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46 Cards in this Set

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  • Back
  • 3rd side (hint)
Which questions need to be anwered after the full evaluation?
1)What type of nutritional mgmt?
2) should there be therapy, and if so, type?
3) Which specific therapy strategy?
3 questions
Goal of dysphagia treatment is____
Re-establishment of oral feeding while maintaining adequate hydration and nutrition
What's normal state?
WHat should be considered in deciding on therapy with patient?
1) Dx
3) Reaction to comp. strategies
4) severity of dysphagia
5) ability to follow directions?
6) respiratory function?
7) availability of caregiver support
8 items
Patient will need non-oral supplement if it takes them more than ___ to swallow every food consistency
10 secs
in seconds
Swallowing therapists can discourage use of
wide, semi-flexible feeding tubes
kind of tubes
If patients aspirate more than ___ of every bolus, they should not eat orally
in percent
Compensatory procedures____
eliminate patient's symptoms and control food flow
two things
COmpensatory procedures include___
posture changes, sensory enhancement, volume and speed changes, consistency/viscosity changes, and intraoral prosthetics
5 things
Changing patient's head/body posture can eliminate aspiration in up to __ of dysphagic patients
in percent
Chin-down posture is good for
-reduced tongue base retraction
-delayed pharyngeal swallow
-reduced airway closure
-reduced laryngeal closure
4 things
chin-up posture is good for
-inefficient oral transit (+ associated tongue control problems)
1 thing
Head rotation to damaged side is good for
-unilateral pharyngeal wall dysfunction
-unilateral vocal fold weakness
2 things
Head tilt towards stronger side is good for
-unilateral oral and pharyngeal impairment on same side
combined thing
Lying down is good for
-bilateral pharyngeal wall contraction
(and reduced laryngeal relevation)
combined thing
Sensory awareness techniques are used with
1) people with swallow apraxia
2) tactile food agnosia
3) delayed onset/triggering of pharyngeal swallow
4) reduced oral sensation
5) delayed onset of oral swallow
5 things
What are sensory enhancement techniques?
1) increasing pressure on tongue
2) presenting sour bolus
3) presenting cold bolus
4) presenting chewable bolus
5) increasing volume of bolus
6) thermal-tactile stim.
How do you do thermal-tactile stim.?
Dip laryngeal mirror into crushed ice, rub against anterior faucial pillars
WHat's the exaggerated suck-swallow?
increased vertical tongue-jaw sucking mvt wiht mouth closed
What kinds of intra-oral prosthetics are there?
Palatal lift prosthesis, palatal obturator, palatal augmentation/reshaping
Therapy procedures are designed to__
change physiology of swallow
What's indirect therapy?
Work with saliva
Indirect therapy is used with patients who__
Aspirate on all food consistencies and volumes
Therapy techniques include
oralal-motor, ROM exercises, sensory enhancement, and swallow maneuvers
ROM exercises improve mvt of
lips, jwa, tongue (oral and base), larynx, vocal folds
Thermal-tactile stim. should be done when?
Delay in trigger of pharyngeal swallow has been ID's on min. 2 consecutive swallows
The role of thermal-tactile stim. is to __
heighten sensitivity for the swallow in CNS
How does the dump and swallow technique work? Who is it for?
Patient holds breath, gets liquid placed in mouth, then tosses head back to dump all contents into pharynx. Swallow as man times as needed while holding breath. This is for people with oral transit problems.
What to do for reduced labial closure?
ROM lip exercises
What to do for reduced tongue lateralization?
Lateral ROM exercises for tongue
Reduced buccal tension
Facial exercises; also place external pressure on cheek
What to do for reduced ROM of mandible
mandible ROM exercises
What to do for reduced oral sensitivity?
Place food in best part of mouth.
What to do for tongue thrust?
1) verbal instructions
2) applying downward pressure on middle of tongue
3) put food posteriorly in mouth
What to do for tongue pumping?
Alert patient, tell htem to hold bolus against palate and initiate swallow with one stroke
What to do for reduced tongue strength?
Resistance exercises
What to do for swallowing apraxia?
Heighten sensory awareness
What to do for scarred tissue?
Can't be improved with exercises; place food posterior to scarring
What to do for delayed/absent pharyngeal swallow trigger?
THermal-tactile stim, suck-swallow, or sensory enhancement
What does Masako maneuver do?
exercise glottopharyngeus muscle --- increased forward mvt of pharyngeal wall
Compensatory techniques for reduced pharyngeal wall contraction include
1) alternate bolus consistencies
2) limit diet to thin or liquid boluses
3) repetitive dry swallows to clear pharynx
Surface electromyography can provide biofeedback on __
degree of muscle effort
Ultrasound can probide biofeedback on__
tongue movement
Videoendoscopy can provide biofeedback on___
closure of true vocal folds
When should swallowing treatment begin for surgically treated head and neck patients?
As soon as healing has progressed enough
Tracheostomy and nonoral feeding tubes are generally left in place during swallowing therapy -- true or false?
Surgical intervention to improve oropharyngeal swallowing should not be attempted until at least ___
6 months of therapy