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Dysphagia > Module 1 > Flashcards

Module 1 Flashcards

(46 cards)

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1
Q

Dysphagia:

A

impairment in emotional, cognitive, sensory and/or motor acts transferring food from mouth to stomach
Swallowing disorder
Any difficulty swallowing
Difficulty moving food from mouth to stomach

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2
Q

“dysphagia”…. How do we say that?

Not to be confused with dysphasia

A

Childhood aphasia (developmental)

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3
Q

Aspiration:

A

anything going below the level of the VF (food, liquid, saliva)

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4
Q

FTT:

A

Failure to thrive not commuting enough nutritions for your body’s needs

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5
Q

Bolus:

A

latin for ball: anything we swallow

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6
Q

Regurgitation:

A

Spitting food back up

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7
Q

Odynophagia:

A

pain when swallowing

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8
Q

Stricture:

A

closing off of throat?

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9
Q

Alimentation:

A

how you eat and drink

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10
Q

PO:

A

Per oral

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11
Q

NPO:

A

Nothing per oral

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12
Q

Penetration:

A

Things stating to go the wrong way almost aspirated

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13
Q

Peristalsis:

A

How muscles contract to move things down

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14
Q

PNA:

A

Pneumonia

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15
Q

GERD:

A

Gastro-esphogeal reflux disease

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16
Q

Hypernatremia:

A

too much sodium and not enough water

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17
Q

Swallowing

A

is a response that triggers a sequence of muscle contractions that propels prepared food to the stomach
The mechanism of swallowing is a timed series of events.
Muscle contractions/relaxations must take place smoothly.

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18
Q

Swallowing requires:

A

large area of brain stem
—-sequence is preprogrammed by neural ——–circuitry in the brain stem called the “swallowing center”.
6 cranial nerves (paired= 1 for each side)
—–5,7,9,10,and 12
numerous receptors
——Sensory
——taste and the swallow trigger and cough reflex
31 pairs of muscles
—–face, mouth, pharynx, esophagus

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19
Q

Reflexive Swallow

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A

swallowing can be reflexively evoked (involuntary swallowing)
Several regions of the brain can be stimulated and evoke a swallow that is not a part of voluntary deglutition
Swallowing occurs ~ 600 - 1000 times a day (one time a min)
»»most times during a meal
»»least while sleeping
We all probably aspirate some while we’re sleeping
That’s OK – we’re normal (hopefully)
.5 ml of saliva produced per minute in adults

20
Q

Incidence

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A

160,000 to 573,000 new cases of dysphagia each year caused by stroke.
25%-50% of stroke patients
Overall incidence? 6-10 million (ASHA)
13-14% of all patients hospitalized in major medical centers
30-35% of pts in rehab centers
up to 59% of pts in SNFs

21
Q

Acute Care (ICU, step down unit, floor)

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A 
Shorter stay
Medically involved, notable medical  complications 
13-33% prevalence within the hospital
i.e. CVA, TBI, SCI, brain tumor patients
Inpatient Rehab Setting
usually a floor of a hospital 
	Stable but still needing medical assistance 
Typical length of stay: 14-21 days
3 hours or more of tx per day
----1 speech 
----1 occupation 
----1 physical
22
Q

Long-term Care/SNF

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A

Can’t live independently

Can get discharged if they get better

23
Q

Home health

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A

You go to the patients house

24
Q

Outpatient

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A

You are in your clinic and they come to you

45min to 1hr 1-3 times per week

25
Who is on the dysphagia team?
``` SLP Must get referral from DR Pt/Family Dietician OT/PT Nurses CNAs MDs (i.e. primary care physician, GI, otolaryngologist, neurologist) Radiologist (swallow study) RT (respiratory therapy) ```
26
Neurologic disorders (most common)
caused by a change in the neurology of the brain CVA: Stroke Motor Neuron Diseases (ALS): changes in motor movement and function Parkinson’s: motor and sensory component Alzheimer’s/Dementia: cognitive change in function MS: Coordination issue or feeling things in their mouth
27
Pulmonary complication (quick track to dying)
Choking episodes Asphyxia: solid getting lodged Laryngospasm: constriction in the larynx Bronchospasm: a sudden constriction of the muscles in the walls of the bronchioles. Chronic bronchitis Aspiration pneumonia
28
Structural Impairments
Vertebre calcification Extra bone forming, making area more ridged and bulky Tumors Traumatic injuries: broken jaw Webs: Pieces of tissue connecting one side to the other that causes things to get stuck Diverticulum Cleft lip/palate Micrognathia (Pierre-Robin syndrome) Inflamation of the oral/pharyngeal/esophageal tract
29
Psychiatric
Bulimia related This can lead to burning away the muscles of the larynx or pharynx Psychogenic dysphagia phagophobia: scared to swallow maybe it hurts when they swallow
30
other causes of dysphagia
Infectious diseases Muscular disorders Iatrogenic: caused by treatment of diagnostic procedures Normal Aging
31
Malnutrition
``` Inadequate dietary intake Involuntary weight change Decreasing functional status Dizziness Fatigue Decreased immune response ```
32
Dehydration
``` Dryness of lips Dryness or thickened oral secretions Sunken eyeballs Elevated temperature Hypotension: changes in blood pressure (lower) Decreased urine output and UTI Constipation Decreased cognitive status and confusion Nausea and vomiting Non-oral feeding Increased dependence, cost, and time consuming care. ```
33
Anatomic Structures of Swallowing | Oral Cavity
``` lips teeth hard/soft palate mandible uvula floor of mouth (FOM) tongue, base of tongue ```
34
Pharynx
``` Pharyngeal constrictor muscles Wavelike motion of muscles to move food down superior medial inferior ```
35
Vllecula
a wedge-shaped space formed between the BOT and epiglottis
36
Pyriform sinuses:
the space formed by the attachment of the fibers of the inferior pharyngeal constrictor to sides of thyroid cartilage Pyriform sinuses & valleculae are the pharyngeal recesses into which food can fall and get trapped
37
Larynx:
``` Purpose is to keep things out of the lungs when you swallow Begins at the base of the tongue epiglottis aeryepiglottic folds laryngeal vestibule FVF TVF subglottic space ```
38
Esophagus
About 22 cm long Flaccid collapsed tube (flat at rest/ closed) Bounded by 2 tonically contracted spitter muscles UES: about 1 inch long LES: about 1.5 inches long
39
Cricopharyngeus muscle
UES, PE segment, CP segment Most inferior structure of the pharynx pyriform sinuses end here valve at the top of the esophagus designed to keep air from entering esophagus prevents material from refluxing into pharynx
40
3 sections of the esophagus
1. Cervical esophagus runs from suprasternal notch to thoracic inlet 2. Thoracic esophagus from inlet, around aortic notch to level of 8th thoracic vertebrae 3. Abdominal esophagus mainly the LES
41
Layers
``` epithelium laminae propria muscularic mucosae Esophageal muscles ---inner circular ---outer longitudinal ---1/3 striated, 1/3 striated/smooth, 1/3 smooth ```
42
Feeding
is placement of food in the mouth through the oral stage of swallowing when food is propelled posteriorly. Generally discussed when talking about newborns or infants
43
Therapy for feeding:
positioning of food tongue manipulation excercises chewing varying consistencies organizing lingual peristalsis
44
Swallowing
``` involves all stages Therapy for swallowing stimulation of swallowing response improving pharyngeal transit of material airway protection strengthening swallowing musculature all feeding techniques ```
45
Gag
Noxious stimulus or motorically triggered Gag is a reflex Purpose of gag is to eliminate foreign substances anteriorly Absent gag reflex with poor cough trigger= dysphasia
46
Volumes Swallowed | Varies with viscosity of food
``` Saliva: 1 ml Cup drinking: 20+ ml Pudding: 6 cos Thick paste: 5 cos Meat: 2 ccs ```

Dysphagia (6 decks)

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