intro to dysphagia Flashcards
(42 cards)
What is dysphagia
difficulty swallowing or difficulty moving bolus from the mouth to the stomach
is dysphagia age specific
no
what are etiologies of dysphagia
- infection
- structural malformations
- surgery (thryoid/RLN/cervical)
- conditions that weaken/damage muscles/nerves (CVA,PD,TBI)
what are the consequences of dysphagia
- dehydration
- malnutrition
- aspiration pneumonia
- quality of life
what are the different types of dysphagia
- oral
- pharyngeal
- *oraopharyngeal
- esophageal
what does oral dysphagia include
- tongue mvmt
- lip closure
- pocketing
- transport
what does pharyngeal dysphagia include
- airway closure
- residues
- motility
- UES
what does esophageal dysphagia include
- motility
- LES
- fistula
- diverticulum
- HCI: reflux, ulcer
how many stages of dysphagia are there
3 per carmichael
- oral
- pharyngeal
- esophageal
logemann puts oral prep as stage 1 putting a total of 4 stages
what is involved in the oral prep/oral stage
- mastication
- bolus formation
- bolus transport from the oral cavity to the -pharynx
how long is the oral prep/oral stage
time varies with bolus consistency
how long is the pharyngeal stage
~1 second
what is involved in the pharyngeal stage
- epiglottis inverts over the laryngeal vestibule
- larynx and hyoid bone are pulled anteriorly and superiorly to open the pharynx
- relax the cricopharyngeus (UES) muscle
- assist VFs in closing off the glottis
- bolus is propelled through the pharynx toward the esophagus by action of pharyngeal constrictors
how long is the esophageal stage
~10 seconds
what is involved in the esophageal stage
- bolus flow through the esophagus via peristalic contractions of striated and smooth muscle along the esophageal wall
- relaxation of LES allows bolus to flow into the stomach
what are the signs and symptoms for the oral or pharyngeal dysphagia
- coughing or choking with swallowing
- difficulty initiating swallowing
- food sticking in the throat
- sialorrhea/xerostomia
- drooling/ spillage
- unexplained weight loss
- change in dietary habits
- penetration
- aspiration
- recurrent pneumonia
- change in voice or speech (wet voice)
- nasal regurgitation
- wet, gurgly voice quality
what are the signs and symptoms of esophageal dysphagia
- sensation of food sticking in the chest or throat
- oral or pharyngeal regurgitation
- change in dietary habits
- recurrent pneumonia
- reflux
- aspiration
what are the signs and symptoms of silent aspiration
NO s/s
-possible signs: tearing, runny nose
what is feeding
-placement of food in the mouth before initiation of swallow
what stage involves feeding
-oral prep stage (salivation, presentation)
what is swallowing
transfer of food/drink from mouth to stomach
what stages involve swallowing
- oral
- pharyngeal
- esophageal
how long does a swallow screen take
10-15 mins administration/observation of a small bolus
what is included in a swallow screening
- administration/observation of a small bolus
- bedside clinical assessment
- look for signs and symptoms
- cannot assess A&P
- Pre-diagnostic
