Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/21

Click to flip

21 Cards in this Set

  • Front
  • Back
General/Overall Problems: Pt. not responding
Caue: Poor level of consciousness or arousal
General/Overall Problems: Pt. refusing to eat
Cause: Any phase problems, behavioral/psychological/cogntive problems
Oral Preparatory Phase Problems: Weak Oral Structures => Weak labial strength/mobtility (lips)
Results in: 1. Difficulty taing material from utensil 2. Difficulty w/ buccal tension in gathering food resulting in pocketing 3. Leakage of material out of oral cavity
Oral Preparatory Phase Problems: Weak Oral Structures => Weak labial strength/mobtility (range of motion, tongue)
Resulting in: 1. Oral pocketing in lateral or anteriour sulci 2. Difficulty manipulating food into a bolus 3. Lingual statsis (residue or coating)
Oral Preparatory Phase Problems: Weak Oral Structures => poor dentition condition (teeth)
Results in: 1. Decreased ability or inability for mastication/breakdown of the material
Oral Preparatory Phase Problem: Weak Oral Structure => decreased jaw excursion/closure (jaw weakness)
Resulting in: 1. Poor lip closure 2. Poor mastication/breakdown of the material
Oral Transit Phase Problem: Poor tongue motility/control => propelling the bolus to the back of the throat
Resulting in: 1. Tongue pumping (difficulty initiating the swallow) 2. Premature spillage of materials into the pharyngeal area 3. Increased oral transit time 4. Tongue thrusting
Pharyngeal Phase Problem: Poor velo-Pharygenal Closure => Velum must retract and raise to close off V-P port once a swallow is initated
Resulting in: Nasal penetration of the material STRATEGY: try a hard swallow REPORT: "pt. presented with poor VP closure resulting in nasal penetration"
Pharyngeal Phase Problem: Swallow delay => a result of some neurological event/problem (only assess with liquids)
Resulting in: penetration (anything above the vocal folds) or aspiration (anything below the vocal folds) STRATEGY: chin tuck, it helps delay the swallow REPORT: "swallow delay noted resulting in penetration/aspiration of thin liquids"
Pharyngeal Phase Problems: Decreased posterior tongue retractions => tongue should retract back to pharyngel wall to get a good supra-glottic (SG) pressure
Resulting in: Rsidue coating the tongue base STRATEGIES: hard swallow, repeat/extra swallows, alternate solids/liquids REPORT: "decreased posterior tongue retraction noted resulting in residue on the tongue base"
Pharyngral Phase Prblem: Decreased Phayrngeal Wall Contraction => {haryngeal wall must cone forward to help with SG prssure
Resulting in: Residue coating pharyngeal wall STRATEGIES: hard swallows, repeat/extra swallows, alternate solids with liquids REPORT: "decreased pharyngeal wall contraction resulted in residue on the posterior pharyngeal wall"
Pharyngeal Phase Problems: Decreased laryngeal Elevation => larynx must elevate 2 cm or at least 1 vertebrae (number 1)
Resulting in: 1. Poor epiglottic inversion which in turn results in: A. residue in the valleculae B. decreased airway protection STRATEGIES: 1. hard swallow 2. repeat/extra swallow with a head turn 3. alternate solids w/ liquids 4. initial swallow w/ head turn 5. super supra glottic swallow (holding your breath during a swallow)
Pharyngeal Phase Problem: Decreased laryngeal elevation
REPORT: "decreased ;arygeal levation resulted in poor epiglottic inversion which in turn resulted in residue in the valleculae. Decreased laryngeal elevation also resulted in poor CP closure which resulted in…
Pharyngeal Phase Problems: Decreased laryngeal Elevation => larynx must elevate 2 cm or at least 1 vertebrae (number 2)
Resulting in: 2. Poor crico-pharyngeal opening which in turn results in: A. residue in the pyriform sinuses B. backflow of material into laryngeal vestibule from CP STRATEGIES: 1. hard swallow 2. repeat/extra swallow w/ head turn 3. alternate solid w/ liquids 4. inital swallow w/ head turn 5. Mendelsohn maneuver: keep the larynx elevated to keep CP opened
Pharyngeal Phase Problems: decreased epiglotticinversion (NOT DUE TO LARYNGEAL ELEVATION)
Resulting in: reside in the valleculae STRATEGIES: hard swallow, extra/repeat swallows with head turn, alternate solids w/ liquids REPORT: decreased epiglottic inversionwas noted that resulted in residue in the valleculae
Pharyngeal Phase Problem: Poor vocal fold closure => individuals w/ paretic or paralyzed VF will be at risk for aspiration
Resulting in: 1. decreased airway protection 2. decreased SG pressure STRATEGIES: super supra glottic swallow (holding breath during swallow)
Pharyngeal Phase Problems: Poor CP opening (NOT FROM LARYNGEAL ELEVATION) => crico-pharyngeal sphincter must relax to open to allow food to enter the esophagus
Resulting in: 1. residue in the pyriform sinuses and laryngeal vestibule 2. backflow of material from CP STRATEGIES: hard swallow, repeat/extra swallows, alternate solids w/ liquids, Shaker exercises
Shaker Exercise: helps when the CP isn't opening
Stretch out on floor on back, raise head up w/ arms at your sides. Kepp feet, back, and shoulders down. Look at toes 30 times. Then hold head up for1 minute
Pharyngeal Phase Problem: Unilateral Pharyngeal weakness => look for residue symmetry on AP view
Resulting in: more residue on one side (the weak side) STRATEGIES: head turns (turn to weak side bc it will open the strong side), repeat/extra swallows, alternate solids w/ liquids REPORT: unilateral weakness was noted and resulted in residue on one side
Pharyngeal Phase Problems: Structural Anomalies (Zenker's Diverticulum)
Caused by malfunction of CP sphincter, it creates an extra pocket
Pharyngeal Phase Problems: Structural Anomalies (CP Bar)
The opening of the CP sphinter should not open so much, when it doesn’t open there is a knob