Week 3 - Dysphagia Flashcards Preview

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Flashcards in Week 3 - Dysphagia Deck (16)
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1
Q

what are the stages of a normal swallow?

A
  • pre-swallow
  • oral preparation
  • oral stage
  • pharyngeal stage
  • oesophageal stage
2
Q

oral preparatory stage:

  • what kind of process?
  • how can the mechanical stage be bypassed?
  • what occurs in the oral cavity?
  • bolus is kept at?
  • what is the duration?
A
  • voluntary process
  • when taking drinks quickly at once
  • chewing, tasting, mixing with saliva to form bolus
  • front of mouth
  • duration is variable
3
Q

oral stage:

  • what kind of process?
  • what changes occur from the preparatory stage? how does it occur?
  • how long does it last?
A
  • also voluntary
  • bolus is moved to back of the mouth, via the movement of the tongue
  • lasts ~1 second
4
Q

pharyngeal stage:

  • what kind of process?
  • what does it involve the function of?
A
  • involuntary stage
  • involve function of valves to direct food through the pharynx, and to drive food through the pharynx into the oesophagus
5
Q

pharyngeal stage: what are the valves involved and how do they contribute to the process?
what is the “pressure generator” made of?

A
  • velopharyngeal valve: prevents escape of food to the nasal cavity.
  • cricopharyngeal valve: muscle helps food go down the pharynx
  • pressure generator: base of tongue in contact with posterior pharyngeal wall
6
Q

oesophageal stage:
which anatomical structures involved?
what happens to respiration?
how long does this stage last?

A
  • larynx lowers, returns to normal position
    cricopharyngeal contracts, preventing reflux of food
  • respiration resumes
  • 8-20 seconds
7
Q

what is a tipper and a dipper swallow?

A

tipper: tongue placed against incisors, bolus above the tongue
dipper: bolus beneath the anterior tip of tongue, tongue has to dip beneath bolus to elevate it above the tongue

8
Q

what are the 4 changes in swallowing associated with ageing?

A
  • increased frequency of dipper swallow vs tipper
  • delated pharyngeal elicitation
  • loss of muscle reserve
  • increased frequency of laryngeal penetration
9
Q

what are causes of dysphagia in older patients?

A
  • dementia
  • CVA: cerebrovascular accident
  • poor OH
  • thrush
  • parkinson’s disease
  • end of life
10
Q

causes of dysphagia in younger patients?

A
  • head injury
  • degenerative neurological disorders: motor neurone disease, multiple sclerosis, huntington’s disease
  • facial trauma
  • burns
11
Q

trisumus:

  • what is it?
  • why does it occur
  • what is the mechanism that causes it?
  • what functions does it affect?
A
  • decreased oral aperture
  • hypervascularity or neural damage, leading to:
  • persistent contraction of masticatory muscles
  • affects: articulation, resonance, swallowing, chewing, voice (elevates larynx)
12
Q

dry mouth: occurs with?

A
  • radiotherapy
  • medication/polypharmacy
  • sjorgen’s syndrome
  • thrush
13
Q

cleft lip & palate:
general issues with swallowing?
which stage do children usually have problems?

A
  • rare to find issues with swallowing in affected adults, unless they have not had repairs as children
  • usually problems with oral stage, but swallow and airway protection is ok
14
Q

what could be a sign of problems with swallowing?

A
  • drooling
  • coughing
  • moist voice
  • oral residue
  • reduced laryngeal movement
  • patient/carer concern
15
Q

effects of dysphagia?

A
  • poor nutrition/diet; due to avoidance
  • dehydration: not enough fluids
  • recurrent chest infections
  • UTI
  • OH
  • aspiration pneumonia
  • death
16
Q

impact on dental practice:

caution with?

A
  • patient’s posture: caution when lying flat, patient may choke if unable to manage own secretions