Etiology of dysphagia and overview of assessment Flashcards
(37 cards)
If a patient c/o food sticking to the roof of the mouth, then what is the impairment?
reduction of tongue to palate movement; reducted range of tongue motion
If a patient has remnants of food in their mouth after swallowing food, then what is the impairment?
reduced buccal tone or reduced labial tone
If a person’s voice sounds hoarse and they exhibit other signs of dysphagia, then what is the impairment?
There’s material on the true VFs
If a person is a slow eater, then what is that indicative of?
increased oral transport time; pocketing of food may be occurring; damage to the glossopharyngeal nerve
If a person is coughing before swallowing, then what is that indicative of?
early breakage of retro-oral seal due to premature spillage
If a person is constantly wiping their chin, then what is that indicative of?
Reduced antero-oral seal
If food is not going down a person’s throat, then what is that indicative of?
difficulty with triggering the pharyngeal swallow or absence of the pharyngeal swallow
If food is stuck on the throat upon observation, then what is that indicative of?
residue on the posterior pharyngeal wall, vallecula, and pyriform sinuses
If a person is only coughing, then what may that be indicative of?
aspiration or penetration
If liquids exit a person’s nose, then what may that be indicative of?
VPI or nasal penetration
What can etiologies of dysphagia be categorized under?
Neurological Disease: acquired or (stroke or TBI) and progressive/degenerative (e.g., ALS, HD, or PD)
Mechanical/structural factors (e.g., tumors, surgical complication, edema, xerostomia, and inflammation)
Regarding neural control of swallowing, damage to the afferent pathway results in
neuropathy to CNs involved, such as CN V and CN IX, and subsequent deficits in functions performed by the CNs involved in swallowing.
Regarding neural control of swallowing, damage to the brainstem results in
severe swallowing impairment
Regarding neural control of swallowing, damage to the efferent pathway results in ________
Problems with executing movements; so, there may be a delay or absence of movement
What degenerative diseases would impact the efferent pathway and subsequently the neural control of swallowing?
ALS and Myasthenia Gravis
Regarding neural control of swallowing, damage to the subcortical and cortical inputs of swallowing results in __________
delay or issue with initiating the swallow or issue with coordination of muscles or issues with motor execution.
What acquired diseases can impact the subcortical and cortical inputs of swallowing?
unilateral or bilateral anterior cortical CVA
What degenerative diseases can impact the subcortical and cortical inputs of swallowing?
Parkinson’s Disease, dystonia, UMN disease
What are examples of mechanical/structural factors that cause mechanical/structural dysphagia?
Surgery for oral, pharyngeal, laryngeal cancer (either removal or reconstruction); fibrosis due to radiation therapy for cancer; cervical spine disease; acute inflammation of the oropharyngeal tissues; obstruction from a tumor; pharyngoesophageal diverticulum; systemic disease (lupus, Crohn’s disease, rheumatoid arthritis)
What is phagophobia?
fear of swallowing so there’s a refusal to eat; may be associated with a panic disorder or PTSD
What is globus?
sensation of something stuck in your throat
Regarding oral dysphagia, what drugs reduce the output of saliva?
anticholinergics, antidepressants, antispasmodics
Regarding oral dysphagia, what drugs cause sedation?
anticholinergics, antidepressants, antipsychotics
Regarding pharyngeal dysphagia, what drugs interfere with the dopaminergic systems?
antipsychotics: antidepressants, antianxiolytics, and mood stabilizers
