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87 Cards in this Set

  • Front
  • Back
dysphagia is
difficulty moving food from mouth to stomach
patients who report oropharyngeal swallowing disorders are _____ to describe them and are _____ in their localization and definition of the problem
able, accurate
patients with esophageal disorders may be highly ______ in describing and localizing their dysfunction
literature on swallowing falls into three categories:
1. oral stage of the swallow, 2. triggering of the pharyngeal phase 3. pharyngeal and esophogeal stages
feeding techniques describes
describe procedures to improve the oral stages of the swallow, including manipulation of food in prep stage and transport of food through the oral cavity
swallowing therapy describes techniques to improve the _______ of the swallow and the _________of the swallow
triggering, pharyngeal stage (in addition to the prep stage of oral manipulation and oral stage)
feeding is limited to
placement of food in the mouth, manip of food in oral cavity, and oral stage of the swallow when bolus is propelled backwards by the tongue
therapy designed to improve feeding attemps to improve (1-5)
1. positioning of food in mouth 2. manipulation of food in the mouth with tongue 3. chewing a bolus of varying consistencies 4. recollecting the bolus into a cohesive mass 5. organizing lingual action to propell the bolus posteriorly.
feeding techniques deal with the ______and _____ stages of the swallow that terminate when ______________.
the oral prep and oral stages of the swallow that terminate when pharyngeal swallow is triggered.
swallowing therapy includes
reducing any delay in triggering the pharyngeal swallow, improving pharyngeal transit timethe individual neuromotor actions comprising the pharyngeal stage of swallow, as well as all of the techniques used to improve oral and oral prep stage of swallow
swallowing refers to the entire act
of deglutition from placement of food in the mouth until the gastroesophageal junction
the first task of a swallowing therapist is to
identify patients who are at high risk for oropharyngeal dysphagia
screening involves looking for __________ of oropharyngeal dysphagia
signs and symptoms
screening procedures do not define
anatomy or physiology of the oropharynx.
if the technique provides physiologic data,
it is a diagnostic procedure
what are the 4 symptoms of oropharyngeal dysphagia?
1. aspiration 2. penetration 3. residue 4. backflow
entry of food or liquid into the airway below the true vocal folds
entry of food or l into the larynx at some level down to but not below the true vocal cords
food that is left behind in the mouth or pharynx after the swallow
food from the esophagus into the pharynx and/or from the pharynx into the nasasl cavity
the swallowing therapist's job is to
1. identify the symptoms and from the symptoms identify the underlying abnormalities in anatomy that cause symptoms
what are complications of dysphagia?
pneumonia, malnutrition, and dehydration
give the patient a ____ amount of material during bedside
begin the radiographic exam with a small amount (____) and ____ volume as tolerated
1 ml, increasing
any patient whose aspiration is larger than approximately _____ per bolus of a particular food consistency despite interventions should be resticted from eating that consistency
approximately ____ percent of patients who aspirate do not cough in response to this aspiration
even the most experienced clinicians fail to ID approximately _____ percent of the patients who aspirate during a bedside
older individuals are at higher risk ofr oropharyngeal disorders because of stroke and so on, and ____ dysfunction, because of age
symptomatic treatment results in
longer, more expensive care and less effective long-term health for the patient.
diagnosis of dysphagia is designed to identify the ____________ of each patient's ________ and ________
identify the abnormal elements of each patient's anatomy and physiology
the anatomic areas involved in deglutition in clude the
oral cavity, pharynx, larynx, and esophagus
between the anterior and posterior faucial arches are the
palatine tonsils
the ___ is the space formed between the alveolus and cheek or lip musculature
sulcus (lateral sulcus, anterior sulcus)
muscles forming the floor of the mouth includes
1. mylohyoid 2. geneohyoid 3. anterior belly of digastric (all of which attach to the body of the mandible anteriorly and the body of the hyoid bone posteriorly)
the ____ forms the foundation for the tongue
hyoid bone
the laryx is suspended from the hyoid bone by the _____ and ____
thyrohyoid ligament and thyfohyoid muscle
if the hyoid elevates and moves forward,
so will the larynx
the oral tongue includes
tip, blade, front, center, and back
the oral tongue ends at the
circumvillate papillae
the oral stages of swallow is under
cortical or voluntary neural control
the tongue base (pharyngeal portion) begins at _____ and extends to the _____
circumvillate papillae, hyoid bone
the tongue base is under ______ but can be placed ____
involuntary neural control coordinated in the brainstem (medullary swallow center), can be placed under voluntary control
the roof of the mouth is formed by the
maxilla (hard palate), velum (soft palate), uvula
the ______ muscle helps to pull the soft palate down and forward
palatoglossus muscle
velopharyngeal port closure happens with a combo of muscle pulls such as:
palatopharyngeus, levator palatal muscle, and fibers of the superior pharyngeal constrictor
three large salivary glands are on each side
1. parotid glands 2. submandibular 3. sublingual
the parotid gland produces _________ fluid
the submandibular and sublingual gland produce
both types of fluid (sublingual glands more mucous)
pharyngeal structures involved in deglutition include three pharyngeal constrictors:
superior, medial, and inferior, which form the posterior and lateral pharyngeal walls
median raphe
the midline of the posterior pharyngeal wall. pharyngeal constrictor muscles arise here and run laterally to attach to structures located anteriorly
inferior fibers of the superior constrictor that attach to teh tongue base are known as the
glossopharyngeus muscle
the fibers of the inferior constrictor attach
to the sides of the thyroid cartilage anteriorly
teh spaces that are formed between fibers of the inferior constrictor and the thyroid cartilage are called
pyriform sinuses, which end inferiorly at the cricopharyngeal muscle.
the _______ is the most inferior structure of the pharynx
cricopharyngeal muscle
cricopharyngeal muscle fibers attach to the
posterolateral surface of the cricoid lamina
the cricopharyngeal muscle fibers are in some degree of _______ ________ in the awake individual to prevent air from entering the esophagus during respiration
tonic contraction
during sleep, the cricopharyngeous
loses some of its tonic contraction
a secondary role of the UES is to
reduce the risk of material backflowing from the esophagus and into the pharynx
the UES is defined as a ______ zone of elevated pressure capable of withstanding pressures of up to _______ of water in the esophagus.
2-4 cm , 11cm of water.
the cricopharyngeal sphincter has greatest pressure ________ to the swallow and ________
immediately prior, during inspiration
the esophagus is a collapsed muscular tube approximately ____ cm long with a sphincter at each end
the esophagus has ___ layers of muscle: the ______ and the ______
2: inner circular, outer longitudinal
the ____ wall of the trachea is the _____ wall of the esophagus
posterior, anterior
the pharynx opens into the
the larynx serves primarily as a
valve to keep food from entering the airway during swallowing
the topmost structure of the larynx is the _______
epiglottis, the top third which rests against the base of the tongue
the epiglottis is attached to the hyoid bone by the ______ and the base of the epiglottis is attached by ligament to the _______
hyoepiglottic ligament, thyroid notch
the wedge shaped space formed between the base of the tongue and the epiglottis is the
the valleculae is subdivided by the
hyoepiglottic ligament
the valleculae and the two pyriform sinuses are known as the
pharyngeal recesses into which food may fall and reside before or after the pharyngeal swallow triggers
the ____ are located against the base of the tongue and take up a small amount of vallecular space
lingual tonsils
the opening into the larynx is known as the
laryngeal vestibule
the laryngeal vestibule is bounded by the
epiglottis, aryepiglottic folds, and arytenoid cartilage, and ends at the superior surface of the false vocal folds
the aryepiglottic folds contain
the aryepiglottic muscle, quadrangular membrane, and cuneiform cartilages
the aryepiglottic folds form the _____ walls of the laryngeal vestibule
the arytenoids ____ _______ during swallowing
tilt anteriorly - which contributes to the closure of the airway entrance
the space that is formed between the false and true vocal folds is known as the
laryngeal ventricle
together the ________ and ______; the _____, base of ______, __________, ______ form three levels of sphincter in the larynx
epiglottis and aryepiglottic folds, arytenoids, epiglottis, false VF, true VF
the larynx and trachea are suspended in the neck between the ______ and the ______
hyoid bone, sternum
the act of deglutition is described in four phases:
1. oral prep phase, 2. oral phase of the swallow 3. pharyngeal phase 4. esophageal phase
swallowing frequency is greatest during ______ and least during ______
eating, sleep
mean deglutition frequency is approx ____ swallows per day
swallowing and respiration are ________ functions
respiration _____ during the pharyngeal phase of deglutition in humans of all ages, including infants
swallows of saliva in the pharynx usually do not
include any oral prep or oral stage of the swallow
from the time the material is placed in the mouth ____ seal is maintained, which requires an _____ nasal airway
labial, open
the tongue cups around the liquid bolus with teh sides of the tongue sealed against the ________ ________
lateral alveolus