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Dysphagia Test 1 > Chapter 1 > Flashcards

Chapter 1 Flashcards

(60 cards)

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1
Q

What is Dysphagia?

A

difficulty swallowing and/or difficulty moving bolus from mouth to stomach

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2
Q

Is dysphagia age specific?

A

no, ages can range from newborn to elderly

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3
Q

What are some etiologies of Dysphagia?

A

infection, structural malformations, surgery, conditions that weaken/damage muscle/nerves

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4
Q

What are some examples of the types of surgeries that can lead to Dysphagia?

A

thyroid, RLN, cervical

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5
Q

What are some examples of the types of conditions that weaken/damage muscle/nerves?

A

CVA, parkinson’s, TBI

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6
Q

What are some consequences of Dysphagia?

A

Dehydration, malnutrition, aspiration pneumonia and overall quality of life

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7
Q

What is the leading cause of death in Parkinson’s?

A

Aspiration pneumonia

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8
Q

What are the types of dysphagia?

A

Oral, pharyngeal and esophageal

although oropharyngeal can also be mentioned when its a combination of oral and pharyngeal

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9
Q

The types of dysphagia correlate with the __

A

phases of dysphagia

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10
Q

What are some of examples of oral dysphagia?

A

tongue movement, lip closure, pocketing and transport

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11
Q

What are some examples of pharyngeal dysphagia?

A

airway closure, residues, motility and UES

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12
Q

What are some examples of esophageal dysphagia?

A

motility, LES, fistula, diverticulum, HCI-reflux, ulcer

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13
Q

Patients who report oropharyngeal swallowing are able to describe symptoms accurately. T/F

A

True

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14
Q

Patients with esophageal disorders may be highly inaccurate in describing their symptoms. T/F

A

True

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15
Q

Literature on deglutition or swallowing falls into three categories: _

A

Physiology of normal swallow, changes in physiology if swallowing as a result of a variety of medical conditions and methodologies for screening/diagnosis and management of patients with dysphagia

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16
Q

What is diverticulum?

A

pockets in esophagus

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17
Q

What are the stages of dysphagia?

A

oral, pharyngeal and esophageal

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18
Q

Describe the oral stage.

A

mastication, bolus formation, and bolus transport from the oral cavity to pharynx.
This stage begins when lips close after food enters mouth.

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19
Q

How long does the oral stage last?

A

It is dependent on the bolus

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20
Q

Describe the pharyngeal stage.

A

The epiglottis inverts over the laryngeal vestibule. The larynx and hyoid bone are pulled anteriorly and superiorly to open the pharynx, relax the cricopharyngeus (UES) muscle, and assist the vocal folds in closing off the glottis. The bolus is propelled through the pharynx toward the esophagus by action of pharyngeal constrictors.

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21
Q

How long is the pharyngeal phase?

A

about 1 second

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22
Q

When does the pharyngeal phase begin?

A

when the head of the bolus gets past the posterior faucial pillar

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23
Q

The majority of disorders are found in what phase of the swallow?

A

pharyngeal

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24
Q

Describe the esophageal stage.

A

The bolus flows through the esophagus via peristaltic contractions of striated and smooth muscle along the esophageal wall. Relaxation of the LES allows bolus to flow into stomach, then closes to prevent food from coming back up

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25
The stage before lips close is called __
feeding
26
When doing therapy with swallowing, it is important to remember what about the oral stage?
keep it to a "normal" time limit
27
How long does the esophageal stage last?
8-20 seconds depending on bolus
28
What are some signs and symptoms of oral or pharyngeal dysphagia?
``` coughing or choking with swallowing difficulty initiating swallowing food sticking to the throat sialorrhea/xerostomia drooling or spillage unexplained weight loss change in dietary habits penetration aspiration recurrent pneumonia change in voice (wet gurgly voice) Nasal regurgitation tearing and/or nose running Sore throat ```
29
Spillage is defined as
premature spillage over tongue base | they will cough
30
What is penetration?
food or drink into laryngeal vestibule, past epiglottis
31
What is aspiration?
food or drink past vocal folds and into trachea
32
What does a wet gurgly voice indicate?
bolus on the vocal folds
33
Why is nasal regurgitation a symptom of oral or pharyngeal dysphagia?
VP not closing or extreme reflux
34
Tearing and/or runny nose can indicate
silent aspiration
35
What are some signs and symptoms of esophageal dysphagia?
``` sensation of food sticking in the chest or throat chest pain oral or pharyngeal regurgitation change in dietary habits recurrent pneumonia reflux aspiration ```
36
Head, neck and chest radiation cause the esophagus to __
narrow
37
Silent aspiration occurs in what stage?
pharyngeal mostly but can be have esophageal problems too
38
What is feeding?
placement of food in the mouth before initiation of swallow
39
Feeding is also called __
Oral prep stage
40
What is swallowing?
transfer of food/drink from mouth to stomach
41
What is a swallow screening?
10-15 minute administration/observation of a small bolus. It is a pre-diagnostic tool
42
What are the parts of a bedside clinical assessment?
medical history, level of alertness, patient interview, oral motor exam, assess swallow with small bolus
43
What signs and symptoms are you looking for in a screening or bedside assessment?
spillage, oral reside, long transit time, cough, throat clear, gurgly voice, tearing, runny nose, wrong auscultation
44
What is auscultation?
listening to the internal sounds of the body, usually using a stethoscope
45
ID symptoms to explain
abnormalities in anatomy or physiology causing dysphagia (etiology)
46
Diagnostic Procedures examine the physiology through looking at
timing, tongue base motion, epiglottic dysfunction, laryngeal excursion, UES dysfunction, peristalsis, paralysis and sensitivity
47
Diagnostic procedures examines the immediate effects of
treatment
48
What are some imaging diagnostic procedures?
``` FEES/FEESST videofluoroscopy ultrasound videoendoscopy Scintigraphy ```
49
What are some nonimaging diagnostic procedures?
EMG, EEG, acoustic (accelerometer or stethoscope), pharyngeal manometry
50
What are some treatments for dysphagia?
``` diet modification- last resort compensatory strategies maneuver exercise stimulation experimental prosthetic surgery ```
51
Describe diet modification as a treatment for dysphagia.
``` change volume, viscosity, texture, temperature of food/drink NPO-NG tube G tube PEG tube J tube TPN ```
52
Describe compensatory strategies as a treatment for dysphagia.
Mostly positional like posture chin tuck head rotation multiple swallows
53
What are some maneuver strategies as a treatment for dysphagia.
Supraglottic, Super-glottic, Mendelsohn, Effortful swallow
54
What are some exercise strategies as a treatment for dysphagia.
shaker, masako, oral muscle strengthening
55
What are some stimulation strategies as a treatment for dysphagia.
thermal/tactile stim
56
What are some experimental strategies as a treatment for dysphagia.
neuromuscular electrical stimulation, deep pharyngeal neuromuscular stimulation, myofascial release, botox
57
Who is part of the team for a patient with dysphagia?
``` SLP physician/ neurologist/ ENT nursing dietician OT PT Radiologist Pharmacist social worker psychologist ```
58
Why is keeping a good relationship with the pharmacist important?
because many drugs cause dysphagia
59
What are some examples of prosthetic treatment?
palatal lift or obturator
60
What are some examples of surgery treatment?
CP myotomy, diverticulectomy, dilation

Dysphagia Test 1 (5 decks)

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