Term
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Definition
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Definition
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Term
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Definition
| Small mass of chewed food |
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Term
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Definition
| When food or liquid spills into the larynx and airway past the level of the true VF |
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Definition
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Term
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Definition
| "pertaining to swallowing" |
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Definition
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Definition
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Definition
| 85% of patients recover or significantly improve with therapy |
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Term
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Definition
13-15% acute patients
30-35% rehab. patients
40-50% geriatric patients
55% with TBI or CVA accident
75% with head and neck cancer
Children with dysphagia often develop negative experiences with food or oral aversion |
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Term
2 systems shared for swallowing:
Where swallowing center is located: |
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Definition
Respiratory and digestive
Swallowing center initiated in brainstem |
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Term
| Upper aerodigestive tract |
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Definition
Anatomical features related to swallowing function
contains: nasal and oral cavities, pharynx, larynx, esophagus |
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Term
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Definition
1. Oral, seen from the mouth
2. Pharyngeal, section from the soft palate (velum) to the valleculae |
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Term
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Definition
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Term
| Upper aerodigestive muscles (3) |
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Definition
Mylohyoid - mandible to hyoid
Geniohyoid - chin to hyoid
Digastric - U-shaped connecting mandible, chin, and hyoid bone |
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Term
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Definition
| Posterior to larynx, inferior of pharynx |
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Term
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Definition
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Term
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Definition
[image]
Main muscles that make up the wall of the throat |
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Term
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Definition
1. Superior pharyngeal constrictor
2. Middle pharyngeal constrictor
3. Inferior pharyngeal constrictor |
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Term
| Pharyngeal Structures for Swallowing |
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Definition
Soft palate/velum
Pharyngeal walls (lateral and medial)
Valleculae
Pyriform sinuses* |
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Term
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Definition
Upper esohpageal sphincter (UES)
esophagus can be used for speech if larynx is removed |
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Term
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Definition
Located at the joint of esophagus and pharynx
Cricopharyngeal region (inferior portion of inferior constrictor)
prevents air from entering esophagus |
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Term
| Gastrointestinal Tract Structures |
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Definition
| Esophauges, LES (right above stomach), stomach, large and small intestines, etc. |
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Term
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Definition
Phases are dynamic and overlapping, they allow bolus to move from mouth to stomach safely and efficiently
Some phases are voluntary and some are involuntary
4 Phases:
Oral Prep, Oral, Pharyngeal, Esophageal |
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Term
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Definition
Preparation for swallowing, voluntary
Food is sealed in mouth, move food with tongue and mandible to make bolus |
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Term
| Oral Stage (oral transport) |
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Definition
Velum elevates, tongue elevation begins and bolus is moved posteriorly
Tongue cups bolus at roof of mouth
Swallowing reflex is triggered, last voluntary phase |
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Term
| SLP works with bullemic and anorexic patients with oral aversion for which stages? |
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Definition
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Term
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Definition
Involuntary
Continued elevation of velum, larynx elevates, epiglottis and VF (true and false) closes, peristalsis, relaxation of sphincter due to pressure of food/liquid |
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Term
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Definition
| Wave-like contractions in throat to push food down to stomach |
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Term
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Definition
Bolus passes UES and into esophagus, bolus moves from cricopharyngeal junction (UES) to LES and stomach via peristalsis
8-20 seconds approx. |
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Term
| Common Diagnoses Associated with Dysphagia |
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Definition
| TBI, stroke, Parkinson's, MS, Huntington's, Cerebral Palsy, etc. |
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Term
| Types of Dysphagia (within 4 Stages) |
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Definition
Oral Prep Dysphagia
Oral Stage Dysphagia
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food may spill into pharynx before swallowing or food retained after swallowing
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may have difficulty meeting nutritional needs
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reduced tongue functioning
Pharyngeal Phase Dysphagia
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difficulty initiating swallowing
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residue left over after swallowing
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pharyngeal muscles may be weak
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aspiration
Esophageal Dysphagia
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often have pharyngeal stage complaints
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problems with food transfer (UES)
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backflow or reflux
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peristalsis disrupted
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food may feel stuck, or esohpagus may be narrow
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Term
Signs* and Symptoms** (within stages)
what is seen*
patient complaints** |
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Definition
Oral Prep and Oral Stage
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increased effort, taking too long to eat
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tired of eating, fatigue
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can't eat certain types of food
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Loss of food/liquids from mouth or residues left after swallowing
Pharyngeal Stage
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coughing, choking, gagging, altered vocal quality after swallowing (wet or gurgled voice)
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sensation of food stuck in throat
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Problems may occur without symptoms!
Esophageal Stage
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difficulty managing solids
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food stuck (heart burn)
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regurgitation or reflux after meal
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complaints of dysphagia without overt signs
All types of dysphagia can be associated with respiratory problems or infections |
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Term
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Definition
Look at case history (type of food, when, progression, medical conditions), Clinical swallow evaluation, videofluoroscopy, fiberoptic endoscopic evaluation, oral mechanism examination, etc.
Esophageal problem requires further evaluation |
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Term
| Clinical Swallow Evaluation |
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Definition
Radiation to head and neck areas so very short, x-ray "movie"
Involves oral-motor and cranial nerve assessment; possible observation during meal to follow food |
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Term
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Definition
Uses radiation
Images swallowing process, following food/liquid through mouth, pharynx, and into esophagus |
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Term
| Fiberoptic Endoscopic Evaluation of Swallowing |
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Definition
Doesn't use radiation, not as common, less view of structures
Flexible camera passed through nasal cavity and videotaped |
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Term
| Oral Mechanism Examination |
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Definition
| Notes abnormalities, asymmetry, sagging, motor differences, oral reflexes, sensation, throbbing, etc |
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Term
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Definition
SLP and dietician work on dietary modifications
Surgical or medicinal treatments done elsewhere
Dysphagia therapy performed by SLP (skill building, compensations/adaptations) |
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Term
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Definition
| Exercises, swallowing manuevers, changes in head/throat position, improve self-feeding techniques, modify environment/utensils/foods |
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Term
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Definition
| General decline of overall health, associated with other diseases, psychological impact, significant cost of feeding tubes and special foods |
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