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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
Q

Etiologies of dysphagia

A

Neurologic disorders

Pulmonary disorders

Infectious diseases

Muscular disorders

Structural impairments

Latrogenic (caused by treatment or diagnostic procedures)

Psychiatric or behavioral

Normal aging

26
Q

Neurologic etiologies of dysphagia

A

CVA

Motor Neuron Diseases (ALS)

Parkinson’s

Alzheimer’s / Dementia

MS

27
Q

Structural etiologies of dysphagia

A

Tumors

Traumatic injuries

Webs

Diverticulum

Cleft lip/palate

Micrognathia (Pierre-Robin syndrome)

28
Q

Psychiatric etiologies of dysphagia

A

Bulimia related

Paychogenic dysphagia (phagophobia: fear swallowing)

29
Q

Negative outcomes of dysphagia

A

Malnutrition

Dehydration

Pulmonary complication

Non-oral feeding

Increased dependence, cost, and time consuming care

30
Q

Malnutrition

A

Inadequate dietary intake

Involuntary weight change

Decreasing functional status

Dizziness

Fatigue

Decreased immune response.

31
Q

Dehydration

A

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
Q

Dysphagia pulmonary complications

A

Choking episodes

Asphyxia

Laryngospasm

Bronchospasm: a sudden constriction of the muscles in the walls of the bronchioles

Chronic bronchitis

Aspiration pneumonia

33
Q

Anatomic structures of swallowing

A

Oral cavity

Pharynx

Larynx

Esophagus

34
Q

Anatomical structures of the oral cavity

A

Lips

Teeth

Hard/soft palate

Mandible

Uvula

Floor of mouth (FOM)

Tongue, base of tongue

35
Q

Anatomical structures of the Pharynx

A

Pharyngeal constrictor muscles (superior, medial, inferior)

Vallecula

Pyriform sinuses

36
Q

Vallecula

A

A wedge-shaped space formed between the Base of tongue and the epiglottis.

37
Q

Pyriform sinuses

A

The space formed by the attachment of the fibers of the inferior pharyngeal constrictor to sides of thyroid cartilage.

38
Q

Anatomical structure of the larynx

A

Begins at BOT

Designed to keep food out of the airway

Components: epiglottis, aeryepiglottic folds, laryngeal vestibule, FVF, TVF, subglottiv space.

39
Q

Anatomical structure of the esophagus

A

~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
Q

Cricopharyngeus muscle

A

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
Q

Cervical esophagus

A

Runs from suprasternal notch to thoracic intlet

42
Q

Thoracic esophagus

A

Runs from thoracic inlet around aortic notch to level of 8th thoracic vertebrae

43
Q

Abdominal esophagus

A

Mainly the LES

44
Q

Feeding

A

Placement of food in mouth through the oral stage of swallowing when food is propelled posteriorly

45
Q

Therapy for feeding

A

Positioning of food
Tongue manipulation exercises
Chewing varying consistencies
Organizing lingual peristalsis

46
Q

Therapy for swallowing

A

Stimulation of swallowing response

Improving pharyngeal trasit of material

Airway protection

Strengthening swallowing musculature

All feeding techniques

47
Q

Gag

A

Noxious stimulus ot motorically triggered.

Reflex with the purpose of eliminating substances anteriorly.

48
Q

Volume of saliva

49
Q

Colume of cup drinking

50
Q

Volume of pudding

51
Q

Volume of thick paste

52
Q

Volume of meat

Dysphagia (2 decks)

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