Dysphagia 2

Question 1

Oral Prep Stage

Answer 1

CN V, VII, X, XII

VOLUNTARY

Question 2

Oral Stage

Answer 2

CN XII

VOLUNTARY

Question 3

Pharyngeal Stage

Answer 3

CN IX, XI, X

VOLUNTARY & INVOLUNTARY

Question 4

Esophageal Stage

Answer 4

CN X

INVOLUNTARY

Question 5

Lower Brainstem Stroke

Answer 5

difficulty, delayed, or absent pharyngeal swallow, reduced laryngeal elevation, reduced UES opening, info regarding taste, cough, & gag reflex so can GROSSLY aspirate (can have absent cough reflex)

Question 6

Upper Brainstem Stroke

Answer 6

delayed swallow, not absent

Question 7

Total Laryngectomy

Answer 7

backflow of material into pharynx, poor pharyngeal pressure, nasal regurgitation, fistula can cause retrograde aspiration, reduced UES or PES opening, reduced pharyngeal stripping wave, complaints of food “sticking”

Question 8

oral cancer

Answer 8

everything reduced, slowed or delayed in oral and pharyngeal stages

Question 9

laryngeal cancer

Answer 9

reduced laryngeal elevation, glottal & laryngeal closure, UES/PES opening, & pharyngeal wall contraction

Question 10

UES

Answer 10

upper esophageal sphincter-located at lower end of pharynx. guards entrance to esophagus. pressure driven, larynx elevates and UES opens to let bolus into esophagus. prevents reflux of esophageal contents into pharynx.

Question 11

floor of mouth

Answer 11

elevates hyoid and larynx

Question 12

when to introduce infant to food

Answer 12

4-6 months. based on when reflexive responses have diminished along with motor development (sitting up, holding cup, etc)

Question 13

signs of reflux in infants

Answer 13

gagging, choking, apnea, halitosis, burping, frequent swallowing, emesis (vomiting)

Question 14

Pierre Robin Sequence

Answer 14

u-shaped cleft, glossotopsis (tongue held back), micrognathia (small jaw), retrognathia (retraction of jaw-obstructs airway, respiratory distress with feeding because tongue constantly moving back, *grunting, coughing, sputtering,

Question 15

eosinophilic esophagitis

Answer 15

allergic inflammation of the esophagus. causes food impaction, poor appetite, and reflux

Question 16

factors affecting premie swallowing

Answer 16

• posture-may be hyperextended which results in higher risk of aspiration and reflux
• immature respiratory system
• immature structural alignment

Question 17

SLP vs OT

Answer 17

OT-self-feeding and posturing

SLP-oral motor skills, mealtime behaviors, reaction to food types/textures

Question 18

feeding

Answer 18

often behaviorally motivated, results in aversion to or refusal of foods/liquids

Question 19

swallowing

Answer 19

reduced function of oral, pharyngeal & esophageal structures

Question 20

how to know if infant is having sensory issue

Answer 20

unable to sort solids & liquid, holds food under tongue and in cheek, nipple confusion with breast and bottle feeding

Question 21

hyporreactive

Answer 21

diminished response to taste and temp. drools and stuffs too much food because can’t get sensory info

Question 22

hyperreactive

Answer 22

excessive response to taste/temp. gag and choke. reflux, respiratory problems.

Question 23

why is posture important

Answer 23

oral/pharyngeal-tongue would be retracted, poor lip seal, and reduced lingual and higher risk for aspiration
esophageal-higher incidence of reflux because of gravity helping reflux. so if child is hyperextended you want them to be more forward

Question 24

OST

Answer 24

oral sensorimotor treatment-jaw, lips, tongue. desensitize them to different sensory components by stimulating senses (don’t give them edible things, just bite sticks, etc.)

Question 25

differences in bottles and nipples

Answer 25

``` size of hole, pliability, shape. Dr. Browns-reduces air syringe bottles-control volume pidgeon/chu chu-cleft palate wide neck nipples-improve lip closure ```

Question 26

behavior treatment

Answer 26

least intrusive intervention. education and stress reduction. create best possible environment and provide resources.

Question 27

oral apraxia

Answer 27

happens from LH stroke. voluntary movement disorder of sequencing (inability to sequence motor movements)

Question 28

why are TBI patients difficult to treat

Answer 28

behavioral issues, impulsivity, poor awareness of deficits, attention issues

Question 29

Parkinsons clinical features

Answer 29

resting tremor (even tongue and palate), cog wheeling (muscle jerk), pill rolling, mask expression, hunched body posture, dysarthria

Question 30

Parkinsons swallowing

Answer 30

poor bolus control, random tongue movement, tongue pumping/lingual rolling, weak swallow reflex, drooling, incoordination of swallow and respiration

Question 31

anti-psych medication

Answer 31

slow down CNS to calm and over time slows down swallow. Idiopathic dysphagia

Question 32

LMN Disease

Answer 32

myasthenia gravid-fatigue towards end of meal | ALS-decrease in pressure pump system

Question 33

xerostomia

Answer 33

dry mouth. can't make as much saliva so swallow difficult

Question 34

side effects of radiation

Answer 34

fibrosis, dry mouth, mucositis, painful swallowing (odynophagia), edema, dental changes, sores in mouth, decreased taste buds, fatigue

Question 35

fibrosis

Answer 35

muscles scarred and neck becomes stiff and rigid. longer they sit without swallowing, the more scarred and you can't change fibrosis. swallowing is best swallow therapy