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28 Cards in this Set
- Front
- Back
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compensatory stragegies
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1. postural changes
2. improving oral sensory awareness 3. food consistencies (diet changes) |
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therapy procedures
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1. oral motor control exercises
2. oral and pharyngeal ROM exercises 3. sensory-motor integration 4. swallowing maneuvers |
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postural changes
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1. chin down/ chin tuck
2. head turn/ head rotation 3. head tilt 4. head back/ chin up 5. lying down on side or back |
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chin down/ chin tuck
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- increases velleculae space
-narrows airway entrance -allows more time to trigger pharyngeal swallow -pushes epiglottis posterior -pushes base of tongue to back to pharyngeal wall |
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chin down/ chin tuck used with...
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-reduced posterior base of tongue movement
-unilateral laryngeal dysfunction |
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head turn/ head rotation
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- turn head to weaker side to allow bolus to pass on intact side
-pulls cricoid cartiledge away from posterior pharyngeal wall which decreases resting pressure on UES -increases VF closure by applying extrinsic pressure -narrows laryngeal entrance |
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head turn/ head rotation used with...
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-unilateral pharyngeal paresis
-cricopharyngeal dysfunction -unilateral laryngeal dysfunction |
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head tilt
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tilt head to stronger side to direct bolus to most intact side
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head tilt used with...
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-unilateral oral weakness
-unilateral oral/pharyngeal weakness |
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head back/ chin up
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-uses gravity to facilitate drainage of food out of oral cavity
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head back/ chin up used with...
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-decreased tongue control
-decreased posterior propulsion of bolus -decrease lip closure - used only if pt. has adequate laryngeal closure and can use supraglottic swallow |
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lying down on side or back
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-eliminates effect of gravity on pharyngeal residue
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lying down on side or back used with...
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-decreased pharyngeal contractions resulting in residue
-not indicated if residue builds after each swallow or hx of reflux |
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improve oral sensory awareness
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-increase downward pressure with spoon on the tongue
-present sour/cold bolus -present a bolus requiring chewing -thermal-tactile stimulation -suck- swallow |
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swallowing maneuvers
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1. supraglottic swallow
2. super-supraglottic swallow 3. effortful swallow 4. menselsohn maneuver |
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supraglottic swallow
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-pt take deep breath, holds while swallowing, coughs when breath is released
-don't take another breath immediately |
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supraglottic swallow used with...
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-reduced/late VF closure
-delayed pharyngeal swallow |
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super-supraglottic swallow
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-same as supraglottic swallow but pt uses more effort when holding breath
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super-supraglottic swallow used with...
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-reduced closure of airway entrance
-required alert pt |
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effortful swallow
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-have pt. squeeze the muscles of throat as hard as he can while swallowing
- "Swallow hard" |
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effortful swallow used with...
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-reduced posterior movement of tongue base
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mendelsohn maneuver
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-swallow saliva several times
-ask if pt can feel adam's apple -swallow normal- when apple goes to top "Grab" it and hold up for a few seconds |
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mendelsohn maneuver used with...
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-reduced laryngeal movement
-discoordinated swallow |
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delayed pharyngeal swallow use...
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-chin down
-thermal stim |
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reduced airway closure use...
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-chin down
-chin down head turn -super-supraglottic swallow -chin down, super-supraglottic swallow -thickened liquids and repeat |
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reduced VF closure use...
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-chin down
-head turn to damage side -chin down, head turn -supraglottic swallow, chin down, head turn -thickened liquid and repeat |
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reduced hyo-laryngeal elevation use...
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-head turn
-mendelson maneuver -head turn and hendelson maneuver |
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reduced tongue base retraction movement use...
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-chin down
-effortful swallow -chin down and effortful swallow |
