Dysphagia Chapter 4 Disorders

Front 1

1.Oral Prep Disorder: Reduced Tongue Shaping/Coordination

Back 1

Signs/Symptoms:Cannot hold a bolus
Aspiration: possibly before swallow

Front 2

2.Oral Prep Disorder: Reduced lip closure

Back 2

Signs/Symptoms: Cannot hold food in the mouth anteriorly
Aspiration: No

Front 3

3.Oral Prep Disorder: Reduced range of tongue motion or coordination

Back 3

Signs/Symptoms:Cannot form a bolus
Aspiration: No

Front 4

4.Oral Prep Disorder: Reduced labial tension or tone

Back 4

Signs/Symptoms:Food falls into anterior sulcus
Aspiration: No

Front 5

5.Oral Prep Disorder: Reduced buccal tension/tone

Back 5

Signs/Symptoms: Food falls into lateral sulcus:
Aspiration: No

Front 6

6.Oral Prep Disorder: Reduced Tongue Control; Tongue thrust

Back 6

Signs/Symptoms: abormal tongue position, increased oral transit
Apspiration: No

Front 7

7.Oral Phase Disorder: Apraxia of Swallow; Reduced oral sensation

Back 7

Signs/Symptoms: delayed onset/initation of oral swallow, searching tongue movements
Aspiration: No

Front 8

8.Oral Phase Disorder: Tongue thrust

Back 8

Signs/Symptoms: Tongue moves forward to start swallow, seen in kids with CP and after individuals after stroke or TBI
Aspiration: No

Front 9

9.Oral Phase Disorder: Reduced Labial tension and tone

Back 9

Signs/Symptoms: Residue in anterior sulcus
Aspiration: No

Front 10

10.Oral Phase Disorder: Reduced buccal tension and tone

Back 10

Signs/Symptoms: Residue in the lateral sulcus
Aspiration: No

Front 11

11.Oral Phase Disorder: reduced tongue shaping or failure of peripheral seal of the tongue to the anterior and lateral alveolus

Back 11

Signs/Symptoms: Residue on the floor of the mouth
Aspiration: No

Front 12

12.Oral Phase Disorder: Tongue scarring

Back 12

Signs/Symptoms: Residue in a midtongue depression
Aspiration: No

Front 13

13.Oral Phase Disorder: Reduced tongue range of movement or strength

Back 13

Signs/Symptoms: Residue of food on tongue, usually food of thicker consistencies

Front 14

14.Oral Phase Disorder: Lingual discoordination

Back 14

Signs/Symptoms: Disturbed lingual contraction (peristalsis), tongue moves in random, non-productive movements, anterior/posterior movements become disorganized

Front 15

15.Oral Phase Disorder: Reduced tongue elevation

Back 15

Signs/Symptoms: incomplete tongue-palate contact, struggling tongue behaviors

Front 16

16.Oral Stage Disorder: Reduced tongue elevation or strength

Back 16

Signs/Symptoms: Adherence of food on the remaining hard palate-due to reduced elevation,increase in amount of viscous food collected on palate reduced strength

Front 17

17.Oral Stage Disorder: Reduced lingual control

Back 17

Signs/Symptoms: Reduced anterior/posterior movement

Front 18

18.Oral Stage Disorder: Parkinson's Disease

Back 18

Signs/Symptoms: Repetitive Lingual Rocking-Rolling tongue actions; takes 10 seconds to swallow

Front 19

19.Oral Stage Disorder: Reduced lingualvelar seal

Back 19

Signs/Symptoms: Uncontrolled bolus/premature loss of liquid or pudding consistency in the pharynx--reduced tongue control
Aspiration: possible before swallow, pharyngeal swallow is not triggered!; premature loss of food requiring chewing is normal, but premature loss of liquid or pudding of 1 to 10 ml is not

Front 20

20.Disorder between oral and Pharyngeal stages: Delayed pharyngeal swallow

Back 20

Signs/Symptoms: head of bolus progresses too far in the pharynx prior to the activation of the pharyngeal swallow, complain of difficulty swallowing liquids, bolus may enter pyriform sinuses, valleculae, or open airway; this is not be be confused with premature bolus loss!

Front 21

21.Disorder between oral and pharyngeal Stage Disorder: Timing the pharyngeal delay

Back 21

Signs/Symptoms: a delay of more than 2 seconds in adults, 1 second in children

Front 22

22.Pharyngeal Stage Disorder: Reduced velopharyngeal closure

Back 22

Signs/Symptoms:nasal penetration during swallow, food and liquid will more back and upward into the nose

Front 23

23.Pharyngeal Stage Disorder: Pseudoepiglottis

Back 23

Signs/Symptoms: After total laryngectomy, a fold of mucosa at base of tongue, prevents food from moving past pseudoepiglottis

Front 24

24.Pharyngeal Stage Disorder: Cervical Osteophytes

Back 24

Signs/Symptoms: bony outgrowth from cervical vertibrae, can narrow the pharynx,direct toward airway entrance, or give patients the sensation that "something is there"

Front 25

25.Pharyngeal Stage Disorder: Unilateral Pharyngeal Wall Weakness

Back 25

Signs/Symptoms: Residue on one side of pharynx, food may collect in pyriform sinues

Front 26

26.Pharyngeal Stage Disorder: Reduced Pharyngeal Contraction Bilaterally

Back 26

Signs/Symptoms: Coating on the pharyngeal walls after the swallow

Front 27

27.Pharyngeal Stage Disorder: Reduced tongue base posterior movement

Back 27

Signs/Symptoms: Vallecular reside after swallow
Aspiration: possible, if vallecular residue is great

Front 28

28. Pharyngeal Stage Disorder: Scar Tissue; Pharyngeal pouch

Back 28

Signs/Symptoms: Coating of food in a depression or on the pharyngeal wall
Aspiration: risk after swallow if residue is great

Front 29

29.Pharyngeal Stage Disorder: Reduced laryngeal elevation

Back 29

Signs/Symptoms: Residue at the top of the airway
Apiration: risk for food sitting on top of airway after the swalllow

Front 30

30.Pharyngeal Stage Disorder: Reduced closure of the airway entrance (arytenoids to base of epiglottis and false vfs)

Back 30

Signs/Symptoms: Laryngeal penetration and aspiration after the swallow, penetration-at entrance of airway but not below vocal folds, aspiration-entry of food into the airway below true vfs

Front 31

31.Pharyngeal Stage Disorder: Reduced Laryngeal closure

Back 31

Signs/Symptoms: aspiration during swallow: should follow the progression: true vfs-->arytenoids to bae of epilgottis and false vfs(airway entrance)-->aryepiglottic folds and epiglottis

Front 32

32.Pharyngeal Stage Disorder: Reduced anterior laryngeal motion; cricophargngeal dysfunction; stricture

Back 32

Signs/Symptoms: Residue (stasis) in pyriform sinuses, pharyngeal swallow has been triggered

Front 33

33.Pharyngeal Stage Disorder: Reduction in pharyngeal pressure generation

Back 33

Signs/Symptoms: residue throughout the pharynx including pyriform sinues, valleculae

Front 34

34.Esophageal Stage Disorder: Achalasia

Back 34

Signs/Symptoms: failure of LES to relax, reflux, tumor, stenosis, esophageal to pharyngeal backflow is seen

Front 35

35.Esophageal Stage Disorder: Tracheosophageal Fistula

Back 35

Signs/Symptoms: Fistula allows food entering the esophagus to flow back into the trachea, may aspirate after swallow

Front 36

36.Esophageal Stage Disorder: Zenker's Diverticulum

Back 36

Signs/Symptoms: Side pocket that forms when pharyngeal or esophageal muscle herniates around the UES, aspiration after swallow, during the swallow the pocket fills with food

Front 37

37.Esophageal Stage Disorder: GERD

Back 37

Signs/Symptoms: back flow of food and stomach acid from the stomach into the esophagus, usually not identified with an MBS, send them to a GI