dysphagia
disorder of ?
many muscles used for speech production are also used for? so SLPs frequently participate in?
dysphagia is found in ? of gen. pop.
about ? of SLPs who work in hospitals and extended care facilities do ?
chewing /swallowing
- chewing and swallowing, eval. and treatment of dysphagia
- 7%
- 75%/dysphagia assessment or intervention
effects of dysphagia
- person may not be able to ?
- food or liquid may enter the ?
- prevents a person from fully participating in?
- removes a person’s?
- ingest enough food or liquid for adequate nutrition or hydration
- respiratory system (aspiration) through the larynx
- family rituals and social events that include food
- pleasure from eating
dysphagia deglutition mastication bolus aspiration
- swallowing diff.
- act of normal swallowing
- technical term for chewing
- soft mass of food
- entry/leakage of food into breathing airway
before we eat... preparing yourself to be ? examples: - - - - without this prep. eating might feel
physiologically ready to take in food
- salivate at thought or sight of food
- position yourself to eat by sitting up
- aroma may stimulate hunger
- rituals: hand washing, saying grace etc
rushed and less satisfying
stages of swallowing
1
2
3
oral (transfer) stage
pharyngeal (transport) stage
esophageal (entrance) stage
oral (transfer) phase
- food or liquid is ? and made into a?
- we should chew ?
- the tongue moves the ? where the ?
- normal
- typically takes about
- manipulated in oral cavity/bolus
- 25 times
- bolus toward back of the mouth/pharyngeal reflex is triggered
- nasal breathing
- 1 sec
pharyngeal (transport) phase -velum? -pharyngeal swallowing reflex causes the food to ? -during this time, the larynx -prevents the bolus from ? phase is complete when -typically takes about
moves up to prevent food from entering nasal cavity
- pass through pharyngeal cavity to entrance of esophagus
- moves up and forward
- entering trachea/lungs by closing epiglottis over vocal folds
- bolus enters esophagus
- 1 sec
esophageal (entrance) phase
the muscles of the esophagus move the bolus in?
typically takes
-wavelike contractions from top of esophagus to stomach
8-10 sec
types of dysphagia oropharyngeal dysphagia: -most common -occurs during esphageal dysphagia: -occurs during functional: sensation of solid and liquid foods ? not assoc. with ?
dysphagia
oral and pharyngeal stages of swallowing
esophageal stage
sticking, lodging, or passing abnormally through esophagus
-anatomic abnormalities, GERD, or well recognized motility disorders
oral stage disorders: improper problems chewing due to ? problems forming collection of premature problems moving food or liquid to the ?
lip seal
reduced tongue movement or reduced range of jaw movement
-bolus
-food residue
-swallowing
back of the mouth due to reduced or weakened tongue movements
pharyngeal stage disorders delayed or absent? aspiration ? inadequate ? failure to close the ? - -
swallow reflex before and or after swallow closure of trachea velopharyngeal part -nasal regurgitation -vallecular residue
esophageal stage disorders -food is backed up from - esophagus cannot ? - esophagus may be ? -
esophagus to pharynx
-GERD
contract enough to move food through
-peristasis
obstructed
-stenosis
assessment case history and background info regarding dysphagia: -location of ? - -
clinical assessment: -what and what factors -what functioning - -exam -exam
swallowing prob.
easy and difficult to swallow foods
nature and severity of disorder
bedside swallow evaluation -caregiver and env. -cognitive and communicative -head and body posture oral-motor -swallowing
instrumentation Videoflouroscopic or modified barium (MBS) swallow study: -barium is -different ? -views are?
coated onto or mixed into food or liquid
size, textures and consistencies of food and or liquids tested
video recorded for later analysis
Fiberoptic endoscopic evaluation of swallowing (FEES)
- a small, flexible tube with a ? is placed in?
- patient can
- provides a visual examination of the pharynx only
light and a camera lens at the end /patients nose and down into pharynx
- cough, hold breath, swallow
- before and after the swallow (pharyngeal stage cannot be visualized)
swallowing therapy and lifestyle changes: body and head? -ex: modification of ? -changes in liquid thickness are most often considered when ? modifying? -ex: provide adapted swallowing focus on improving
positioning
-changes such as tilting the chin down to help narrow airway
- foods and liquids: texture, qualities, temp.
- risk for aspiration, decreased control over mouth/tongue, or there is a reduced sensory awareness
feeding techniques
- allowing extra time between swallows or placing food in sensitive area of mouth
- feeding equipment
- techniques
- muscle strength and coordination
