Swallowing Disorders

Question 1

how is a moderate swallowing disorder defined?

Answer 1

reduced pharyngeal propulsion

Question 2

how is a mild oral stage dysphagia characterized?

Answer 2

reduced oral preparation and delayed transport

Question 3

pharyngeal swallow delay

Answer 3

a delay in initiating the pharyngeal swallow after oral transport have moved bolus into the pharynx
(very common)

Question 4

in a pharyngeal swallow delay, material often piles up in the __________

Answer 4

valleculae (the space between the tongue base and the epiglottis)

Question 5

laryngeal penetration

Answer 5

material falls into the larynx, but remains above VFs

Question 6

nasal regurgitation

Answer 6

material is pushed into the nasal cavity due to incomplete nasal closure

Question 7

subglottic aspiration

Answer 7

material falls below the VFs into the trachea and potentially into lungs

Question 8

residue

Answer 8

material that remains in the pharynx after the swallow is completed

Question 9

aspiration

Answer 9

usually classified by amount

-trace, mild, moderate, severe

Question 10

aspiration before the swallow is associated with…

Answer 10

delayed pharyngeal swallow

Question 11

aspiration during the swallow is associated with…

Answer 11

reduced laryngeal elevation and closure

Question 12

aspiration after the swallow is associated with…

Answer 12

poor pharyngeal propulsion and residue in the pharynx after the swallow

or is laryngeal elevation is poor

Question 13

most prevalent consequences of dysphagia

Answer 13

• reduced quality of life
• difficulty eating
• altered diet textures
• embarrassment
• lack of social contact during eating

Question 14

physical consequences of dysphagia

Answer 14

• reduced nutrition/dehydration

- can effect cognitive and motor function

Question 15

aspiration pneumonia

Answer 15

• problem with thicker textures
• occurs when client cannot clear aspirated material
• develops because of multiple factors (not just aspiration)

Question 16

airway obstruction/choking

Answer 16

• results from improper feeding, rather than the swallowing disorder
• texture is not a problem

Question 17

stroke victims w/ dysphagia have most problems with…..

Answer 17

pharyngeal stage

Question 18

progressive neurological conditions and dysphagia…

Answer 18

-often oral stage is affect first, and may be quite severe before pharyngeal problems emerge

Question 19

head/neck cancer and dysphagia

Answer 19

often most severe as mouth and/or larynx are reconstructed after surgey

Question 20

what can be used to assess dysphagia?

Answer 20

• clinical or bedside eval
• modified barium swallow
• videoendoscopy

Question 21

modified barium swallow

Answer 21

• assess what’s wrong with swallow
• try rehabilitation strategies to see their effects on the swallow
• tilt head/turn to side

Question 22

three strategies to rehab

Answer 22

1 improve basic function
2 compensatory strategies that work around swallowing problem (head tuck etc)
3 modified diet texture

Question 23

compensatory strategies

Answer 23

• chin tuck
• head turn
• supraglottic swallow (cough swallow exhale)
• mendlsohn maneuver

Question 24

mendlsohn maneuver

Answer 24

• freeze mid swallow

- keeps larynx in middle so it doesn’t go down