Dysphagia and Neuromotor Functions Flashcards Preview

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Flashcards in Dysphagia and Neuromotor Functions Deck (32)
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1
Q

Is dysphagia a disorder?

A

No.

It is a symptom!

2
Q

What is a simple definition of dysphagia?

A

Pathology in the physiology of swallowing.

3
Q

List the three kinds of bolus flow abnormalities.

A

Aspiration
Laryngeal Penetration
Residue

4
Q

What are the two (sometimes three) stages of swallowing that we deal with as SLPs?

A

[Oral Preparatory phase]
Oral phase
Pharyngeal phase

5
Q

What is the phase after the pharyngeal phase?

A

Esophageal Phase.

But this is not within our scope of practice.

6
Q

The goal is to swallow blankly and blankly

A

Efficiently and Safely

7
Q

What is a bolus?

A

What you form of the food you consume to prep it for swallowing.

8
Q

What is laryngeal penetration?

A

When the bolus goes into the airway, but not into the trachea. Above the vocal folds.

9
Q

What is aspiration?

A

When the bolus passes the vocal folds in the airway.

10
Q

What is residue?

A

When the bolus remains in the oral and/or pharyngeal areas after a swallow.

11
Q

Explain a Feeding vs. Swallowing Disorder

A

Swallowing is more anatomical with respects to the oral and pharyngeal aspects of swallowing.
BUT
Feeding is a larger aspect of eating, nutrition.

12
Q

Why do SLPs deal with Swallowing?

A

Swallowing is a neuro-motor function – like speech production.

Most children and adults with neuro-motor speech disorders have an accompanying swallowing disorder.

Speech-production and swallowing involve same anatomical structures.

13
Q

Who else can be on a swallow team?

A
Otolaryngologist
Gastroenterologist
Radiologist
Neurologist
Respiratory therapist
Occupational therapist
Dietician
Dentist
Nurse
Neurodevelopmental specialist
Patient’s family
14
Q

What is swallow apnea?

A

Swallow apnea designates the oropharyngeal phase of swallowing during which respiration ceases.

15
Q

What are some of the healthcare settings for dysphagia treatment?

A
In patient: Acute and Sub-acute care
Skilled Nursing Facility (SNF)
Inpatient Rehabilitation setting
Outpatient clinics
Home health setting (not as common)
16
Q

What are the 5 cranial nerves involved in swallowing?

A
Trigeminal (V) 
Facial (VII)
Glossopharyngeal (IX)
Vagus (X)
Hypoglossal (XII)
17
Q

Are cranial nerves LMN or UMN?

A

Lower Motor Neurons!

18
Q

What are the four stages of swallowing?

A

Oral Preparation Stage
Oral Stage
Pharyngeal Stage
Esophageal Stage

19
Q

What structures are involved in the oral stage?

A

Lips, jaw, tongue, hard palate, soft palate, cheek, mandible, and maxilla.

20
Q

What structures are involved in the pharyngeal stage?

A

Base of the tongue, velum soft palate, larynx (hyoid bone, epiglottis, laryngeal vestibule, true and false vocal folds, ary-epiglottic folds.), and cricopharyngeus (the other name for the UES = Upper Esphageal Sphincter).

21
Q

What structures are involved in the esophageal stage?

A

The esophagus.

22
Q

What occurs in the oral prep stage?

A

The food or liquid is prepared into a bolus

23
Q

What occurs in the oral stage?

A

Bolus is propelled to the back of the mouth (oropharynx) 1-1.5 seconds

24
Q

What occurs in the pharyngeal stage?

A

Velopharyngeal closure
Tongue base to posterior pharyngeal wall retraction
Closure of the epiglottis
Hyoid elevation and laryngeal vestibule squeeze
Approximation of the true and false vocal folds
Pharyngeal stripping - alternating contractions
The opening of the UES (or cricopharyngeus)

25
Q

Why is the movement of the tongue base posteriorly and the pharyngeal wall retraction important?

A

It reduces the space, creating a high-pressure system to propel the bolus down the pharynx.

26
Q

What is the space called between the tongue and the epiglottis?

A

The vallecula

27
Q

What is the triangular space on either side of the larynx called? Why should we care?

A

Pyriform sinuses. Because this can be a location for residue to collect.

28
Q

What is peristalsis?

A

The alternating contraction/relaxation that pushes the bolus through the esophagus to the stomach. A wavelike motion.

29
Q

What is the other sphincter in the esophagus? Why do we care?

A

The lower esophageal sphincter.

Because of GERD and LPR.

30
Q

How many kinds of consistencies of food are tested during a swallow exam?

A

5

31
Q

What would negatively affect the efficiency of the oral prep phase?

A

poor salivary function, surgical defects, and neurological disorders.

32
Q

What are the three salivary glands?

A

Parotid
Sub-Mandibular
Sub-lingual