Dysphagia and Related Disorders Medical Term Flashcards PDF

eFlashcards From Clinical Management of Swallowing Disorders, Sixth Edition by Thomas Murry, Karen Chan, and Erin H. Walsh. Copyright © 2026 by Plural Publishing, Inc. All rights reserved. Achalasia Achalasia a disorder of the esophagus that prevents normal swallowing....

eFlashcards From Clinical Management of Swallowing Disorders, Sixth Edition by Thomas Murry, Karen Chan, and Erin H. Walsh. Copyright © 2026 by Plural Publishing, Inc. All rights reserved. Achalasia Achalasia a disorder of the esophagus that prevents normal swallowing. In achalasia, which means “failure to relax,” the esophageal sphincter remains contracted. Achalasia affects the esophagus, the tube that carries swallowed food from the back of the throat down into the stomach. A ring of muscle called the lower esophageal sphincter encircles the esophagus just above the entrance to the stomach. Normal peristalsis is interrupted and food cannot enter the stomach. Achalasia is caused by degeneration of the nerve cells that normally signal the brain to relax the esophageal sphincter. The ultimate cause of this degeneration is unknown. Autoimmune disease or hidden infection is suspected. Acini Acini small, saclike dilations composing a compound gland. Acute airway obstruction Acute airway obstruction a severe blockage of the airway that partially or fully prevents air from reaching the lungs. Following an acute airway obstruction, there is often an inhalation that causes the blocked material to enter the lungs. Adipokines Adipokines hormone secreted by adipose tissue; regulates metabolic health and inflammation. Advance directive Advance directive legal document that specifies a patient’s decisions on the type of medical and personal care they want (and do not want) to receive when reaching the end-of-life stage. Akathisia Akathisia a movement disorder characterized by inner restlessness and the inability to sit or stand still. Akathisia may appear as a side effect of long-term use of antipsychotic medications, Lithium, and some other psychiatric drugs. Persons with akathisia typically have restless movements of the arms and legs such as tapping, marching in place, rocking, crossing and uncrossing the legs. They may feel anxious at the thought of sitting down. Aminoglycosides Aminoglycosides broad-spectrum antibacterial medications used to treat infections. Neomycin and streptomycin are 2 of the more common drugs in this category. Amyotrophic lateral sclerosis (ALS) Amyotrophic lateral sclerosis (ALS) often referred to as “Lou Gehrig’s disease,” ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed. Dysphagia is progressive in ALS. Anaerobic pneumonia Anaerobic pneumonia see aspiration pneumonia. Anterior faucial arches Anterior faucial arches the arches that separate the mouth from the pharynx. Antihistamines Antihistamines a class of medications used to treat common allergies. Aphagia Aphagia the inability or refusal to swallow. It is related to dysphagia which is difficulty swallowing, and odynophagia, painful swallowing. Aphagia may be temporary or long term, depending on the affected organ. It is an extreme, life-threatening case of dysphagia. Depending on the cause, untreated dysphagia may develop into aphagia. Aphasia Aphasia an acquired communication disorder that impairs a person’s ability to process language but does not affect intelligence. Aphasia impairs the ability to speak and understand others, and most people with aphasia experience difficulty reading and writing. Apnea Apnea a period of time during which breathing stops or is markedly reduced. There are 3 forms of apnea: blockage of the airways, cessation of respiratory effort (usually brain related and referred to as “central”), and a combination of airways blockage and central apnea. Apneas usually occur during sleep as well as briefly during a normal swallow. Arnold-Chiari malformation Arnold-Chiari malformation a malformation of the brain in which brain tissue extends into the spinal canal. Pain and swallowing difficulties are common symptoms, and they may not occur until later in childhood. Aspiration Aspiration the inhalation of either oropharyngeal or gastric contents into the airway below the vocal folds. Aspiration pneumonia Aspiration pneumonia also known as anaerobic pneumonia. This is inflammation of the lungs and airways to the lungs (bronchial tubes) from breathing in foreign material. Aspiration pneumonia is caused by breathing foreign materials (usually food, liquids, vomit, or fluids from the mouth) into the lungs. This may lead to: A collection of pus in the lungs (lung abscess) An inflammatory reaction A lung infection (pneumonia) Atrophy Atrophy muscle atrophy is the wasting or loss of muscle tissue. There are 2 types of muscle atrophy. Disuse atrophy occurs from a lack of physical exercise. In most people, muscle atrophy is caused by not using the muscles enough. The most severe type of muscle atrophy is neurogenic atrophy. It occurs when there is an injury to, or disease of, a nerve that connects to the muscle. This type of muscle atrophy tends to occur more suddenly than disuse atrophy. Examples of diseases affecting the nerves that control muscles: Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) Guillain-Barre syndrome Polio (poliomyelitis). Autism Spectrum Disorder Autism Spectrum Disorder a range of neurodevelopmental conditions that may include difficulties with social interaction, repetitive unusual patterns of behavior, inability to respond appropriately to environmental conditions and communication problems. Autoimmune diseases Autoimmune diseases a varied group of more than 80 serious, chronic illnesses that involve almost every human organ system. This group includes diseases of the nervous gastrointestinal and endocrine systems as well as skin and other connective tissues, eyes, blood, and blood vessels. In all of these diseases, the underlying problem is similar — the body’s immune system becomes misdirected, attacking the very organs it was designed to protect. Axonotmesis Axonotmesis Interruption of the axons of a nerve that results in degeneration of its distal (peripheral) segment without appreciable damage to the supporting structures Baclofen Baclofen a muscle relaxer and an antispastic agent. Baclofen is used to treat muscle symptoms caused by multiple sclerosis, including spasm, pain, and stiffness. Barium Barium a radiopaque element that allows visualization of the boluses in fluoroscopy. Barrett’s esophagus Barrett’s esophagus a serious complication of gastroesophageal reflux disease (GERD). In Barrett’s esophagus, normal tissue lining the esophagus changes to tissue that resembles the lining of the intestine. About 10% of people with chronic symptoms of GERD develop Barrett’s esophagus. Barrett’s esophagus does not have any specific symptoms, although patients with Barrett’s esophagus may have symptoms related to GERD. It does, though, increase the risk of developing esophageal adenocarcinoma, a serious, potentially fatal cancer of the esophagus. Beckwith-Wiedemann syndrome Beckwith-Wiedemann syndrome a condition that affects many parts of the body. It is classified as an overgrowth syndrome, which means that affected infants are considerably larger than normal (macrosomia) and tend to be taller than their peers during childhood. Growth begins to slow by about age 8, and adults with this condition are not unusually tall. In some children with Beckwith-Wiedemann syndrome, specific parts of the body on one side or the other may grow abnormally large, leading to an asymmetric or uneven appearance. This unusual growth pattern, which is known as hemihyperplasia, usually becomes less apparent over time. Some infants with Beckwith-Wiedemann syndrome have an abnormally large tongue (macroglossia), that may interfere with breathing, swallowing, and speaking. Benzodiazepines Benzodiazepines among the most commonly prescribed depressant medications in the United States today. More than 15 different types of benzodiazepine medications exist to treat a wide array of both psychological and physical maladies based on dosage and implications. Commonly prescribed benzodiazepines include Xanax (alprazolam), Librium (chlordiazepoxide), Valium (diazepam), Ativan (lorazepam), and Rohypnol (flunitrazepam). Many of these drugs slow the motion of the esophagus. Beta-agonist Beta-agonist an agent, chemical, or chemical reaction that tends to null another. Bifid uvula Bifid uvula A bifid uvula is a uvula that is forked or split in appearance. The uvula is a structure in the rear middle of the mouth, located in front of the tonsils, which forms part of the soft palate. Bile Bile a yellow-green fluid that is made by the liver, stored in the gall bladder, and passes through the common bile duct into the duodenum where it helps digest fat. The principal components of bile are cholesterol, bile salts, and the pigment bilirubin. Bipolar electrocautery Bipolar electrocautery an electrocautery in which both active and return electrodes are incorporated into a single, handheld instrument, so that the current passes between the tips of the two electrodes and affects only a small amount of tissue. Bite reflex Bite reflex a swift, involuntary biting action that may be triggered by stimulation of the oral cavity. The bite can be difficult to release in some cases, such as when a spoon or tongue depressor is placed in a patient’s mouth. Bolus Bolus a rounded mass that can be hard (pill) or soft (chewed food or liquids) that is given or taken and delivered to the swallowing organs of the body. Botulinum toxin Botulinum toxin (botulin) a neurotoxin made by Clostridium botulinum; causes paralysis in high doses but is used medically in small, localized doses to treat disorders associated with involuntary muscle contraction and spasms. Botulism Botulism a rare but serious illness. The cause is a toxin (poison) made by a bacterium called Clostridium botulinum. It occurs naturally in soil. There are several kinds of botulism. Foodborne botulism comes from eating foods contaminated with the toxin. Wound botulism happens when a wound infected with the bacteria makes the toxin. It is more common in heroin users. Infant botulism happens when a baby consumes the spores of the bacteria from soil or honey. All forms can be deadly and are medical emergencies. Symptoms include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Treatment may include antitoxins, intensive medical care, or surgery of infected wounds. Brachytherapy Brachytherapy an advanced cancer treatment. Radioactive seeds or sources are placed in or near the tumor itself, giving a high radiation dose to the tumor while reducing the radiation exposure in the surrounding healthy tissues. Bradycardia Bradycardia a slower than normal heart rate. The heart usually beats between 60 and 100 times a minute in an adult at rest. A heart with bradycardia beats fewer than 60 times a minute. Bradycardia can be a serious problem if the heart does not pump enough oxygen-rich blood to the body. For some people, however, bradycardia does not cause symptoms or complications. An implanted pacemaker and other treatments may correct bradycardia and help the heart maintain an appropriate rate. Brainstem stroke Brainstem stroke a stroke that originates in the brainstem. Because the brainstem handles many of the body’s basic life support functions, such as swallowing, breathing, and heart rate, a brainstem stroke can be fatal. As with other strokes, early treatment is essential. Bruxism Bruxism the habit of clenching and grinding the teeth. It most often occurs at night during sleep, but it may also occur during the day. It is an unconscious behavior, perhaps performed to release anxiety, aggression, or anger. Bulbar Bulbar relating to the medulla oblongata, cerebrum, and pons. Bulbar palsy is a motor neuron disease affecting the lower cranial nerves. The bulbar region is responsible for many involuntary functions in life. Candida Cachexia Cachexia a general state of health marked by weight loss and muscle loss or wasting. May be disease related or due to lack of proper nutrition. Candida a yeast infection of the esophagus caused by the same fungus that causes vaginal yeast infections. The infection develops in the esophagus when the body’s immune system is weak (such as in people with diabetes or HIV). It is usually very treatable with antifungal drugs. Candidiasis Candidiasis a fungal infection caused by yeasts that belong to the genus Candida. There are over 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally live on the skin and mucous membranes without causing infection; however, overgrowth of these organisms can cause symptoms to develop. Symptoms of candidiasis vary depending on the area of the body that is infected. Candidiasis that develops in the mouth or throat is called “thrush” or oropharyngeal candidiasis. Like Candida, this viral infection can develop in the esophagus when the body’s immune system is weak. It is treatable with antifungal drugs. Celiac disease Celiac disease a condition that damages the lining of the small intestine and prevents it from absorbing parts of food that are important for staying healthy. The damage is due to a reaction to eating gluten, which is found in wheat, barley, rye, and possibly oats. The exact cause of celiac disease is unknown. The lining of the intestines contains areas called villi, which help absorb nutrients. When adults and children with celiac disease eat foods or use products that contain gluten, their immune system reacts by damaging these villi. This damage affects the ability to absorb nutrients properly. A person becomes malnourished, no matter how much food they eat. The disease can develop at any point in life, from infancy to late adulthood. People with celiac disease are more likely to have: Autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosus, and Sjogren syndrome Addison disease Down syndrome Intestinal cancer Intestinal lymphoma Lactose intolerance Thyroid disease Type 1 diabetes Central pattern generators (CPGs) Central pattern generators (CPGs): biological neural networks that produce rhythmic patterned outputs without sensory feedback. CPGs have been shown to produce rhythmic outputs resembling normal “rhythmic motor pattern production” even in isolation from motor and sensory feedback from limbs and other muscle targets. To be classified as a rhythmic generator, a CPG requires (1) 2 or more processes that interact such that each process sequentially increases and decreases, and (2) that, as a result of this interaction, the system repeatedly returns to its starting condition. CPGs have been found in practically all vertebrate species investigated, including humans. Cervical osteophyte Cervical osteophyte a bony outgrowth or protuberance on the cervical vertebrae. Unless, the osteophyte is exceptionally large, it will not interfere with swallowing even when it can be observed on radiological exams. Cervical spondylosis Cervical spondylosis common, age-related changes in the area of the spine at the back of the neck. With age, the vertebrae (the component bones of the spine) gradually form bone spurs, and their shock- absorbing disks slowly shrink. These changes can alter the alignment and stability of the spine. They may go unnoticed, or they may produce problems related to pressure on the spine and associated nerves and blood vessels. This pressure can cause weakness, numbness, and pain in various areas of the body. Chagas disease Chagas disease also known as American or South American trypanosomiasis. This is an acute, subacute, or chronic form of trypanosomiasis seen widely in Central and South America, caused by Trypanosoma cruzi, and transmitted by the bites of reduviid bugs. The acute form, prevalent in children, is marked initially by an erythematous nodule (chagoma) at the site of inoculation; high fever; unilateral swelling of the face with edema of the eyelid (Romana’s sign); regional lymphadenopathy; hepatosplenomegaly; and meningoencephalic irritation. The subacute form may last for several months or years and is characterized by mild fever, severe asthenia, and generalized lymphadenopathy. The chronic form, which may or may not be preceded by an acute episode, is characterized principally by cardiac manifestations (myocarditis) and gastrointestinal manifestations (including megaesophagus and megacolon). Charcot-Marie-Tooth disease Charcot-Marie-Tooth disease a genetic disease of nerves characterized by progressively debilitating muscle weakness, particularly of the limbs. The foremost feature is marked wasting of the distal extremities, particularly the peroneal muscle groups in the calves, resulting in “stork legs.” The disease usually weakens the legs before the arms. Charcot-Marie-Tooth is one of the more frequent genetic diseases and the most common genetic disease of peripheral nerves. Physical therapy can help to delay somewhat the wasting of limbs. The disease is genetically heterogeneous. It can be inherited as an autosomal dominant, autosomal recessive, or X-linked trait. There are also sporadic cases with no family history of the disease that are due to new dominant mutations. Abbreviated CMT. CHARGE syndrome CHARGE syndrome a recognizable (genetic) pattern of birth defects that occurs in about one in every 8,000 to 10,000 births worldwide. It is an extremely complex syndrome, involving extensive medical and physical difficulties that differ from child to child. The majority of the time, there is no history of CHARGE syndrome or any other similar conditions in the family. Babies with CHARGE syndrome are often born with life-threatening birth defects, including complex heart defects and breathing problems. Swallowing and breathing problems make life difficult even when they come home. All are likely to require special feeding arrangements. Despite these seemingly insurmountable obstacles, children with CHARGE syndrome often far surpass their medical, physical, educational, and social expectations. Choreiform Choreiform writhing or twitching movements that affect coordination. In patients with autoimmune diseases, swallowing as well as other fine motor movements are disrupted. Chronic cough Chronic cough a cough lasting 8 weeks or longer despite treatment. Chronic refractory cough is a cough lasting longer despite numerous treatments. Chronic traumatic encephalopathy Chronic traumatic encephalopathy a neurodegenerative disease caused by repeated injuries to the head, such as concussions (major and minor). The condition is known to begin years after injuries and can evolve into mood disorders, thought processing and dementia. Clinical swallow evaluation (CSE) Clinical swallow evaluation (CSE) observations of bolus control and signs of wetness hoarseness in voice quality. The CSE may involve small amounts of liquid or food given to a patient to determine the need for an instrumental examination. Colostrum Colostrum the first milk after an infant is delivered. Colostrum is rich with nutrients that are distinct from mature milk that flows as the baby or a pump stimulates lactation. This transition is often characterized by a change in color from yellow to white, though other hues can be normal. Community-acquired pneumonia (CAP) Community-acquired pneumonia (CAP) develops in people with limited or no contact with medical institutions or settings. The most commonly identified pathogens are Streptococcus pneumoniae, Haemophilus influenzae, atypical bacteria (i.e., Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella), and viruses. Symptoms and signs are fever, cough, sputum production, pleuritic chest pain, dyspnea, tachypnea, and tachycardia. Diagnosis is based on clinical presentation and chest x-ray. Treatment is with empirically chosen antibiotics. Prognosis is excellent for relatively young or healthy patients, but many pneumonias, especially when caused by S. pneumoniae, Legionella, Staphylococcus aureus, or influenza virus, are serious or even fatal in older, sicker patients. Co-morbid Co-morbid a condition when one or more additional conditions are co-existing with the primary condition Cortical regulation Cortical regulation refers to the direct regulation by the brain of physiological functions including cellular functions. This regulation occurs through the autonomic nervous system exerting direct innervation of body organs and tissues that starts in the brainstem. Lower brain areas are under control of cerebral cortex. Corticosteroids Corticosteroids any of the class of drugs of steroid hormones made by the cortex or the adrenal gland. Used regularly in treating inflammation. Coughing Coughing a cough is a forceful release of air from the lungs that can be heard. Coughing protects the respiratory system by clearing it of irritants and secretions. Craniotomy Craniotomy a surgical operation in which an opening is made in the skull. Cricopharyngeal myotomy Cricopharyngeal myotomy a surgical operation that divides the cricopharyngeal muscle by cutting or slicing parts of the muscle to weaken or relax it. Thus, when an individual swallows, the small muscle is relaxed and does not prevent the flow of the bolus from passing into the esophagus. Prior to performing this operation, the surgeon may elect to dilate the muscle in hopes that dilation will achieve passage of the bolus. Cytokines Cytokines essential proteins involved in immune system function. Decannulation Decannulation the removal of a cannula or tube that may have been inserted during a surgical procedure. Deep tendon reflex Deep tendon reflex reflexes that involve muscle contractions when tendons are stimulated. Dehydration Dehydration lack of proper fluids in the body. Dehydration is a dangerous condition that may cause tissue breakdown or even shock. Once diagnosed, the patient may require hospitalization and intravenous fluid support until stable. Dementia Dementia significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. Criteria for the diagnosis of dementia include impairment of attention, orientation, memory, judgment, language, motor and spatial skills, and function. By definition, dementia is not due to major depression or schizophrenia. Dementia is reported in as many as 1% of adults 60 years of age. It has been estimated that the frequency of dementia doubles every 5 years after 60 years of age. Alzheimer disease is the most common cause of dementia. There are many other causes of dementia, including (in alphabetical order) AIDS (due to HIV infection), alcoholism (the dementia is due to thiamine deficiency), brain injury, brain tumors, Creutzfeldt-Jakob disease, dementia with Lewy bodies (tiny round structures made of proteins that develop within nerve cells in the brain), drug toxicity, encephalitis, meningitis, Pick disease (a slowly progressive deterioration of social skills and changes in personality leading to impairment of intellect, memory, and language), syphilis, thyroid disease (hypothyroidism), and vascular dementia (damage to the blood vessels leading to the brain). Diazepam Diazepam a benzodiazepine used as an antianxiety agent, sedative, antipanic agent, antitremor agent, skeletal muscle relaxant, anticonvulsant, and in the management of alcohol withdrawal symptoms. Diplopia Diplopia the perception of two images of a single object. Diverticula Diverticula A gut diverticulum (singular) is an outpouching of the wall of the gut to form a sac. Diverticula (plural) may occur at any level from esophagus to colon. A true diverticulum includes all three layers of the gut; the lining mucosa, the muscularis, and the outer serosa. False diverticula are missing the muscularis and are therefore very thin walled. Colonic diverticula are typically false. Dopamine Dopamine a monoamine neurotransmitter formed in the brain by the decarboxylation of dopa and essential to the normal functioning of the central nervous system. Dopamine is classified as a catecholamine (a class of molecules that serve as neurotransmitters and hormones). Dopamine is formed by the decarboxylation (removal of a carboxyl group) from dopa. A reduction in its concentration within the brain is associated with Parkinson’s disease. Down syndrome Down syndrome see Trisomy 21. Dysgeusia Dysgeusia an unpleasant alteration of taste sensation, often with a metallic taste. Dysphagia Dysphagia difficulty swallowing. The condition results from impeded transport of liquids, solids, or both from the pharynx to the stomach. Dysphagia should not be confused with globus sensation, a feeling of having a lump in the throat, which is unrelated to swallowing and occurs without impaired transport. Dysphagia lusoria Dysphagia lusoria dysphagia said to be due to compression by the right subclavian artery arising abnormally from the descending aorta and passing behind the esophagus. Lusoria is a term used to describe the moving or dancing compression by the right subclavian artery. Dystonia Dystonia a movement disorder characterized by sustained, irregular, muscle contractions that result in writhing or twisting movements and unusual body postures. Eaton-Lambert syndrome Eaton-Lambert syndrome a disease seen in patients with lung cancer; characterized by weakness and fatigue of hip and thigh muscles and an aching back; caused by antibodies directed against the neuromuscular junctions. Electrocautery Electrocautery the cauterization of tissue by means of an electrode that consists of a red hot piece of metal, such as a wire, held in a holder, and is heated by either direct or alternating current. The term “electrocautery” is used to refer to both the procedure and the instrument used in the procedure. Electromyography (EMG) Electromyography (EMG) a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds, or numerical values that a specialist interprets. An EMG uses tiny devices called electrodes to transmit or detect electrical signals. During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle. A nerve conduction study, another part of an EMG, uses electrodes taped to the skin (surface electrodes) to measure the speed and strength of signals traveling between 2 or more points. EMG results can reveal nerve dysfunction, muscle dysfunction, or problems with nerve-to-muscle signal transmission. Emphysema Emphysema a chronic respiratory disease where there is overinflation of the air sacs (alveoli) in the lungs, causing a decrease in lung function, and often, breathlessness. Empyema Empyema a condition in which pus (fluid filled with immune cells) accumulates in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space. Empyema, also called pyothorax or purulent pleuritis, usually develops after pneumonia, which is an infection of the lung tissue. Pus in the pleural space cannot be coughed out. Instead, it needs to be drained by a needle or surgery. Endoluminal (intraluminal) Endoluminal (intraluminal) related to the interior space of tubular structures in the body, e.g., esophagus, intestines. Enteral nutrition Enteral nutrition a way to provide food through a tube placed in the nose, the stomach, or the small intestine. A tube in the nose is called a nasogastric tube or nasoenteral tube. A tube that goes through the skin into the stomach is called a gastrostomy or percutaneous endoscopic gastrostomy (PEG) tube. A tube into the small intestine is called a jejunostomy or percutaneous endoscopic jejunostomy (PEJ) tube. Enteral nutrition is often called tube feeding. Epidemiology Epidemiology Classical — The study of populations in order to determine the frequency and distribution of disease and measure risks. Clinical — Epidemiology focused specifically upon patients. Epidemiology is the study of populations in order to determine the frequency and distribution of disease and measure risks. Epiglottitis Epiglottitis a potentially life-threatening condition that occurs when the epiglottis swells, blocking the flow of air into the patient’s lungs. A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to the throat, and various infections. The most common cause of epiglottitis in children in the past was infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia, meningitis, and infections in the bloodstream. Epiglottitis can occur at any age. Eosinophilic esophagitis Eosinophilic esophagitis an immune-mediated inflammatory disease of the esophagus. The condition happens when the immune system makes white blood cells in reaction to an allergen. Esophageal body Esophageal body the body of the esophagus is composed of 2 muscle types. The proximal esophagus is predominantly striated muscle, while the distal esophagus and the remainder of the gastrointestinal tract contain smooth muscle. The mid esophagus contains a graded transition of striated and smooth muscle types. The muscle is oriented in 2 perpendicular opposing layers: an inner circular layer and an outer longitudinal layer, known collectively as the muscularis propria. The longitudinal muscle is responsible for shortening the esophagus, while the circular muscle forms lumen- occluding ring contractions. Esophageal diverticulum Esophageal diverticulum an outpouching of mucosa through the muscular layer of the esophagus. It can be asymptomatic or cause dysphagia and regurgitation. Diagnosis is made by barium swallow; surgical repair is rarely required. Esophageal motility disorders Esophageal motility disorders any medical disorder causing difficulty in swallowing, regurgitation of food and a spasm-type pain which can be brought on by an allergic reaction to certain foods. A disruption in the finely tuned muscles that transfer the bolus along the esophagus. Esophagectomy Esophagectomy a surgical procedure to remove a portion of the esophagus and then reconstruct it using part of another organ, usually the stomach or large intestine. Esophagectomy is a common treatment for esophageal cancer, and less common for Barrett esophagus and achalasia (a swallowing disorder). Esophagitis Esophagitis an inflammation that may damage tissues of the esophagus, the muscular tube that delivers food from the mouth to the stomach. Esophagitis can cause painful, difficult swallowing, and chest pain. Causes of esophagitis include stomach acids backing up into the esophagus, infection, oral medications, and allergies. Treatments for esophagitis depend on the underlying cause and the severity of tissue damage. If left untreated, esophagitis can damage the lining, interfere with normal function, and lead to complications such as scarring, stricture, and difficulty swallowing. Esophagoduodenoscopy (EGD) Esophagoduodenoscopy (EGD) an endoscopic test of the esophagus and stomach usually done by a gastroenterologist. Now known as EGD. Esophagram Esophagram also known as barium swallow. This is a series of x- rays of the esophagus. The x-ray pictures are taken after the patient drinks a solution that coats and outlines the walls of the esophagus. Evidence-based practice Evidence-based practice a term to describe the integration of the best research available that fits the needs of the patient. Evidence based practice is composed of three components, the best external evidence available, the practitioners expertise and the patient’s preference for treatment Exophytic tumor Exophytic tumor a tumor that grows outward beyond the surface epithelium from which it originates. External beam radiation therapy (EBRT) External beam radiation therapy (EBRT) uses high-energy rays (or particles) to destroy cancer cells or slow their rate of growth. A carefully focused beam of radiation is delivered from a machine outside the body. External beam radiation therapy usually involves treatments 5 days a week for about 6 weeks. The treatment itself is painless and much like getting a regular x-ray. Each treatment lasts only a few minutes, although the setup time — getting the patient into place for treatment — usually takes longer. EBRT has effects on swallowing, mainly related to inflammation. Fasciculation Fasciculation involuntary muscle twitches. Fetal alcohol syndrome Fetal alcohol syndrome the sum total of the damage done to the child before birth as a result of the mother drinking alcohol during pregnancy. Fetal alcohol syndrome (FAS) always involves brain damage, impaired growth, and head and face abnormalities. Fetal alcohol syndrome is one of the leading causes of mental retardation in the United States. FAS is an irreversible, lifelong condition that affects every aspect of a child’s life and the lives of the child’s family. However, FAS is 100% preventable if a woman does not drink alcohol while she is pregnant. There is no cure for FAS. Children born to mothers who drink alcohol demonstrate failure to thrive. As the child begins to mature, signs of mental retardation begin to appear. However, with early identification and diagnosis, children with FAS can receive services such as special feeding, modified diets, and ultimately special education that can help increase their potential. Flexible endoscope Flexible endoscope endoscopy with flexible cabling that allows examination of labyrinthine structures in the body. Flexible endoscopic evaluation of swallowing (FEES) Flexible endoscopic evaluation of swallowing (FEES) a diagnostic procedure used to evaluate velopharyngeal, phonatory, and swallowing functions in adults and children. This study allows for assessment of the anatomy as well as direct observation of swallowing function and control of the movement of secretions, liquids and food. Foremilk Foremilk milk ejected from the breast at the onset of feeding. Fibrosis Fibrosis the formation of fine scar-like structures that cause tissues to harden and reduces the flow of fluids through these tissues. The formation of fibrous tissue, as in repair or replacement of parenchymatous elements. Tissue that has lost its normal elasticity due to scarring. Fistula Fistula an abnormal or surgically made passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs. Full-term newborn Full-term newborn retained in the uterus for the normal period of gestation before birth. Functional Magnetic Resonance Imaging (fMRI) Functional Magnetic Resonance Imaging (fMRI) a non-invasive examination of the neural mechanisms of motion-induced tasks such as speaking and swallowing using magnetic resonance imaging. The images actually map brain activity. Gag reflex or pharyngeal reflex Gag reflex or pharyngeal reflex a reflex contraction of the back of the throat, evoked by touching the soft palate. It prevents something from entering the throat except as part of normal swallowing and helps prevent choking. Different people have different sensitivities to the gag reflex. Galactogogues Galactogogues a substance intended to increase milk production. It includes foods, herbs, and prescription medications. Gastroesophageal reflux (GER) Gastroesophageal reflux (GER) return of stomach contents back up into the esophagus. This frequently causes heartburn because of irritation of the esophagus by stomach acid. Gastroesophageal reflux disease (GERD) is the condition brought on by GER. Gastroparesis Gastroparesis also known as delayed gastric emptying. This is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Gastrostomy Gastrostomy a surgical procedure for inserting a tube through the abdomen wall and into the stomach. The tube, called a “g-tube,” is used for feeding or drainage. Gastrostomy is performed because a patient temporarily or permanently needs to be fed directly through a tube in the stomach. Gastrostomy is also performed to provide drainage for the stomach when it is necessary to bypass a long-standing obstruction of the stomach outlet into the small intestine. Gelfoam Gelfoam a substance that is used to improve vocal fold bulk. Gelfoam is injected into paralyzed or partially paralyzed vocal folds to increase bulk and improve closure of the vocal folds. Gestation Gestation duration of development in the womb post conception. Globus Globus a subjective feeling of a lump or foreign body in the throat. It is sometimes called globus pharyngeus. The term “globus hystericus” was previously used because of the belief that psychogenic factors were involved and that globus sensation was just a type of somatization disorder presenting with pseudo- neurological symptoms. However, it is now widely considered that globus sensation can have underlying physiological or anatomical causes and there are thought to be a number of potential etiologies. Glossitis Glossitis a condition in which the tongue is swollen and changes color. Fingerlike projections on the surface of the tongue (called papillae) are lost, causing the tongue to appear smooth. Changes in the appearance of the tongue may be a primary condition or it may be a symptom of other disorders such as dehydration. Glossitis occurs when there is acute or chronic inflammation of the tongue. Glossodynia Glossodynia also known as burning mouth syndrome, burning tongue, and orodynia. This is a condition characterized by a burning or tingling sensation on the lips, tongue, or entire mouth. Glossopharyngeal nerve Glossopharyngeal nerve the ninth cranial nerve (CN IX). Problems with the glossopharyngeal nerve result in trouble tasting and swallowing. Glossoptosis Glossoptosis downward tipping of the tongue or posterior displacement of the tongue. If the tongue is retracted far enough, it may prevent fusion of the hard palate. May be seen in patients with Pierre Robin sequence. Halitosis Halitosis the condition of having stale or foul-smelling breath. Hematoma Hematoma an abnormal localized collection of blood in which the blood is usually clotted or partially clotted and is usually situated within an organ or a soft tissue space, such as within a muscle; caused by a break in the wall of a blood vessel. The break may be spontaneous, as in the case of an aneurysm, or caused by trauma. Hemiparesis Hemiparesis muscle weakness on only one side of the body. When hemiparesis happens as a result of a stroke, it commonly involves muscles in the face, arm, and leg. Swallowing is often seen being done on one side of the mouth. Herpes simplex virus (HSV) Herpes simplex virus (HSV) an infection that causes herpes. Herpes can appear in various parts of the body, most commonly on the genitals or mouth. There are 2 types of the herpes simplex virus. HSV-1, also known as oral herpes, can cause cold sores and fever blisters around the mouth and on the face. HSV-2 is generally responsible for genital herpes outbreaks. Hiatal hernia Hiatal hernia a condition in which part of the stomach is pushed (or herniates) into the esophagus. In mild cases, medication or diet may resolve the symptoms; in severe cases, surgery is required. Hindmilk Hindmilk milk ejected from the breast at the end of the feeding and is typically of higher fat content. High resolution manometry High resolution manometry a manometric test that has has pressure sensors placed around 1- to 2-cm apart (compared with 3 to 5 cm in conventional ones) and the pressure measures are more accurately obtained and analyzed compared to conventional manometry. Homunculus Homunculus (in Latin, it means “little man”) a representation of a small human being showing a topographical layout of the motor functions (or sensory functions) of the brain. Human immunodeficiency virus (HIV) Human immunodeficiency virus (HIV) a virus that gradually attacks the immune system, which is the body’s natural defense against illness. If a person becomes infected with HIV, that person will find it harder to fight off infections and diseases. The virus destroys a type of white blood cell called a T-helper cell and makes copies of itself inside them. T-helper cells are also referred to as CD4 cells. Huntington disease Huntington disease a hereditary disorder with mental and physical deterioration leading to death. Although characterized as an “adult-onset” disease, it can affect children as well. Huntington disease describes an autosomal dominant pattern of inheritance with high penetrance (a high proportion of persons with the gene develop the disease). The characteristic findings of Huntington disease are caused by loss of neurons (nerve cells) in the brain. The disease is due a gene in chromosome band 4p16.3. The gene, called HD, contains an unstable repeating sequence of 3 nucleotide bases (CAG) in the DNA. Normal people have an average of 19 CAG repeats and at most 34 such repeats while virtually all patients with Huntington disease have more than 40. The Huntington disease gene codes for a protein that has been named (confusingly) huntingtin whose function is unknown. The elevated numbers of CAG repeats in the Huntington disease gene lead to the production of an elongated huntingtin protein that appears to correlate with the loss of neurons in the disease. Mood disturbance is usually the first symptom seen, with bipolar disorder–like mood swings that may include mania, depression, extreme irritability or angry outbursts, and psychosis. Other symptoms include dysphagia, chorea (restless, wiggling, turning movements), muscle stiffness and slowness of movement, and difficulties with memory and other cognitive processes. The HD gene is located on chromosome 4, and is an autosomal dominant gene. Only one copy need be inherited to cause the illness. Diagnosis is by genetic testing, and family members of people with Huntington disease may also want to know if they carry the HD gene. At this time, there is no cure for HD, although medication may be used to control symptoms of the illness, such as mood swings and chorea. Hyperbilirubinemia Hyperbilirubinemia also known as jaundice. Occurs when there is excess bilirubin in a newborn’s blood that creates a yellowing of their skin, eyes, and tissues. There are several causes of jaundice, including physiological, inadequate feeding, substance in the breast milk, blood incompatibility, and poor liver function. Hypersomnolence Hypersomnolence excessive need for sleep despite no findings of an underlying disease. Jet lag, pregnancy, overeating or anxiety may be associated with hypersomnolence. Hypoglossal nerve (CN XII) Hypoglossal nerve (CN XII) this nerve controls critical movements of the tongue. CN XII aids in moving the bolus in place for chewing Hypokinesia Hypokinesia slow or diminished movement of body musculature. It may be associated with basal ganglia diseases, mental disorders, and prolonged inactivity due to illness. Hypopharyngeal phase Hypopharyngeal phase the phase of swallowing when the bolus enters the region where the larynx and the esophagus join, an area known as hypopharynx. Hypothyroid Hypothyroid deficiency of thyroid hormone that is normally made by the thyroid gland, which is located in the front of the neck. Hypotonia Hypotonia decreased muscle tone. It can be a condition on its own, called benign congenital hypotonia, or it can be indicative of another problem where there is progressive loss of muscle tone, such as muscular dystrophy or cerebral palsy. It is usually detected during infancy. Hypoxemia Hypoxemia a below-normal level of oxygen in the blood, specifically in the arteries. Hypoxemia is a sign of a problem related to breathing or circulation, and may result in various symptoms, such as shortness of breath. Hypoxemia is determined by measuring the oxygen level in a blood sample taken from an artery (arterial blood gas). It can also be estimated by measuring the oxygen saturation of the blood using a pulse oximeter — a small device that clips to the finger. Normal arterial oxygen is approximately 75 to 100 mm Hg. Values under 60 mm Hg usually indicate the need for supplemental oxygen. Normal pulse oximeter readings usually range from 95% to 100%. Values under 90% are considered low. Hypoxia Hypoxia a reduction of oxygen supply to a tissue below physiological levels despite adequate perfusion of the tissue by blood. Insensate Insensate (1) Lacking sensation or awareness; inanimate. (2) Lacking human feeling or sensitivity; brutal; cruel. (3) Lacking sense; stupid; foolish. Intensity-modulated radiation therapy (IMRT) Intensity-modulated radiation therapy (IMRT) an advanced type of radiation therapy used to treat cancer and noncancerous tumors. IMRT uses advanced technology to manipulate photon and proton beams of radiation to conform to the shape of a tumor. The goal of IMRT is to conform the radiation dose to the target and to avoid or reduce exposure of healthy tissue to limit the side effects of treatment. Intubation Intubation insertion of a tube into the trachea for the purpose of aided ventilation. Ischemia Ischemia inadequate blood supply (circulation) to a local area due to blockage of the blood vessels to the area. Isokinetic neck exercises Isokinetic neck exercises head exercises performed with a specialized apparatus that provides variable resistance to a movement, so that no matter how much effort is exerted, the movement takes place at a constant speed. Such exercise is used to improve muscular strength and endurance, especially after injury. Isometric neck exercises Isometric neck exercises head exercises that only require the hands for strengthening the neck muscles. Isometric exercises are the very basic strengthening exercises to help build endurance to the muscle. Isometric exercises recruit muscles in order to strengthen without pain or movement. Jejunostomy tube Jejunostomy tube also known as a J-tube, a feeding tube inserted through the abdomen and into the jejunum (the second part of the small bowel) to assist with feeding and to provide nutrition. Killian triangle Killian triangle a triangular area in the wall of the pharynx between the oblique fibers of the inferior constrictor muscle, and the transverse fibers of the cricopharyngeus muscle through which the Zenker diverticulum occurs. Lactation inhibition factor Lactation inhibition factor complex mechanic. Laryngeal adductor reflex (LAR) Laryngeal adductor reflex (LAR) an involuntary protective response to stimuli in the larynx. The superior laryngeal nerve (SLN) acts as the afferent limb and the recurrent laryngeal nerve (RLN) as the efferent limb of this reflex, which is modulated by the central nervous system. Laryngeal penetration Laryngeal penetration material entering the laryngeal vestibule during the act of swallowing. Laryngopharyngeal Reflux (LPR) Laryngopharyngeal Reflux (LPR) a condition that occurs in a person who has gastroesophageal reflux disease (GERD). Acid made in the stomach travels up the esophagus. When that stomach acid gets to the throat, it is called laryngopharyngeal reflux. Laryngospasm Laryngospasm an uncontrolled involuntary contraction of the vocal folds that may last from seconds to minutes that partially blocks normal inhalation but breathing out is usually easier. Latching Latching the manner of the baby taking the nipple and preparing to suck. Lower motor neuron Lower motor neuron a nerve cell that goes from the spinal cord to a muscle. The cell body of a lower motor neuron is in the spinal cord, and its termination is in a skeletal muscle. The loss of lower motor neurons leads to weakness, twitching of muscle (fasciculation), and loss of muscle mass (muscle atrophy). A lower motor neuron lesion is a lesion in nerve fibers traveling from the anterior grey column of the spinal cord to a specific muscle or muscles — the lower motor neuron. One major characteristic used to identify a lower motor neuron lesion is flaccid paralysis — paralysis accompanied by loss of muscle tone. Lung abscess Lung abscess a pus-filled cavity in the lung surrounded by inflamed tissue and caused by an infection. Lung abscess is usually caused by bacteria that normally live in the mouth and are inhaled into the lungs. Symptoms include fatigue, loss of appetite, night sweats, fever, weight loss, and a cough that brings up sputum. Diagnosis is usually determined with a chest x-ray. People usually need to take antibiotics for several weeks before a lung abscess clears up. Lyme disease Lyme disease a bacterial illness caused by a bacterium called a “spirochete.” Lyme disease is spread by ticks when they bite the skin. Lyme disease can cause abnormalities in the skin, joints, heart, and nervous system. Macroglossia Macroglossia the abnormal enlargement of the tongue. In rare cases, macroglossia occurs as an isolated finding that is present at birth (congenital). In many cases, macroglossia may occur secondary to a primary disorder that may be either congenital (e.g., Down syndrome or Beckwith-Wiedemann syndrome) or acquired (e.g., as a result of trauma or malignancy). Magnetic resonance imaging (MRI) Magnetic resonance imaging (MRI) a special radiology technique designed to image internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures. In MRI, the scanner is a tube surrounded by a giant circular magnet. The patient is placed on a movable bed that is inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. A computer processes the receiver information, and an image is produced. The image and resolution are quite detailed and can detect tiny changes of structures within the body, particularly in the soft tissue, brain and spinal cord, abdomen, and joints. See also fMRI. Malnutrition Malnutrition poor nourishment of the body often due to not eating healthy foods, improper digestion, poor absorption of nutrients, or a combination of these factors. Manometry Manometry measurement of pressure using a device called a manometer. Esophageal manometry is done to measure muscle pressure and movements in the esophagus in the evaluation of achalasia. Masako maneuver Masako maneuver also known as tongue hold maneuver. The patient holds the tongue between the teeth while swallowing. This exercise is performed without food or liquid in the mouth. This exercise strengthens the muscles of the tongue base. Mastication Mastication the act of chewing. Maxillectomy Maxillectomy a surgical procedure to remove all or part of the maxilla and is used to treat oral cavity cancer and cancers affecting the jaw and sinus cavity. Medialization laryngoplasty Medialization laryngoplasty a procedure that provides support to a vocal fold that lacks the bulk, the mobility, or both, to achieve full adduction during vocalization and/or swallowing. A medialization laryngoplasty is done by inserting a silastic shim or surgical Gore-Tex into the lateral portion of the vocal fold. It is also frequently called a thyroplasty since the procedure is performed through the thyroid cartilage. Mendelsohn maneuver Mendelsohn maneuver An exercise to aid in larynx elevation. The exercise is done with liquid or a small amount of pureed food. As you begin the swallow, use the throat muscles to stop the thyroid cartilage (Adam’s apple) at its highest point. Hold it there for a few seconds; use your fingers to help if necessary. Micrognathia Micrognathia: a small and retracted jaw. Modified barium swallow (MBS)/videofluoroscopic swallow study (VFSS) Modified barium swallow (MBS) / videofluoroscopic swallow study (VFSS) a fluoroscopic procedure designed to determine whether food or liquid is entering a person’s lungs, also known as aspiration. It permits the medical team to observe the coordination of anatomical structures in the mouth and throat, as they are actively functioning when chewing, drinking, and swallowing. It also identifies the reason for aspiration.  Modified blue dye test/ Modified Evans Blue Dye Test (MEBDT) Modified blue dye test/Modified Evans Blue Dye Test (MEBDT) a screening test to determine aspiration of liquids, foods and saliva. A few drops of blue dye is added to the bolus. The trachea is then suctioned to determine if there was blue coloring detected. If detected, the test is positive for aspiration. Motor apraxia Motor apraxia also known as kinesthetic apraxia, limb-kinetic apraxia. This is the inability to carry out, on command, a complex or skilled movement, though the purpose thereof is clear to the patient. Muscle tension dysphagia Muscle tension dysphagia also known as functional dysphagia. This is term used to describe a subset of patients with dysphagia but who show normal oropharyngeal and esophageal phases of swallow function evidenced by instrumental assessments. Myasthenia gravis Myasthenia gravis an autoimmune disorder that causes weakness and rapid fatigue in muscles under voluntary control. In swallowing, this can be in the lips, tongue, or other muscles under voluntary control. Myositis Myositis inflammation of muscle tissue. There are many causes of myositis, including injury, medications, and diseases. Myotomy Myotomy the dissection or cutting of a muscle, performed to gain access to underlying tissues or to relieve constriction in a sphincter, such as in severe esophagitis or pyloric stenosis. With the patient under general anesthesia, a longitudinal cut is made through the sphincter muscle to create a relaxed state in the muscle. Nasoduodenal tubes Nasoduodenal tubes feeding tubes that are inserted transnasally and end in the first section of the small intestines. Nasogastric (NG) Nasogastric (NG) referring to a method of supplying the stomach with food or medicine through the nose. This usually involves a tube. Nasojejunal tubes Nasojejunal tubes feeding tubes that are inserted transnasally and end in the second section of the small intestines. Nasopharyngoscope Nasopharyngoscope a telescopic instrument, electrically lighted, for examination of the nasal passages and the nasopharynx. Nd:YAG (neodymium-doped yttrium aluminum garnet; Nd:Y3Al5O1) Nd:YAG (neodymium-doped yttrium aluminum garnet; Nd:Y3Al5O1) a crystal that is used as a lasing medium for solid- state lasers. Neoplasia Neoplasia also known as a tumor. This is new growth, usually refers to abnormal new growth and thus means the same as tumor, which may be benign or malignant. Unlike hyperplasia, neoplastic proliferation persists even in the absence of the original stimulus. Neoplasm Neoplasm also known as a tumor. This is an abnormal growth of tissue in animals or plants. Neoplasms can be benign or malignant. Neural control Neural control the process used by the nervous system to control everything from movement to physiological processes. The body is a series of complex interconnected systems that work together to sustain life on a variety of ways, and neural control is the underpinning of these systems. Neuroplasticity Neuroplasticity the brain’s ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment. Nonnutritive sucking Nonnutritive sucking considered a natural reflex to satisfy a child’s need for contact and may include unrestricted sucking on a breast, digit, pacifier, or other object like a blanket or toy. This nonnutritive sucking may make a child feel secure and relaxed, and allow the child to learn about the environment through mouthing objects. Normal deglutition Normal deglutition consists of a succession of muscular contractions from above downward or from the front backward, which propel food from the oral cavity toward the stomach. The action is generally initiated at the lips; it proceeds back through the oral cavity, and the food is moved automatically along the dorsum of the tongue. When the food is ready for swallowing, it is passed back through the fauces. Once the food is beyond the fauces and in the pharynx, the soft palate closes off the nasopharynx, and the hyoid bone and larynx are elevated upward and forward. This action keeps food out of the larynx and dilates the esophageal opening so that the food may be passed quickly toward the stomach by peristaltic contractions. The separation between the voluntary and involuntary characteristics of this wave of contractions is not sharply defined. At birth the process is already well established as a highly coordinated activity, i.e., the swallowing reflex. Nosocomial Nosocomial originating or taking place in a hospital, acquired in a hospital, especially in reference to an infection or pneumonia. Nosocomial pneumonia Nosocomial pneumonia also known as hospital-acquired pneumonia [HAP] or health care–associated pneumonia [HCAP]. This is pneumonia that occurs more than 48 hours after admission but that was not incubating at the time of admission. Nucleus ambiguus Nucleus ambiguus on each side is a motor nucleus within the medulla of the brainstem. It lies dorsomedial to the spinal lemniscus and ventral to the nucleus of tractus solitarius. It supplies skeletal muscle fibers via 3 cranial nerves: Glossopharyngeal nerve: stylopharyngeus muscle Vagus and cranial root of accessory nerve Pharyngeal branch to the muscles of the base of the tongue Superior laryngeal nerve to cricothyroid muscle Recurrent laryngeal nerve to intrinsic muscles of the larynx Nucleus of tractus solitarius Nucleus of tractus solitarius a brainstem nucleus on each side of the upper medulla. It lies lateral to the dorsal nucleus of the vagus, to which it has many connecting neurons, and medial to the spinal tract and the nucleus of the trigeminal nerve. The nucleus has afferent fibers that extend inferiorly within the upper medulla as the tract of solitarius. The superior part of the nucleus receives fibers from the: Chorda tympani branch of the facial nerve; involved with taste sensation from the anterior two-thirds of the tongue Lingual branch of the glossopharyngeal nerve; involved with taste from the posterior third of the tongue Internal laryngeal branch of vagus nerve; involved with taste in the region of the valleculae The inferior part of the nucleus receives fibers from the: Vagus nerve Glossopharyngeal nerve Functionally, cells of the nucleus play a role in: Blood pressure regulation Cough reflex Gag reflex Sneeze reflex Vomiting Inspiration Obturator Obturator as related to dentistry, an obturator refers to a replacement prosthetic device that is used to replace upper teeth or associated structures (palate, gingiva, etc.) that may have been damaged in surgery, trauma, or altered development. Odynophagia Odynophagia a severe sensation of burning, squeezing pain while swallowing caused by irritation of the mucosa or a muscular disorder of the esophagus, such as gastroesophageal reflux, bacterial or fungal infection, tumor, achalasia, or chemical irritation. Oropharyngeal phase Oropharyngeal phase the phase of swallowing when the bolus is transferred from the oral cavity to the pharynx. Oxytocin Oxytocin reproductive hormone released when milk “lets down.” It creates a calming effect on the mother. Stress and pain can inhibit its release. Parenchyma Parenchyma the tissue characteristic of an organ, as distinguished from associated connective or supporting tissues. Parenteral nutrition Parenteral nutrition also known as intravenous feeding or parenteral alimentation. This is a method of getting nutrition into the body through the veins. While it is most commonly referred to as total parenteral nutrition (TPN), some patients need to get only certain types of nutrients intravenously. Parenteral nutrition is often used for patients with Crohn disease, cancer, short bowel syndrome, and ischemic bowel disease. Parkinson’s disease Parkinson’s disease a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson’s disease, the disorder also commonly causes stiffness or slowing of movement. In the early stages of Parkinson’s disease, the face may show little or no expression, or the patient’s arms may not swing when the patient walks. Speech may become soft or slurred. Parkinson’s disease symptoms worsen as the condition progresses over time. Although Parkinson’s disease cannot be cured, medications may markedly improve symptoms. In occasional cases, surgery to regulate certain regions of the brain and improve symptoms may be suggested. Passavant ridge Passavant ridge also known as Passavant pad. This is a prominence seen during swallowing on the nasopharyngeal wall by contraction of the superior pharyngeal constrictor; When the palate is not optimally functioning during swallowing, this deficiency may be compensated for by a greater convergence of Passavant ridge. Pemphigus Pemphigus one of a group of chronic, relapsing autoimmune skin diseases that causes blisters and erosions of the skin and mucous membranes. The immune system mistakenly regards the cells in the skin and mucous membranes as foreign and attacks them. Penetration Penetration inhalation of either oropharyngeal or gastric contents into the airway above the vocal folds; can indicate high risk for aspiration. Pepsin Pepsin an enzyme produced in the mucosal lining of the stomach, acts to degrade protein. Pepsin is 1 of 3 principal protein-degrading, or proteolytic, enzymes in the digestive system, the other 2 being chymotrypsin and trypsin. The 3 enzymes were among the first to be isolated in crystalline form. During the process of digestion, these enzymes, each of which is particularly effective in severing links between particular types of amino acids, collaborate to break down dietary proteins to their components (i.e., peptides and amino acids), which can be readily absorbed by the intestinal lining.  Percutaneous endoscopic gastrostomy or percutaneous endogastrostomy (PEG) Percutaneous endoscopic gastrostomy or percutaneous endogastrostomy (PEG) an endoscopic medical procedure in which a tube (PEG tube) is passed into a patient’s stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. The procedure does not require a general anesthetic; mild sedation is typically used. PEG tubes may also be extended into the small intestine by passing a jejunal extension tube (PEG-J tube) through the PEG tube and into the jejunum via the pylorus. Peripheral nervous system (PNS) Peripheral nervous system (PNS) includes the nerves leading from the brainstem and spinal cord, and in addition, sensory nerve cells called ganglia located outside of the brainstem. Peristalsis Peristalsis a series of organized muscle contractions that occur throughout the digestive tract. Peristalsis is also seen in the tubular organs that connect the kidneys to the bladder. Peristalsis is an automatic and important process that moves food through the digestive system. Phagophobia Phagophobia dysphagia secondary to fear of swallowing often brought on by a single event such as vomiting or choking on food or liquid. It has also been referred to as a form of psychogenic dysphagia. Pharyngeal manometry Pharyngeal manometry a test to the measure of pharyngeal pressure. This manometric test is performed with a catheter, a thin tube about 35-cm long and constructed with multiple pressure sensors, which is passed. The pressures are measured as the patient performs a series of wet and dry swallows Primary motor cortex Primary motor cortex located in the frontal lobe of the brain, the primary motor cortex generates neural impulses that control execution of movement. Primary peristalsis Primary peristalsis the peristaltic wave triggered by the swallowing center. The peristaltic contraction wave travels at a speed of 2 cm/s and correlates with manometry- recorded contractions. The relationship of contraction and food bolus is more complex because of intrabolus pressures from above (contraction from above) and the resistance from below (outflow resistance). Photodynamic therapy (PDT) Photodynamic therapy (PDT) a treatment that uses special drugs, called photosensitizing agents, along with light to kill cancer cells. The drugs only work after they have been activated or “turned on” by certain kinds of light. Pierre Robin sequence or complex Pierre Robin sequence or complex Pierre Robin was a French physician who first reported the combination of small lower jaw, cleft palate, and tongue displacement in 1923. Pierre Robin sequence or complex is the name given to a birth condition that involves the lower jaw being either small in size (micrognathia) or set back from the upper jaw (retrognathia). As a result, the tongue tends to be displaced back toward the throat, where it can fall back and obstruct the airway (glossoptosis). Most infants, but not all, will also have a cleft palate, but none will have a cleft lip. Almost all will have swallowing problems due to the anatomy of the oral cavity. Pierre Robin sequence/complex, like most birth defects, varies in severity from child to child. Problems in breathing and feeding in early infancy are the most common. Parents need to know how to position the infant in order to minimize problems (ie, not placing the infant on the infant’s back). For severely affected children, positioning alone may not be sufficient, and the pediatrician may recommend specially designed devices to protect the airway and facilitate feeding. Some children who have severe breathing problems may require a surgical procedure to make satisfactory breathing possible. Pilocarpine Pilocarpine a cholinergic drug — that is, a drug that mimics the effects of the chemical acetylcholine, which is produced by nerve cells. Pneumonitis Pneumonitis noninfectious causes of lung inflammation. Pneumonia is a type of pneumonitis. Polymethylmethacrylate (PMMA) Polymethylmethacrylate (PMMA) a suspension of microscopic synthetic polymer beads (microspheres) in a vehicle such as bovine collagen, hyaluronic acid, or some other colloidal suspending agent. Artecoll (PMMA suspended in bovine collagen) and MetaCrill (PMMA suspended in a chemical colloid) are two brands of PMMA injectable augmentation products. The resin has long been used by orthopedic surgeons in bone cement for joint replacement or to replace a skull bone defect. Pompe disease Pompe disease a rare (estimated at 1 in every 40,000 births), inherited and often fatal disorder that disables the heart and skeletal muscles. It is caused by mutations in a gene that makes an enzyme called acid alpha-glucosidase (GAA). Normally, the body uses GAA to break down glycogen, a stored form of sugar used for energy. Excessive amounts of lysosomal glycogen accumulate everywhere in the body, but the cells of the heart and skeletal muscles are the most seriously affected. Researchers have identified up to 300 different mutations in the GAA gene that cause the symptoms of Pompe disease, which can vary widely in terms of age of onset and severity. The severity of the disease and the age of onset are related to the degree of enzyme deficiency. The swallowing problems relate to muscle weakness and muscle fatigue. Positron emission tomography (PET) Positron emission tomography (PET) a method of examining neural activity associated with specific motions such as speaking or swallowing. Although it is noninvasive, it has the disadvantage of exposure to radiation. Postprandial Postprandial after eating. Prader-Willi syndrome (PWS) Prader-Willi syndrome (PWS) a genetic disorder that occurs in approximately 1 out of every 15,000 births. PWS affects males and females with equal frequency and affects all races and ethnicities. PWS is recognized as the most common genetic cause of life- threatening childhood obesity. PWS was first described by Swiss doctors Andrea Prader, Alexis Labhart, and Heinrich Willi in 1956 based on the clinical characteristics of 9 children they examined. The common characteristics defined in the initial report included small hands and feet, abnormal growth and body composition (small stature, very low lean body mass, and early onset childhood obesity), hypotonia (weak muscles) at birth, insatiable hunger, extreme obesity, and intellectual disability. PWS results from an abnormality of chromosome 15, and definitive diagnosis is now based on genetic testing. Prandial aspiration Prandial aspiration the entry of material from the oropharynx or gastrointestinal tract into the larynx and lower respiratory tract during food or liquid intake. A person may either inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. The aspirated material is often colloquially referred to as “going down the wrong pipe.” Presbyphagia Presbyphagia changes in swallowing functions during healthy aging. Such changes are not severe enough to cause dysphagia but may affect overall swallowing efficiency and safety for older adults. Primary lactation insufficiency Primary lactation insufficiency inability to produce sufficient milk supply despite adequate stimulation with a baby or pump. Causes may be apparent, such as inadequate glandular tissue, or could be unexplained. Progressive supranuclear palsy Progressive supranuclear palsy a neurological disorder of unknown origin that gradually destroys cells in many areas of the brain, leading to serious and permanent problems with the control of gait and balance. The most obvious sign of the disease is an inability to aim the eyes properly, which occurs because of damage in the area of the brain that coordinates eye movements. Some patients describe this effect as a blurring. Another common visual problem is an inability to maintain eye contact during a conversation. This can give the mistaken impression that the patient is hostile or uninterested. Patients also often show alterations of mood and behavior, including depression and apathy as well as progressive mild dementia, lack of appetite or dysphagia for solids. The disease is “progressive” because it worsens over time; “supranuclear” because the main problem is not in the nuclei (clusters of cells in the brainstem) that directly control eye movements, but in higher centers that control the nuclei; and “palsy,” which means weakness, in this case of eye movement. Progressive supranuclear palsy (PSP) characteristically begins with loss of balance. Nearly all patients eventually develop the characteristic difficulty in moving the eyes up and down, the sign that often arouses a doctor’s suspicion of the correct diagnosis. Although PSP gets progressively worse, no one dies from PSP itself. Difficulty swallowing can eventually permit aspiration of food into the trachea (windpipe). PSP may also be complicated by the effects of immobility, especially pneumonia, and by injuries from falls. Prokinetic agents (or prokinetics) Prokinetic agents (or prokinetics) medications that help control acid reflux. Prokinetics help strengthen the lower esophageal sphincter (LES) and cause the contents of the stomach to empty faster. This allows less time for acid reflux to occur. Prosthodontist Prosthodontist a prosthodontist is a dentist with advanced specialty training including the design and fitting of prosthetic appliances, dental implants, dentures, veneers, crowns, and teeth whitening. Proton therapy Proton therapy a type of radiation therapy that uses protons (positively charged particles) instead of x-rays. Because it can be targeted specifically to the tumor, it has fewer side effects. Pseudobulbar palsy Pseudobulbar palsy bilateral corticobulbar tract damage in which speech and swallowing disorders are common. Ptosis Ptosis also known as drooping eyelid. This is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or looseness of the skin of the upper eyelids. Pulse oximetry Pulse oximetry a technique to measure the oxygen saturation of arterial blood by means of a photoelectric technique. Pulsed-dye laser (PDL) Pulsed-dye laser (PDL) the pulsed-dye laser uses a beam of light at a specific wavelength; used for conditions or spots on the skin that are made up of blood and blood vessels. Regurgitation Regurgitation a backward flowing, for example, of food, or the sloshing of blood back into the heart (or between chambers of the heart) when a heart valve is incompetent and does not close effectively. Reliability Reliability a test’s ability to measure the same thing consistently across multiple uses. Respiratory distress syndrome Respiratory distress syndrome rapid shallow breathing following injury or infection to the lungs. In newborns, a breathing disorder caused by immature lungs usually in premature infants. Rett syndrome Rett syndrome a uniform and striking, progressive neurological developmental disorder and one of the most common causes of mental retardation in females. It is an X-linked dominant neurological disorder that affects girls only and is one of the most common causes of mental retardation in females. Girls with the syndrome show normal development during the first 6 to 18 months of life followed first by a period of stagnation and then by rapid regression in motor and language skills. The hallmark of Rett syndrome is the loss of purposeful hand use and its replacement with stereotyped hand- wringing. Screaming fits and inconsolable crying are common. Because of these autistic-like behaviors, feeding is highly irregular. Other key features include loss of speech, behavior reminiscent of autism, panic- like attacks, bruxism (grinding of teeth), rigid gait, tremors, intermittent hyperventilation, and microcephaly (small head). Rheumatoid arthritis Rheumatoid arthritis a chronic inflammatory disorder that can affect more than just joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when the immune system mistakenly attacks the body’s tissues. Rheumatoid arthritis affects the lining of joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. Sarcoidosis Sarcoidosis an autoimmune disease of unknown origin that causes small lumps (granulomas) due to chronic inflammation to develop in a great range of body tissues. Sarcoidosis can appear in almost any body organ, but most often starts in the lungs or lymph nodes. It also affects the eyes, liver, and skin; it less often affects the spleen, bones, joints, skeletal muscles, heart, and central nervous system (brain and spinal cord). In the majority of cases, the granulomas clear up with or without treatment. In cases where the granulomas do not heal and disappear, the tissues tend to remain inflamed and become scarred (fibrotic). Sarcopenia Sarcopenia a condition that occurs with aging or immobility, characterized by progressive and generalized loss of skeletal muscle mass and strength and/or physical performance. Schatzki ring Schatzki ring described by Richard Schatzki, M.D., in 1953; a narrowing of the lower part of the esophagus caused by changes in the esophageal mucosa. In the majority of cases, Schatzki ring is benign and asymptomatic; the condition is associated with hiatal hernias and can disrupt the normal esophageal functions. It has been suggested that long-term gastroesophageal reflux disease causes chronic inflammation and thus chronic damage to the lower esophagus. The damage will heal and form a scar that is the Schatzki ring. Scintigraphy Scintigraphy a procedure used to track movement of the bolus and quantify the residual bolus in the oropharynx, pharynx, larynx, and trachea using a special camera (gamma camera). The patient swallows a small amount of a radionuclide material such as technetium 99m combined with liquid or food for this test. Scleroderma Scleroderma a disease of connective tissue with the formation of scar tissue (fibrosis) in the skin and sometimes also in other organs of the body. Scleroderma is classified into diffuse and limited forms. The CREST syndrome is a limited form of scleroderma. CREST stands for calcinosis (the formation of tiny deposits of calcium in the skin); Raynaud phenomenon (spasm of the tiny artery vessels supplying blood to the fingers, toes, nose, tongue, or ears); esophagus (esophageal involvement by the scleroderma); sclerodactyly (localized thickening and tightness of the skin of the fingers or toes); and telangiectasias (dilated capillaries that form tiny red areas, frequently on the face, hands, and in the mouth behind the lips). Secondary peristalsis Secondary peristalsis the peristaltic wave that is induced by esophageal distension from the retained bolus, refluxed material, or swallowed air. The primary role is to clear the esophagus of retained food or any gastroesophageal refluxate. Selective serotonin reuptake inhibitors (SSRIs) Selective serotonin reuptake inhibitors (SSRIs) a class of medications used to treat depression. Prozac, Zoloft, and Paxil are examples of SSRIs. Besides dry mouth and nausea, there are many side effects of these medications, and they must be prescribed diligently after careful examination. Sensitivity Sensitivity a test’s accuracy in identifying true cases of the target disorder. Serology Serology the science of blood testing to identify antibodies and antigens to determine immune deficiencies in serum, plasma and other body fluids. Sialorrhea Sialorrhea excessive drooling. This condition is usually caused by nerve or muscle problems or a breakdown in the skin around the mouth. Drooling is related to forward spillage. Posterior drooling may result in excessive spillage down into the airway. Silent aspiration Silent aspiration aspiration without any obvious signs of swallowing difficulty, such as coughing or breathing difficulty. Silent aspiration is related to loss of sensation in the vagus nerve. Sjögren’s syndrome Sjögren’s syndrome an autoimmune disease of salivary and tear glands. Sjogren’s syndrome involves inflammation of glands and other tissues of the body. Most patients with Sjogren’s syndrome are female. Sjogren’s syndrome can be complicated by infections of the eyes, breathing passages, and mouth. Sjogren’s syndrome is typically associated with antibodies against a variety of body tissues (autoantibodies). Slough Slough to separate from surrounding living tissue. Used of dead tissue. Spasticity Spasticity stiff or rigid muscles with exaggerated, deep tendon reflexes (e.g., a knee-jerk reflex). The condition can interfere with walking, movement, or speech. Specificity Specificity a test’s accuracy in rejecting cases that do not match the target disorder. Squamous cell carcinoma Squamous cell carcinoma cancer that begins in squamous cells — thin, flat cells that look under the microscope like fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of hollow organs of the body, and the passages of the respiratory and digestive tracts. Squamous cell carcinomas may arise in any of these tissues. Stenosis Stenosis also known as a stricture. This is an abnormal narrowing in a blood vessel or other tubular organ or structure. Stomatitis Stomatitis inflammation of the mucosal lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth. The word stomatitis literally means inflammation of the mouth. Subluxation Subluxation partial dislocation of a joint. A complete dislocation is a luxation. Suckling Suckling motion than requires the tongue to move anterior to posterior. Usually the infant begins to swallow using this pattern. Compared to sucking which is an inferior to superior motion of the tongue that is acquired later in normal infancy. Surrogate decision-maker Surrogate decision-maker also known as a health care proxy. This is a person who makes health or personal care decisions for an incompetent patient. Swallow reflex Swallow reflex when masticated food passes beyond the facial arches into the hypopharynx, the swallow becomes reflexive, meaning that it is under involuntary control. In a normal swallow, breath holding occurs, the vocal folds adduct, and the bolus passes into the esophagus. Systemic lupus erythematosus (SLE) Systemic lupus erythematosus (SLE) an autoimmune disease. In this disease, the body’s immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs. Tardive dyskinesia Tardive dyskinesia a disorder that involves involuntary movements, especially of the lower face. Tardive means “delayed” and dyskinesia means “abnormal movement.” Third party disability Third party disability a disability to a family member due to the health condition of a significant other. Originally proposed by the World Health Organization as a medical condition. Now recognized in the International Classification of Functioning (ICF) (https://doi.org/10.3109/09638280902927028) Tonic contraction Tonic contraction continuous contraction of a muscle. Tractus solitarius Tractus solitarius a tract composed of mostly sensory fibers that convey information from stretch receptors and chemoreceptors in the walls of the cardiovascular respiratory and intestinal tracts. Its fibers are distributed to the nucleus of the solitary tract. Tracheostomy Tracheostomy a surgically created opening in the neck leading directly to the trachea (the breathing tube). It is maintained open with a hollow tube called a tracheostomy tube. Tracheotomy Tracheotomy a surgical procedure that opens up the windpipe (trachea). It is performed in emergency situations, in the operating room, or at bedside of critically ill patients. Transcutaneous Transcutaneous through the skin. Transoral Transoral by way of the mouth. Treacher Collins syndrome Treacher Collins syndrome a condition that affects the development of bones and other tissues of the face. The signs and symptoms of this disorder vary greatly, ranging from almost unnoticeable to severe. Most affected individuals have underdeveloped facial bones, particularly the cheekbones, and a very small jaw and chin (micrognathia). Some people with this condition are also born with a cleft palate. In severe cases, underdevelopment of the facial bones may restrict an affected infant’s airway, causing potentially life-threatening respiratory problems. People with Treacher Collins syndrome often have eyes that slant downward, sparse eyelashes, and a notch in the lower eyelids called an eyelid coloboma. Some affected individuals have additional eye abnormalities that can lead to vision loss. This condition is also characterized by absent, small, or unusually formed ears. Hearing loss occurs in about half of all affected individuals; hearing loss is caused by defects of the three small bones in the middle ear or by underdevelopment of the ear canal. Trigeminal nerve (CN V) Trigeminal nerve (CN V) responsible for sensation in the face. Sensory information from the face and body is processed by parallel pathways in the central nervous system. CN V is primarily a sensory nerve, but it also has certain motor functions (biting, chewing, and swallowing). Trismus Trismus inability to open the mouth fully. This may be due to spasm of the jaw muscles and be a symptom of tetanus (lockjaw) or it may be due to abnormally short jaw muscles, as in the trismus-pseudo- pamprodactyly syndrome. Trisomy 21 syndrome Trisomy 21 syndrome a common chromosome disorder, often called Down syndrome, due to an extra chromosome number 21 (trisomy 21). The chromosome abnormality affects both the physical and intellectual development of the individual. Trisomy 21 syndrome is associated with a major risk for heart malformations, a lesser risk of duodenal atresia (part of the small intestines is not developed), and a minor but still significant risk of acute leukemia. Children born with Down syndrome are often slow to acquire strong sucking ability; thus, they may be slow to thrive if the swallowing problem is not detected early. In Down syndrome, there are certain characteristic features in the appearance that may individually be quite subtle but together permit a clinical diagnosis of Down syndrome to be made at birth. These signs of Down syndrome include slight flattening of the face, minimal squaring off of the top of the ear, a low bridge of the nose (lower than the usually flat nasal bridge of the normal newborn), an epicanthic fold (a fold of skin over top of the inner corner of the eye, which can also be seen less frequently in normal babies), a ring of tiny harmless white spots around the iris, and a little narrowing of the palate. Upper motor neuron Upper motor neuron a neuron that starts in the motor cortex of the brain and terminates within the medulla (another part of the brain) or within the spinal cord. Damage to upper motor neurons can result in spasticity and exaggerated reflexes. Vagal Vagal a response when the vagus nerve is stimulated. A vagal response may cause dizziness or even cause one to pass out. Vagus nerve Vagus nerve (CN X) a remarkable nerve that supplies nerve fibers to the pharynx (throat), larynx (voice box), trachea (windpipe), lungs, heart, esophagus, and intestinal tract as far as the transverse portion of the colon. The vagus nerve also brings sensory information back to the brain from the ear, tongue, pharynx, and larynx. It originates in the medulla oblongata, a part of the brainstem, and wanders all the way down from the brainstem to the colon. Validity Validity a test’s ability to measure what it is designed to measure. Vasospasm Vasospasm blood vessel spasm, also known as Raynaud’s. Lactation may provoke this condition in the nipples and cause severe pain. It can occur spontaneously without any prior systemic vasospasm or autoimmune condition. Velopharyngeal insufficiency Velopharyngeal insufficiency incomplete closure of the velopharyngeal sphincter between the oropharynx and the nasopharynx. Closure, normally achieved by the sphincteric action of the soft palate and the superior constrictor muscle, is impaired in patients with cleft palate, repaired cleft palate, congenitally short palate, submucous cleft palate, palatal paralysis, and, sometimes, enlarged tonsils. The condition may also result when adenoidectomy or uvulopalatopharyngoplasty (UVP) is done in a patient with a congenital underdevelopment (submucous cleft) or paralysis of the palate. Velo-cardio facial syndrome (VCFS) Velo-cardio facial syndrome (VCFS) a genetic condition characterized by abnormal pharyngeal arch development that results in defective development of the parathyroid glands, thymus, and conotruncal region of the heart. Shprintzen and colleagues first described the syndrome in 1978. More than 180 different clinical features are associated with velocardiofacial syndrome, with no single anomaly present in every patient. Some abnormalities are more common than others. Affected individuals may present with structural or functional palatal abnormalities, cardiac defects, unique facial characteristics, hypernasal speech, hypotonia, and defective thymic development. Palatal abnormalities predispose to speech and feeding difficulties. Verbal apraxia Verbal apraxia a motor speech disorder. It is caused by damage to the parts of the brain related to speaking. Other terms include apraxia of speech, acquired speech apraxia, verbal apraxia, and dyspraxia. Videofluoroscopy Videofluoroscopy using a video-recording system to examine the activity during an x-ray procedure. Vocal fold paresis Vocal fold paresis a condition of the vocal fold when it has lost partial neural innervation. Mobility of adduction and abduction is reduced and slower compared to normal function. Wallenberg syndrome Wallenberg syndrome also known as lateral medullary syndrome. This is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brainstem. Symptoms include difficulties with swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination. Some individuals will experience a lack of pain and temperature sensation on only one side of the face, or a pattern of symptoms on opposite sides of the body, such as paralysis or numbness in the right side of the face, with weak or numb limbs on the left side. Uncontrollable hiccups may also occur, and some individuals will lose their sense of taste on one side of the tongue, while preserving taste sensations on the other side. Wegener granulomatosis Wegener granulomatosis characterized by a granulomatous arteritis involving the upper and lower respiratory tracts, a progressive glomerulonephritis, and extra respiratory symptoms attributable to systemic small-vessel arteritis. Wegener granulomatosis often affects the hard and soft palate and may lead to extensive ulceration, oronasal fistulas, and velopharyngeal insufficiency. Whiteout phase Whiteout phase the time of airway closure during which the swallow cannot be visualized, as the pharyngeal walls contract over the bolus, collapsing the lumen over the endoscope. World Health Organization (WHO) World Health Organization (WHO) an agency of the United Nations that is concerned with world public health. Established in 1948 and headquartered in Geneva, Switzerland. Xanthum gum Xanthum gum a polysaccharide that is used as food additives and liquid thickeners; an addition or alternative to starch-based liquid thickeners. Xerophonia Xerophonia a dry-sounding or strange sounding voice caused by various medications including diabetes medications. In psychiatry, xenophonia relates to a strange sounding voice. Xerostomia Xerostomia more commonly known as dry mouth, is not a disease in itself. Rather, it is a symptom of many other diseases and conditions. These conditions cause saliva production to decrease or stop. Zenker diverticulum Zenker diverticulum also known as pharyngoesophageal diverticulum or pulsion diverticulum of the esophagus; named in 1877 by German pathologist Friedrich Albert von Zenker. This is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle.