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Terms in this set (21)
Structures involved with Dysphagia and Swallowing Disorders
- Oral facial musculature
- Pharyngeal and laryngeal structures
- piriform sinuses
- vocal folds
Praxis/Motor Planning Deficits can cause...
Inability to effectively chew and coordinate tongue movements to move bolus toward base of tongue
Residual food centrally located in mouth
Difficulty forming a bolus with smooth consistency
Facial Paralysis can cause...
Incomplete close of mouth
Loss of bolus out of the front of oral cavity
Sensory Impairment of the Oral Cavity can cause...
Pocketing of food
Spillage of residual food into airway
Timing of swallow sequence to be "off"
Weakness of Tongue can cause...
Inefficient propulsion of bolus at an efficient rate of speed bast base of tongue into pharyngeal cavity
Lack of close at the cricopharyngeal junction which leads to aspiration
Weakness of Elevation of the Pharynx during Swallow can cause...
Incomplete triggering of pharyngeal phase of swallowing
Vocal Cord Paralysis can cause...
Inefficient closure of vocal folds during pharyngeal phase of swallowing which may be safe or can cause aspiration
Penetration of Bronchi by Bolus during Aspiration can cause...
Food to enter lung
True aspiration which can lead to pneumonia
Diminished Esophageal Mobility can cause...
Bolus to sit in esophagus and slowly move down to stomach or up to pharynx
Feeling of food stuck in throat
Aspiration if bolus moves back up towards pharynx
Food enters airway.
Person may cough reflexively to clear throat.
May aspirate silently (bolus enters lung with no rxn, bolus enters and person experiences distress w/o cough, person aspirates when food propels up and person can't swallow it).
1. Staff reports concerns regarding swallowing
2. Persons face changes color during/after eating
3. Person gasps for breath, but has a partial or complete airway obstruction
4. Bedside swallow eval
5. Modified barium swallow (MBS)
6. Flexible endoscopic esophageal swallow (FEES)
Modified Barium Swallow (MBS)
- Performed when person is seated upright.
- Administered trial boluses laced with barium of mixed consistencies
- Video records moving x-ray of swallow.
- Still x-ray shots are taken if aspiration is observed.
- Test ceases if aspiration occurs.
Flexible endoscopic esophageal swallow (FEES)
- done at bedside or in office
- food consistencies are laced with green die
- flexible endoscopic catheter containing video camera passes through nasal cavity and into pharyngeal cavity
- person given variety of consistencies to swallow.
- observations determine if swallow is intact or impaired
- sensation for light touch in pharyngeal cavity (forcing air through tube)
Results of Aspiration
Cough bolus up (reflex intact)
Cough that is too weak to expel bolus
Bolus enters lung with no reaction
Bolus enters lung and causes respiratory distress
Can lead to pneumonia
Seated with appropriate amount of support
Neutral pelvic alignment
NO head/neck extension
Facilitating Lip Closure
Apply slight upward pressure under the lip
Facilitating Jaw Closure
Apply firm upwards pressure under the jaw
Inhibiting Tongue Thrust
Press bowl of spoon downward and hold on tongue
Facilitate lip closure
Place spooon on middle aspect of tongue and apply slight downward pressure
Place food between gums and teeth
Decreasing Tactile Sensitivity in Oral Cavity
Provide firm pressure
Encourage sucking/chewing on a cloth
Rub gums, palate, tongue
Promote oral exploration of toys
Use a NUK toothbrush
Vary textures of foods given
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