Flashcards in O14 Swallowing PART I, FINAL Deck (21):
What is swallowing?
Moving food from mouth to stomach
T/F: Swallowing disorders occur in all age groups
1. Can they protect the airway?
2. Can they get their oral intake all the way to the stomach or does it get hung up somewhere along the way?
What is dysphagia?
Problems or difficulty swallowing;
What are the 3 phases of swallowing?
1. Oral phase
2. Pharyngeal phase
3. Esophageal phase (we don't deal with this phase)
Talk about the oral phase of swallowing.
needs good closure, no leaking
Talk about the pharyngeal phase of swallowing.
o Negative air pressure helps to drive the bolus backwards.
o Many muscles for peristalsis must work together to drive the bolus into the esophagus...
What must happen for a successful swallow in the pharyngeal phase? (six things)
- Tongue muscles- tongue lifts in front & bunches in back.
- ***Larynx lifts and closes in a sphincteric action.***
- Epiglottis closes backwards over the vestibule.
- False and true vocal folds close in.
-True vocal folds close tightly.
- Superior, middle, and pharyngeal constrictors work together to squeeze food into esophagus.
What happens during the esophageal phase?
Upper esophageal sphincter (cricopharyngeus) has relaxed to allow the food into the esophagus.
What are the extrinsic muscles that are used for swallow? (suprahyoids and infrahyoids)
a. Suprahyoids: **laryngeal elevators** critical for swallow, ELEVATE larynx
1. Digastricus - means 2 bellies, anterior and posterior belly.
2. Mylohyoid - this muscle forms the floor of the mouth.
3. Stylohyoid – originates from styloid process of temporal bone; a long and slender muscle that is lateral and superficial to the posterior belly of digastricus
4. Geniohyoid - it is located superiorly to mylohyoid.
b. Infrahyoids: critical for breathing - move the larynx down for panting; **laryngeal depressors**
What are the four structures that protect the larynx?
(from bottom to top)
a. True vocal folds
b. False vocal folds
c. Aryepiglottic folds
What are the spaces and places of the larynx?
2. pyraform sinuses
3. aditus laryngeus/vestibule
4. anterior commissure
5. posterior commissure
What are the three pharyngeal constrictors?
What is the muscle of the upper esophageal sphincter?
Cricopharyngeus - peristaltic motion
***What are the risks for dysphagia?***
Lack of muscle function
Lack of sensation
Lack of cough/clear reflex
food or liquid BELOW the level of the TRUE VOCAL FOLDS.
food or liquid in the vestibule (at the level of the true vocal folds)
What is "Residue"?
Leftover food/liquid in the vestibule or the places and spaces of the larynx. This is a huge aspiration risk.
What is "backflow"?
food or liquid that has gone into the esophagus and has come back up into the pharynx or nasal cavity.
What are four signs and symptoms of aspiration?
Coughing after swallow
History of pneumonia
Laryngeal damage, stroke, neurological damage or disease (lead to lessened sensation)
Food squirting out the tracheostomy (duh)
What is one physiological evaluation for swallow?
Modified barium swallow (MBS) - videoflouroscopic procedure
-MBS looks at function of larynx
1. determine abnormalities causing the symptoms
2. identify & evaluate treatment strategies