Lecture 4 Flashcards
(44 cards)
What is dysphagia?
Difficulty swallowing
What are the causes of dysphagia?
Neurological disorders
Mechanical causes
Head and neck conditions
Age
What are mechanical causes of dysphagia ?
- Abnormal growths or structural changes in the esophagus
* Inflammation or chronic gastric reflux disorders
What are head and neck conditions that cause dysphagia?
• Head and spinal cord injuries; some head and neck cancers (radiation therapy for head and neck cancer)
How do causes of dysphagia differentiations from children to older adults?
- Children: cerebral palsy or developmental disabilities
* Older adults: dry mouth, weakness, general frailty including changes to nerve and muscle function with age
Where can swallowing problems occur?
Swallowing problems can occur anywhere along the path from the mouth to stomac
How common if dysphagia?
- 40% older individuals
- Half of acute care Pts
- 2/3 of long-term care Pts
what are the phases of a normal swallow?
1) Oral preparatory phase
2) Oral transport phase
3) Pharyngeal phase
4) Esophageal phase
What is the oral preparatory phase?
Food/liquid enters the mouth, and the mouth closes. The food is chewed and mixed with saliva, becoming a bolus
What is the oral phase?
The tongue pushes the bolus of food/drink towards the back of the mouth.
What is the pharyngeal phase?
The bolus passes from the mouth through the throat and into the esophagus and the airway closes.
What is the esophageal phase?
The bolus passes through the esophagus into the stomach.
What are the S&S of dysphagia in the oral preparatory phase?
• Food pocketing -decrease cheek tone, sensitivity • Poor bolus formation e.g.:Poor tongue control, partial glossectomy • Food leaks, drooling -decrease lip tone • Difficulty chewing - Poor jaw movement • Excessive saliva • Xerostomia (thick saliva & dry mouth) • Aspiration
What are the S&S of dysphagia in the oral transport phase?
Aspiration due to delayed or absent swallow reflex
Epiglottis sint able to close properly
What are the S&S of dysphagia in the pharyngeal phase?
✓Coughing and/or wet “gurgly” vocal quality (airway protection incomplete or non-existent)
✓Aspiration due to laryngeal closure
What are the S&S of dysphagia in the esophageal phase?
✓Bolus remains in esophagus
-due to decrease esophageal peristalsis, narrowing of esophageal
passage
✓Aspiration after the swallow
What are the 2 kinds of how you know someone has aspiration?
Passage of material below vocal cords into larynx and trachea
Overt: Elicits cough reflex
Silent: Does not elicit cough or choking sensation
What is aspiration associated with?
Chronic expectoration of mucopurulent sputum
Recurrent pulmonary infection
Rapid decrease in respiratory function
What are the 3 kinds of aspiration?
Prandia: Occurs through chewing & swallowing
Salivary: Aspiration of own saliva
Reflux: Refluxate into lungs→ chemical irritation
Who would be on the team of someone who has dysphagia?
Physician SLP RD Radiologit Nurse
What is a BWA?
Bedside swallowing assessment
What do you do for BSA?
• Physical exam:
- Oro-pharyngeal motor function
- Tolerance to food & fluid consistencies
• Clinical evaluation: oral & pharyngeal phases
What are the S&S of dysphagia?
Drooling,pocketing,poorcontrol,weakness,slurredspeech,
wet/’gurgly’ voice, etc.
What is a video-fluoroscopy?
Barium added to food because its metallic it shows up on X-rays
