Compensatory Strategies and Swallowing Maneuvers Flashcards
When is chin tuck used?
When pt. has delayed initiation of the swallow, impaired base of the tongue retraction, pharyngeal weakness, or decreased laryngeal elevation
What does the chin tuck help?
shortening the distance between the epiglottis and the posterior pharyngeal wall and elevation of the larynx
When is head rotation used?
When there is unilateral weakness, unilateral laryngeal dysfunction, or unilateral pharyngeal/ pyriform sinus residue
What side is the head rotated to during a head turn?
the weakened side
What does the head rotation help?
It closes off the weakened side and allows the pharyngeal muscles on the unimpaired side to draw the bolus down
When is the head tilt used?
When there is unilateral oral and pharyngeal weakness
What side is the head tilted towards during a head tilt?
the unimpaired side
When is head back used?
When there is prolonged oral transit
When is cyclical ingestion used?
When there is pharyngeal weakness and poor UES opening
What does cyclical ingestion help?
it clears the valleculae and pyriform sinuses of residue
What is cyclical ingestion?
Patient is instructed to alternate solids and
fluids to clear the oral cavity of residue
unable to be managed with lingual sweeping
When are dry swallows used?
with a patient who exhibits post
swallow residue somewhere within the digestive
tract (oral residue, vallecular residue, pyriform sinus
residue)
What are dry swallows?
Pt. is instructed to dry swallow after every bolus
swallow
What are some bolus control strategies?
changing the placement of the bolus in the mouth, modifying the size of the bolus, practicing lingual sweeps, and slower intake rate.
When is an expiratory cough post-swallow used?
When residue has penetrated the larynx after the swallow
When are thickened liquids used?
When compensatory strategies do not help with the protection of the airway and when there is poor control of thin liquids in the oral cavity
What is the supraglottic maneuver procedure?
Patient holds breath, swallows, coughs, and swallows again
What is the goal of supraglottic maneuvers?
reduce aspiration and increase movement of the larynx
What is the super- supraglottic maneuver procedure?
Pt holds breath, bears down, swallows, coughs, and swallows again
What is the goal of the super supraglottic maneuver?
to reduce aspiration and increase the movement of the larynx
When is thermal stimulation used?
before a bolus in ingested and cyclically throughout the meal
What is the goal of the mendelsohn?
to extend hyolaryngeal excursion
What does thermal stimulation help?
swallow initiation
What is the mendelsohn procedure?
Patient is asked to put finger on larynx and and feel the laryngeal elevation. Patient is asked to swallow long and strong to increase laryngeal elevation
