Lecture 4 - motor with swallow

Question 1

Supraglottic swallow

Answer 1

• used for when reflexive airway protection is impaired
• take a deep breath
• put a small bite of food/liquid
• swallow while holding breath
• cough right after you swallow
• swallow again
• breathe
• fills lungs with air, Closes vocal folds, swallow then cough/forced expiration to clear larynx/eliminate any aspirated material

Question 2

Super-supraglottic swallow

Answer 2

• used for patients who additionally have pharyngeal weakness
• take a deep breath and hold it tight (bear down)
• put a small bite of food/liquid
• swallow hard (keep holding breath and bearing down)
• cough right after you swallow
• swallow again
• breathe

Used for patients have additionally have pharyngeal weakness, encourage regular throat clearing/coughing between mouthfuls

Question 3

Mendelsohn manoeuvre

Answer 3

• used to prolong the swallow by prolonging UES opening but does not necessarily increase the diameter of the UES (upper oesophageal sphincter)
• individuals are prompted to palpate their larynx to learn the movement and are prompted to hold the movement at peak elevation

Question 4

Effortful swallow

Answer 4

• the patient ‘swallows hard’ to increase posterior movement of the tongue base
• increased drive of the bolus through the pharynx reduced residue in the valleculae
• increases global pharyngeal contractility in adults with dysphagia on thin liquids supporting the hypothesis that it generates greater pharyngeal pressure when compared with non-effortful swallow