Podcast
Questions and Answers
What symptoms might indicate dysphagia?
What symptoms might indicate dysphagia?
- Always drinking cold liquids
- Feeling hungry after meals
- Frequent throat clearing without eating
- Extra effort needed to chew or swallow (correct)
Which of the following is NOT a specific cause of dysphagia?
Which of the following is NOT a specific cause of dysphagia?
- Spinal cord injury
- Hypertension (correct)
- Parkinson’s disease
- Multiple sclerosis
What is the purpose of the Fiberoptic Endoscopic Evaluation of Swallowing (FEES)?
What is the purpose of the Fiberoptic Endoscopic Evaluation of Swallowing (FEES)?
- To evaluate taste preferences
- To measure the effectiveness of medication
- To assess pharyngeal and laryngeal structure during swallowing (correct)
- To provide a static view of digestibility
What does the Modified Barium Swallow Study (MBSS) help identify?
What does the Modified Barium Swallow Study (MBSS) help identify?
Which of the following interventions can be used for managing dysphagia?
Which of the following interventions can be used for managing dysphagia?
What could be a sign of aspiration during swallowing assessment?
What could be a sign of aspiration during swallowing assessment?
Which assessment method focuses on the airway protection during swallowing?
Which assessment method focuses on the airway protection during swallowing?
What does pocketing refer to in the context of dysphagia?
What does pocketing refer to in the context of dysphagia?
What is a potential limitation to using maneuvers for swallowing improvement?
What is a potential limitation to using maneuvers for swallowing improvement?
What role does modifying posture play in feeding therapy for children?
What role does modifying posture play in feeding therapy for children?
Which of the following best describes 'Flavor Mapping'?
Which of the following best describes 'Flavor Mapping'?
What is the purpose of 'Flavor Masking' in feeding therapy?
What is the purpose of 'Flavor Masking' in feeding therapy?
Which professional is not typically a part of the feeding team?
Which professional is not typically a part of the feeding team?
What is the main goal of using transitional foods in feeding therapy?
What is the main goal of using transitional foods in feeding therapy?
What is the primary purpose of the supraglottic swallow technique?
What is the primary purpose of the supraglottic swallow technique?
Which of the following is NOT an example of oral-motor therapy or exercises?
Which of the following is NOT an example of oral-motor therapy or exercises?
What characteristic distinguishes the Masako exercise from a maneuver?
What characteristic distinguishes the Masako exercise from a maneuver?
What is the primary function of a nasogastric tube (NG-tube)?
What is the primary function of a nasogastric tube (NG-tube)?
Which exercise involves lifting the head to facilitate the opening of the upper esophageal sphincter?
Which exercise involves lifting the head to facilitate the opening of the upper esophageal sphincter?
What feeding disorder is characterized by extreme food selectivity in children?
What feeding disorder is characterized by extreme food selectivity in children?
Which type of tube is preferred for short-term non-oral nutrition?
Which type of tube is preferred for short-term non-oral nutrition?
Which of the following best describes oral hygiene in the context of swallowing therapy?
Which of the following best describes oral hygiene in the context of swallowing therapy?
What is a common characteristic of the active sleep state in infants?
What is a common characteristic of the active sleep state in infants?
What is the primary function of the rooting reflex in infants?
What is the primary function of the rooting reflex in infants?
Which of the following best describes nutritive sucking compared to non-nutritive sucking?
Which of the following best describes nutritive sucking compared to non-nutritive sucking?
During an assessment, if a child is described as having an alert agitated state, which of the following is true?
During an assessment, if a child is described as having an alert agitated state, which of the following is true?
What occurs during the tonic bite reflex?
What occurs during the tonic bite reflex?
What is a significant indicator of feeding disorders in children?
What is a significant indicator of feeding disorders in children?
Which abnormal reflex indicates difficulty with oral feeding and manipulation?
Which abnormal reflex indicates difficulty with oral feeding and manipulation?
Which of the following describes the muscle tone categories relevant to oral stability?
Which of the following describes the muscle tone categories relevant to oral stability?
Which physiological characteristic should be noted during infant assessment?
Which physiological characteristic should be noted during infant assessment?
What best describes an infant's response during a swallow reflex assessment?
What best describes an infant's response during a swallow reflex assessment?
What type of movement does the swallow reflex perform?
What type of movement does the swallow reflex perform?
What might indicate oral motor weakness in a child?
What might indicate oral motor weakness in a child?
Which action should be taken to assess suck strength in infants?
Which action should be taken to assess suck strength in infants?
What respiratory characteristic defines the drowsy state in infants?
What respiratory characteristic defines the drowsy state in infants?
How does a cleft palate affect sucking ability?
How does a cleft palate affect sucking ability?
What is a common characteristic of jaw thrust in children?
What is a common characteristic of jaw thrust in children?
What is the primary goal of the chin-tuck posture during swallowing?
What is the primary goal of the chin-tuck posture during swallowing?
Which postural technique is primarily aimed at assisting patients with unilateral vocal paralysis?
Which postural technique is primarily aimed at assisting patients with unilateral vocal paralysis?
The head tilt technique is used primarily to address which issue during swallowing?
The head tilt technique is used primarily to address which issue during swallowing?
The effortful swallow method focuses on what aspect of swallowing?
The effortful swallow method focuses on what aspect of swallowing?
What is a potential risk when applying postural techniques for swallowing?
What is a potential risk when applying postural techniques for swallowing?
What is the purpose of the Mendelsohn maneuver during swallowing?
What is the purpose of the Mendelsohn maneuver during swallowing?
Swallowing maneuvers such as the supraglottic swallow mainly focus on what aspect of the swallowing process?
Swallowing maneuvers such as the supraglottic swallow mainly focus on what aspect of the swallowing process?
Which of the following conditions may make postural techniques inappropriate for a patient?
Which of the following conditions may make postural techniques inappropriate for a patient?
Flashcards
Globus Sensation
Globus Sensation
A feeling of fullness in the neck, often associated with swallowing difficulties.
Dysphagia (Painful Swallowing)
Dysphagia (Painful Swallowing)
Pain experienced while swallowing.
Frequent Throat Clearing
Frequent Throat Clearing
The act of clearing the throat frequently, often due to excess mucus or a feeling of something stuck in the throat.
Wet or Gurgly Voice
Wet or Gurgly Voice
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Coughing During/After Eating
Coughing During/After Eating
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Difficulty Coordinating Breathing and Swallowing
Difficulty Coordinating Breathing and Swallowing
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Effortful Chewing/Swallowing
Effortful Chewing/Swallowing
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FEES (Fiberoptic Endoscopic Evaluation of Swallowing)
FEES (Fiberoptic Endoscopic Evaluation of Swallowing)
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Chin-tuck
Chin-tuck
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Chin-up posture
Chin-up posture
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Head rotation (turn to the side)
Head rotation (turn to the side)
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Head tilt
Head tilt
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Effortful swallow
Effortful swallow
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Mendelsohn maneuver
Mendelsohn maneuver
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Swallowing maneuvers
Swallowing maneuvers
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Postural techniques
Postural techniques
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Supraglottic Swallow
Supraglottic Swallow
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Masako Exercise
Masako Exercise
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Shaker Exercise
Shaker Exercise
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Nasogastric Tube (NG Tube)
Nasogastric Tube (NG Tube)
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Gastrostomy Tube (G-tube)
Gastrostomy Tube (G-tube)
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Oral-Motor Therapy
Oral-Motor Therapy
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Feeding Disorder in Children
Feeding Disorder in Children
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Oral Hygiene
Oral Hygiene
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Case History (Feeding Assessment)
Case History (Feeding Assessment)
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Alerting (Feeding Assessment)
Alerting (Feeding Assessment)
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Deep Sleep (Infant Sleep Stages)
Deep Sleep (Infant Sleep Stages)
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Active Sleep (Infant Sleep Stages)
Active Sleep (Infant Sleep Stages)
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Drowsy (Infant Sleep Stages)
Drowsy (Infant Sleep Stages)
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Non-Nutritive Sucking (NNS) Pattern
Non-Nutritive Sucking (NNS) Pattern
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Nutritive Sucking (NS) Pattern
Nutritive Sucking (NS) Pattern
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Swallow Reflex (Feeding Assessment)
Swallow Reflex (Feeding Assessment)
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Chin tuck posture
Chin tuck posture
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Food chaining
Food chaining
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Flavor mapping
Flavor mapping
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Transitional foods
Transitional foods
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Rooting Reflex
Rooting Reflex
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Suckling Reflex
Suckling Reflex
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Tongue Thrust
Tongue Thrust
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Tonic Bite Reflex
Tonic Bite Reflex
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Tongue Retraction
Tongue Retraction
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Jaw Thrust
Jaw Thrust
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Strength, Stability & Posture
Strength, Stability & Posture
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Muscle Tone
Muscle Tone
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Study Notes
Swallowing
- Dysphasia is difficulty moving food from mouth to stomach
- Feeding disorders are avoidance of certain foods
Phases
-
Oral preparatory phase: food and liquids are manipulated, chewed, and formed into a bolus (voluntary)
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Oral phase: tongue moves food/liquid to the back of the mouth (voluntary)
-
Pharyngeal phase: involuntary movement. Food is transported from esophagus to stomach
- Aspiration: food/liquid enters trachea below vocal folds
- Penetration: food/liquid enters trachea but stays above vocal folds
-
Esophageal phase: food transportation from esophagus to stomach
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Residue: food left in mouth or pharynx after a swallow
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Regurgitation: food from the pharynx goes back into the nasal cavity
Oral Phase Issues
- Poor oral control: weak lips, tongue, or jaw; poor sensitivity
- Food spill: food/liquid leaks from oral cavity
- Premature spillage: food falls off tongue before swallow; due to reduced tongue strength/range of motion
- Chewing difficulty: reduced mandible/tongue strength or poor sensitivity
- Food residual: food in oral cavity after swallow; residual food between cheeks and tongue, under tongue, on hard palate
Pharyngeal Phase Issues
- Coughing/choking/wet voice quality: delayed or absent swallow reflex. Reduced laryngeal elevation/closure
- Nasal regurgitation: food/liquid leaks from nasal cavity due to inadequate velopharyngeal closure
Additional Information
- Excessive saliva and mucus: due to aspiration and body's attempt to clear away foreign material
- Signs of dysphagia: drooling, poor oral control, chest infections/pneumonia, food sticking in throat, globus sensation, complaints of pain when swallowing, frequent throat clearing, coughing during/after eating, difficulty coordinating breathing/swallowing, extra effort to chew, malnutrition/dehydration, keeping food in mouth
- Dysphagia causes: stroke, traumatic brain injury, spinal cord injury, dementia, Parkinson's disease, multiple sclerosis, ALS, muscular dystrophy, developmental disabilities
Assessment
- Interview/Case history/medical records including potential impact of medications
- Seating: postural/position evaluation
- Screening/Bedside assessment
- FEES (Fiberoptic endoscopic evaluation of swallowing): to view pharyngeal/laryngeal structures, assess adequate airway, timing of swallow, spillage, residue, aspiration, reflux. Identify strategies for swallowing improvement, postural/diet modification
- MBS (Modified barium swallow study): radiographic procedure to directly view oral, pharyngeal, esophageal function. Evaluate aspiration/penetration, causes, strategies to increase swallowing safety.
Interventions
- Seating position
- Dietary modification (thicken up food/liquids, soften, chop food)
- Postural position technique (chin tuck, rotating head)
- Swallowing maneuvers (supraglottic swallow, holding breath before swallowing)
- Effortful swallow (patient instructed to swallow saliva)
- Masako/tongue hold (prevent coughing/choking) (patient holds tongue forward between teeth during swallow)
- Shaker exercises/head-lifting: increase opening of the upper esophageal sphincter (helps to increase hyoid/laryngeal excursion)
- Oral hygiene
- Nasogastric tube (NGT): inserted to provide non-oral nutrition (short-term use)
- Gastrostomy tube (PEG/G-tube): for long-term nutrition
Children
- Feeding disorders: avoidance of eating or limited food types
- Assessment: case history (medical/feeding status/nutritional information), alterations in feeding-related behaviors (deep/active sleep; drowsy; awake/alert; agitated; crying), physiologic status (heart rate, respiratory rate, oxygen saturation)
Other Features
-
Non-nutritive sucking
-
Primitive reflexes: Babkin, rooting, phasic bite, tongue thrust, sucking, swallow
-
Abnormal reflexes: tonic bite reflex, tongue retraction, jaw thrust
Principles of Oral Structure/Movement/Function
- Movement of the jaw (size, at rest, movement, strength) , Cheeks (tone, strength), Lips (at rest, tone, strength, deviation), Tongue (size, tone, movements), Palate (at rest, hard/soft), Pharynx and Larynx (vocal quality, gag response), and Facial Sensitivity (face, mouth)
Treatment for Infants & Children
- Modify posture
- Manually support jaw/lips/tongue to improve lip sealing and motion
- Adaptive equipment: modification of nipples or use of straws
- Alerting food: changing food consistency, temperature
- Feeding team: Physician, dietitian, behavioural specialist, occupational therapist, SLP
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Description
This quiz evaluates your understanding of dysphagia, including its symptoms, diagnostic methods such as FEES and MBSS, and management strategies. Test your knowledge on feeding therapy techniques and the roles of various professionals involved in treating dysphagia.