinking
20+ ml
50
Volume of pudding
6 ccs
51
Volume of thick paste
5 ccs
52
Volume of meat
2 ccs

Dysphagia (2 decks)

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