Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
What are the two purposes eating serves |
1: Nutrition & Hydration: stay healthy, recover from an illness, grow 2: Pleasure: an individual with dysphagia loses the ability to participate in celebrations of life |
|
|
When the individual has dysphagia eating can become a cognitive task |
1. The individual must THINK ABOUT what he/she is doing. 2. Have the determine if the individual is safe to eat alone. |
|
|
SLPS play a role in treating dysphagia |
1. Communication and swallowing problems can often co-occur (common structures) 2. IT IS WITHIN OUR SCOPE OF PRACTICE |
|
|
Advanced directive |
The patient has stated his/her preference about feeding or other life saving issues. DNR- do not resusitate |
|
|
Aspiration |
Refers to food, liquid, saliva, penetrating larynx and entering airway. 1. goes below vocal folds 2. food or liquid enters lungs rather than stomach after the swallow |
|
|
BCA |
BEDSIDE CLINICAL ASSESSMENT |
|
|
BOLUS |
A ROUNDED MASS SUCH AS A LARGE PILL OR A SOFT MASS OF CHEWED FOOD MIXED WITH SALIVA |
|
|
CVA |
CEREBROVASCULAR ACCIDENT-A STROKE WHICH IS AN INTERRUPTION OF BLOOD SUPPLY TO THE SOME AREAS OF THE BRAIN |
|
|
What are ways a stroke can occur |
1. Embolus: a moving clot from another part of the body that lodges in the artery. 2. Thrombosis: Occurs when the artery fills with plaque. Atherosclerosis 3. Hemorrhagic stroke: bleeding in the brain 4. Aneurysm: a weakening in the artery that bulges and breaks leading to an interruption of blood flow to areas of the brain served by that vessel/ |
|
|
Both an EMBOLUS and THROMBOSIS result in the blockage of an artery to the brain |
This blockage leads to anoxia which is the deprivation of oxygen to the area of the brain served by that vessel.
80% of strokes occur as a result of a blocked artery, blockage over 3 min leads to death of brain tissue. Swelling may lead to additional damage. |
|
|
Deglutition DNR Dysphagia FEES Gtube Gastroenterologist MBS NG tube |
Deglutition: Swallowing DNR: Do not resuscitate dysphagia: difficulty/inability in swallowing FEES: Fiberoptic Endoscopic Evaluation of Swallowing Gtube (gastric tube) feeding tube placed in stomach through incision Gastroenterologist: physician who deal with the digestive tract MBS- modified barium swallow Ng tube (nasogastric tube) feeding tube through the nose. |
|
|
NICE NICU NPO PENETRATION PERISTALSIS PRODUCTIVE COUGH
|
NICE: noninstrumental clinical exam (bca) NICU: neonatal intensive care unit NPO: nil per os PENETRATION: bolus enters larynx BUT remains ABOVE VF PERISTALSIS: contraction of muscles leads to movement of food through digestive tract. PRODUCTIVE COUGH: a cough strong enough to expel material from the airway.
|
|
|
Treatment efficacy Treatment effectiveness |
Treatment efficacy: The extent to which an intervention can be shown to be beneficial under optimal conditions
Treatment effectiveness: the extent to which services are shown to be beneficial under typical conditions. |
|
|
THE FOUR STAGES OF A SWALLOW |
1. Oral Preparatory: involves all the sense, begins with awareness that food is available. chewing, labial seal. 2. Oral: Tongue elevates to touch the alveolar ridge, then the soft palate moves to make contact with the posterior pharyngeal wall to prevent food from entering the nasal cavity. 3. Pharyngeal: begins when bolus makes contact with anterior faucial pillars 4. Esophageal: As the bolus passes the UES the sphincter closes and the peristaltic action of the esophageal muscles carries the bolus to LES
|
|
|
Causes of dysphagia in infants (seen in infants who are premature, cerebral palsy, clefting, genetic disorders, illness, sensory defects). |
1. GERD 2. Stenosis, narrowing of the pyloric sphincter 3. Respiratory disorders 4. Asthma 5. Esophageal atresia- esophagus ends in a blind pouch 6. Laryngeal web-failure of VF to completely separate in utero |
|
|
Causes of dysphagia in adults |
1. Can occur at ANY age 2. Stroke 3. TBI 4. Dementia 5. Neuromuscular diseases (ms, als, parkinsons) 6. Cancer 7. HIV/AIDS |
|
|
Settings where SLPS treat dysphagia |
1. Hospitals 2. Physicians offices 3. Hospice 4. Rehabilitation Facilities |
|
|
People who manage dysphagia |
slp, slpa OT, PT, Dentist, Dietician, Neurologist, ENT, RN, Social worker, MFT, patient and family etc.. |
|
|
Case history for dysphagia |
1. Swallowing prior to illness 2. Foods they like to eat (educate family about bringing food into hospital) 3. Rituals of dining 4. overall health |
|
|
Treatment plan for dysphagia |
Oral motor exercises to strengthen the muscles of the articulators (increase muscle tone and strength for the swallow).
|
|
|
Strategies for feeding a patient with dysphagia (positioning) |
1. Chin tuck 2. Head rotation: turn head to the weaker side if there is unilateral weakness. This directs food down the stronger side by "closing down" the weaker side. 3. Head tilt: toward the stronger side. |
|
|
Swallowing strategies |
1. Double or dry swallow: clear any residual material 2. Effortful/hard swallow: tell patient to squeeze hard in the back of the throat during swallow. 3. Superglottic swallow: forced closure of the VF. Take a breath and hold it, place a small amount of food in mouth, swallow, cough to clear the throat while exhaling, swallow again. |
|
|
Mendelsohn maneuver |
Swallow while placing the thumb and first finger on either side of the larynx. Manually hold the larynx in the elevated position for 3-5 seconds during and after the swallow. Release the larynx and relax. |
|
|
Thermal Tactile stimulation |
The pharyngeal phase begins when the bolus contacts the anterior faucial pillars triggering the swallow.
The SLP strokes the anterior faucial pillar 5x with a frozen glycerine swab before meals to increase sensory awareness. |
|
|
Emotional and Social effects on patients with dysphagia |
1. Eating is social and has emotional significance attached to it. 2. Patients experience a fear of chocking. 3. Depression and loss of interest in things that they used to enjoy. 4. Embarrassment of being "fed like a baby" 5. Psychomotor retardation 6. Speech with no inflection. |
|
|
Emotional effects on the family |
1. Spouse or partner feels "hurt" for their loved one 2. Nervous, and want to help, but afraid of doing it wrong. 3. Stresses, time, energy, patience, tolerance
|
|
|
Mulitcultutral considerations for patients with dysphagia. |
1. The foods they want are not available in the hospital, or they need to ask 2. Cultural rituals of dining. 3. Families sneak in food but with the wrong consistency 4. Families give food that is not included in the diet 5. Must EDUCATE the family for the safety of the patient. |
