deck 2 Flashcards
(27 cards)
What are the 5 key activities that occur during the pharyngeal stage
- closure of the velopharyngeal port
- tongue base retraction
- elevation of hyoid and larynx
- closure of larynx
- relaxation/ opening of the UES
What is the UES
Upper esophageal sphincter: aka Cricopharyngeal opeing or pharyngeal esophageal segment
Located at the lower end of the pharynx and guards the entrance into the esophagus
what role does the UES play in swallowing
- pressure drives it to open, which is caused by larynx elevating
- cricopharyngeus muscle opens to permit entry of bolus into esophaus
- it prevents reflux of esophageal contents into the pharynx to guard airway aspiration
What role does the floor of mouth muscles play in swallowing
the muscles of the floor of the mouth elevate the hyoid and larynx
What are methods we utilized to evaluate swallowing
- Bedside swallow evaluation
- MBS
- FEES
- Manometry
- ultrasound
What are the 4 categores of swallowing treatment
- behavioral- changing behavior to adapt to the swallow disorder- no straws, slow down, tuck your head
- Dietary- changing the diet to adapt to the swallowing disorder- chopped meats, blended food
- Medical- medication changes to adapt to the swallowing disorder- N-G tube, botox
- Sergical- sergical procedure to fix the swallowing disorder- G-tube, thyroplasty
What is the main medical consequence of pharyngeal dysphagia
aspiration pneumonia
What are normal changes in the elderly during the oral stage
- hold bolus more anteriorly
- increased/ prolonged mastication
- redution in tongue mobility
- sensory changes
What are normal changes in the elderly duringg the pharyngeal stage
- larger volumes required to trigger swallow
- slower time for UEs to relfex
- triggering of pharyngeal sswallow below ramus
- uncoupling of the swallow
what are normal changes in the elderly during the esophageal stage
- transmit may be delayed
2. higher incidence of reflux and mobility issues
Why are normal healthy elderly at risk for swalloing problems
- overall reduction in “reserve” anatomical/ physiological changes
- the uncoupling of oral and pharyngeal events
where is the main neural control of swallowing
in the medulla ( brainstem)
Define the NTS
Nucleus tractus solitarii- located in the medulla oblongata which is a cluster of nucleii ( cell bodies) that generate sensory and taste. It is a junction box- coordinates large amount of input and output for sensory/ motor
Define penetration
some of the bolus enters the eara above the glossis. The layrnx and hyoid move up and the trace amount of the bolus is removed from the glottis. Penetration is normal for older adults as long as it clear
Define aspiration
When the blus enters the area above the glottis and it not removed. It passes throught the vocal folds and into the lungs. Aspiration can be normal as long as it is a trace amount.
What is the difference between non-nutritive sucking and nutrative sucking?
Non-nutrative sucking- sucking for pleasure, faster than nutritive sucking, 2 sucks per second, no apneic period, always breathing
nutrative sucking- sucking for nutrition, typically 1 suck per second, there is an apneic period- airway si closed
what are the differences in the anatomy of swallong in infants versus adults
see google doc
How is the infant’s anatomy customized to prevent aspiration
there is no definite oropharynx. The soft palate and epiglottis are squished together, allowing the child to suck and breathe simultaneuosly
What is RDS
Respiratory Distress Syndrome- affects lungs of preterm neonates due to the lack of surfactant (fluid secreted by lungs to stabilize and prevent them from collapsing). Due to lack of fluid, preemies have difficulty inflating and deflating lungs
how would RDS affect infant’s swallowing
RDS affects the infant’s swallowing because they chose to protect their respiratory system through a voluntary refusal to swallow
What are the most important reflexes for the infant
- rooting
- suck/swallow
- tongue thrust
- gag reflex
- cough reflex
What is the suck/swallow reflex
Infants lips/ mouth area are touched, mouth opens and sucking/ suckling begins
Why is the suck/swallow reflex important
because it facilitates transition from breast to bottle
When is the right time to introduce an infant to food
4-6 months. When relexive responses have diminished along with motor development of body and upper extremities
