WEEK 6 - NUTRITION - BASIC SWALLOWING ASSESSMENT

Question 1

STAGE 1 - WHAT IS PREPARATION

Answer 1

• Mastication (chewing) – food is moistened and moved around the mouth by tongue and cheek muscles
• Food is mixed with saliva and forms a bolus

Question 2

STAGE 1 - PREPARATION - WHAT YOU BE ALERT FOR

Answer 2

• Need normal tongue movement
• Need teeth
• Need normal sensation in the mouth
• Need moisture and saliva

Question 3

STAGE 2 - WHAT IS SWALLOWING

Answer 3

· The mouth is closed and the voluntary muscles of the tongue and cheek push the bolus into the pharynx.

Question 4

STAGE 2 - SWALLOWING - WHAT YOU SHOULD BE ALERT FOR

Answer 4

• Patient needs to be able to close their lips
• Be alert for facial asymmetry, tongue weakness, inability to close lips, weak or absent gag reflex, loss of sensation to the oral cavity
• Assess for drooling, pocketing, excessive chewing, nasal drainage

Question 5

STAGE 3 - WHAT IS PHARYNGEAL

Answer 5

· The bolus is propelled down the oesophagus
· The soft palate rises up and closes the nasopharynx
· The tongue and pharyngeal folds block the way back to the oral cavity
· The epiglottis closes over the larynx, thus preventing aspiration.

Question 6

STAGE 3 - PHARYNGEAL - WHAT YOU SHOULD BE ALERT FOR

Answer 6

· Delayed or absent swallowing
· Wet gurgling voice, frequent clearing of throat
· Coughing o History of aspiration

Question 7

STAGE 4 - WHAT IS OESOPHAGEAL

Answer 7

· Wave of peristalsis propels the bolus through the oesophagus to the stomach

Question 8

STAGE 4 - OESOPHAGEAL - WHAT YOU SHOULD BE ALERT FOR

Answer 8

· Burning or sub-sternal distress
· Coughing or wheezing