Upgrade to remove ads
Only $35.99/year

SLHS quiz 3

Terms in this set (49)

What are the stages/phases of swallowing?
- Oral Preparatory Phase
- Oral Phase
- Pharyngeal Phase
- Esophageal Phase
Oral Preparatory Phase
- The role of the oral preparatory phase is to prepare the substance to be swallowed for the act.
- Begins: As soon as food/liquid enters the mouth
- Creation of the bolus
- Breathing continues with inhalation and exhalation through the nose
Oral Phase
- The role is to move the bolus to the rear of the oral cavity for preparation for propulsion down the throat.
- It begins when the tongue pushes bolus back
- Breaking occurs normally, through the nose
Pharyngeal Phase
- The role is to propel the bolus downward through the throat to the entrance to the esophagus.
- Begins when the bolus reaches the anterior faucial pillars located in the posterior region of the oral cavity.
- Breathing halts briefly - apnea moment
What is the danger of the Pharyngeal Phase?
- Penetration: going down the wrong pipe
- Aspiration: coming back up
- Can lead too Asphyxiation (lack of breath), Pulmonary Infection, Pneumonia.
Pharyngeal Phase: Protective Mechanisms
- Soft palate moves up and closes the nasal cavity (elevates)
- Laryngeal elevation
- Epiglottis covers trachea
- Vocal fold adduct (closes)
- Reflexive cough
- Not breathing during this phase
Esophageal Phase
- Moves the bolus through the esophagus and into the stomach
- SLP's do not focus much on this phase involuntary in nature and requires medical intervention when disrupted
Possible Causes of Dysphagia
- Brain Injury
- Progressive Neurological Disease (When things are breaking down and motor is not working as quickly)
- Cancer treatments of the head and neck
Assessment of Swallowing Disorders
- Case history
- Physical feeding and swallowing evaluation
- Online instrumentation
Dysphagia Evaluation: Bedside Swallow Evaluation
- Oral examination
- Feeding trials: to test what textures the patient can swallow.
Fiberoptic endoscopic examination of swallowing (FEES)
A probe down to see what is happening while the patient eats. Different visualization (through the nose into the pharynx) to get a real live picture of the swallow, when everything closes off we can not see what is going on after
Vibeofluoroscopy
Baum (element that shows up on X-rays, con is that it is not portable and radiation
Pediatric Feeding and Swallowing
- Infant anatomy is different
- However babies may have trouble with coordinating the suck/swallow/breathe sequence, with transition to solid foods, if there are syndromes/dev. issues
What to watch for in Infants with swallowing disorders
- Arching/stiffening of the body during feeding
- Irritability during feeding
- Coughing/gagging during meals
- Excessive drooling food/liquid coming out of the mouth or nose
- Increased stuffiness during meals
- Gurgle voice quality
- Frequent spitting up
Treatment of Swallowing disorders (short term and long term)
Short term: Nutrition is key, alternative and supplemental feeding
Long Term: Socio-interactionist approach (scaffolding to work on skills, Practice with food of different textures) Long term alternative nutrition methods (Gastrotomy Tube, Compensatory approaches)
Systems Involved in Speech
- Central and Peripheral Nervous System (Brain, spinal cord, cranial nerves, spinal nerves)
- Respiratory System (Trachea, lungs, diaphragm, abdominal muscles)
- Phonatory System (Larynx, Pharynx, trachea)
- Articulatory System (articulators)
- Resonatory System (Head and neck cavities, velopharyngeal port)
CNS
Brain
Brain Stem
Spinal Cord
PNS
Cranial Nerves
Spinal Nerves
Speech Motor Control
Muscles must coordinate
Breathing
Voicing
Appropriate "shunting" of sound
Coordination of the articulators
Motor Speech Disorder
- Speech production deficit resulting from a problem in speech motor control
- Deficit in speech, not language
- Other oral movements (eating, facial, emotion) can co-occur
Incidence is unknown/complicated
Dependent on what's causing the problem. In 2008, 148,000 diagnoses of motor speech disorder.
Prevalence
MSD composes 51% of acquired communication disorders
Etiology of Motor Disorders
- Brain injury (stroke, TBI, Anoxia, Cerebral Palsy)
- Progressive Neurological Disorders (Parkinson's, ALS, Huntington's Disease, MS)
- MSD are called either Development or Aquired
Apraxia of Speech
Motor planning/programming disorder
- Difficulty grouping and sequencing the correct muscles
- Can be both Acquired or Developmental
Looks Like
- Slow Speech
- Distorted Sounds
- Groping of Articulators
Often Caused by
- Damage to Broca's area
Dysarthria
Motor execution disorder
- Physiological deficit and abnormal movement of muscles
- Can be both acquired or developmental
Looks Like
- Slurred, slow, quiet, or uneven speech
Often caused by progressive disease and trauma
Spastic
Damage to motor strip within the frontal lobe
Flaccid
Damage to lower motor neurons - responsible for muscle contraction or cranial nerves that connect to muscles
Hypokinetic
Damage to basal ganglia - often seen in parkinson's disease
Hyperkinetic
Also damage to the basal ganglia, often idiopathic
Ataxic
Damage to cerebellum
Unilateral Upper Motor Neuron (UMN)
Damage to motor strip and connections to lower motor neurons
Thing to put in an assessment for MSD
- Chart history / interview
- Standardized Tests
- Systematic Observation
- Instrumentation
Perceptual measures
Speech sample (systematic Observation) asking them to produce speech
Acoustic Measures
Spectrograms (instrumentation) Looking at the acoustic speech and recording it and looking at the acoustics
Physiologic Measures
Myogenic potentials (instrumentation) electrodes on different parts of the body, sense waves
Looking at the subsystems of speech to assess
respiration
phonation
resonation
articulations
Treatment of MSD
To learn or relearn the motor aspect of production
- Acquisition
- Retention
- Generalization
Treatment methods of MSD
- Slowing rate of speech
- Improving clarity of speech
- Improving ability in the deficit system (respiration, phonation, resonation, articulation) But also
- Teaching communications strategies
- Augmentative / alternative communication
Culture
The beliefs, customs, arts, etc., of a particular society, group, place, or time
Multiculturalism
A society in which people from diverse racial and ethnic backgrounds, socioeconomic groups, age groups, geographic areas and other variables come together to create a mosaic composed of individuals that form a rich world.
Cultural Competence
- Ability of the provider to recognize, honor and respect the beliefs, interaction styles, and behaviors of the individuals and families they serve.
- Providing appropriate, relevant services to each CLD and his or her family
Developing Cultural Competency (3)
1. Learn about the cultural backgrounds of our clients and their families
2. Be aware of and work to eliminate your own biases and preconceptions
3. Build on the unique strengths, values, and experiences of our clients, their families and their culture
Ethnocentrism
The perspective that members of one's own culture do things the "right way"
Cultural Relativism
The view that actions of other cultures are both different and equally valid.
Stereotype
Fixed oversimplified image of members of a community
Cultural tendencies
Patterns of behavior and value commonly observed among a culture.
Communicative Difference vs. Communicative disorder
...
African American Cultural and Linguistic Variables
- African American Communication is different
- African American English, a rule governed systematic linguistic system
Code Switching
- Being able to switch linguistic styles for different situations
- Present across different dialects and different languages
- Code blending is also a thing
Sets with similar terms