Dysphagia Intervention Flashcards Preview

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Flashcards in Dysphagia Intervention Deck (14):
1

What are swallowing interventions?

 

  • •Compensatory strategies
    • •Diet modification
    • •Compensatory techniques
  • •Biofeedback
  • •Strengthening exercises
  • •NMES (Neuromuscular Electrical Stimulation)
     

2

Diet modification. why restrict? Kinds of diets?

 

  • •Patient’s food is restricted to certain textures with the intention of:
    • •Reducing risk of aspiration/choking And
    • •Decrease effort required to meet nutritional and hydration needs
  • •Foods are selected or prepared to meet diet recommendations
  • •Regular diet: no restrictions. The patient take any solid food.
  • Mechanical Soft Diet: Soft bite sized foods only. Nothing hard or crunchy. Nothing that doesn’t get completely chewed up. Nothing that you can’t cut with the side of a spoon.
  • Pureed Diet: Food has been through a blender. Nothing with any solid chunks that need to be chewed.


3

Diet modification: Drinks. Why thickened? Levels of thickness?

 

  • •Drinks are thickened to
    • •increase viscosity and cohesion of bolus
    • •Slow rate of flow giving the patient more time to protect airway during the swallow
  • •Levels of thickness
    • •Thin Liquid
    • •Nectar Thick Liquid
    • •Honey Thick liquid
    • •Pudding thick Liquid

4

Mixed consistencies


•Mixed consistencies: a combination of multiple textures. Typically includes a thin liquid. Can be the most difficult of all options.
 

5

What are compensatory techniques?


•Environmental Modification
•Behavioral Modification
•Maneuvers
 

6

Compensatory Maneuvers: chin tuck


•Chin Tuck
•Decreases airway opening. Makes it easier to protect airway.
•Is often over used by nurses, doctors and SLPs
•Patient must be evaluated using the technique before it is prescribed
•Useful for patients who:
•Have trouble protecting airway
 

Can sometimes INCREASE risk of aspiration.

Don’t have to move muscles as far

7

Compensatory Maneuvers: Mendelsohn


•Mendelsohn Maneuver
•Can also be used as an exercise to improve laryngeal elevation
•Requires patient to hold larynx in an elevated position mid-swallow
•When done correctly, larynx will remain closed and upper esophageal sphincter open
•Useful for patients who: 

Give more time for food to get where it needs to go

8

Compensatory Maneuvers: Supraglottic Swallow 


•Supraglottic swallow
•Patient hold breath prior to swallowing to help with laryngeal closure
•After the swallow, the patient forcibly exhales or coughs to help clear airway. 
Forcing airway closed by holding breathe before they swallow

9

Biofeedback


•Electrodes are placed on the anterior neck.
•Electrodes measure the strength of muscle contraction
•Patients can monitor their performance and work towards set goal

Sense muscle contractions

10

Muscle strengthening Exercises


•Mendelsohn Maneuver
•Masako maneuver
•Shaker Maneuver

 

11

Muscle strengthening Exercises:
Mendelsohn Maneuver

Same as before, also strengthens muscles

12

Muscle strengthening Exercises:
Masako maneuver


•“Tongue hold Swallow”
•Good for strengthening: base of tongue
•Risk factors:
 

13

Muscle strengthening Exercises:
Shaker Maneuver


•Intended to strengthen the muscles responsible for hyoid and laryngeal elevation.
•What Limitations do you see?
•Need a certain dgree of strehgnth, needs right facility that is set up for this
 

14

Neuromuscular Electrical Stimulation (NMES)


•Electrodes are applied to the anterior neck and or face
•A small electrical current is passed through the muscles under the electrodes
•Effect may facilitate muscle contraction or have a resistance effect, or both