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46 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which questions need to be anwered after the full evaluation?
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1)What type of nutritional mgmt?
2) should there be therapy, and if so, type? 3) Which specific therapy strategy? |
3 questions
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Goal of dysphagia treatment is____
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Re-establishment of oral feeding while maintaining adequate hydration and nutrition
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What's normal state?
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WHat should be considered in deciding on therapy with patient?
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1) Dx
2)Prognosis 3) Reaction to comp. strategies 4) severity of dysphagia 5) ability to follow directions? 6) respiratory function? 7) availability of caregiver support |
8 items
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Patient will need non-oral supplement if it takes them more than ___ to swallow every food consistency
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10 secs
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in seconds
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Swallowing therapists can discourage use of
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wide, semi-flexible feeding tubes
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kind of tubes
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If patients aspirate more than ___ of every bolus, they should not eat orally
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10%
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in percent
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Compensatory procedures____
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eliminate patient's symptoms and control food flow
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two things
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COmpensatory procedures include___
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posture changes, sensory enhancement, volume and speed changes, consistency/viscosity changes, and intraoral prosthetics
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5 things
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Changing patient's head/body posture can eliminate aspiration in up to __ of dysphagic patients
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80%
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in percent
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Chin-down posture is good for
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-reduced tongue base retraction
-delayed pharyngeal swallow -reduced airway closure -reduced laryngeal closure |
4 things
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chin-up posture is good for
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-inefficient oral transit (+ associated tongue control problems)
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1 thing
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Head rotation to damaged side is good for
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-unilateral pharyngeal wall dysfunction
-unilateral vocal fold weakness |
2 things
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Head tilt towards stronger side is good for
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-unilateral oral and pharyngeal impairment on same side
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combined thing
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Lying down is good for
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-bilateral pharyngeal wall contraction
(and reduced laryngeal relevation) |
combined thing
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Sensory awareness techniques are used with
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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
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What are sensory enhancement techniques?
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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. |
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How do you do thermal-tactile stim.?
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Dip laryngeal mirror into crushed ice, rub against anterior faucial pillars
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WHat's the exaggerated suck-swallow?
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increased vertical tongue-jaw sucking mvt wiht mouth closed
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What kinds of intra-oral prosthetics are there?
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Palatal lift prosthesis, palatal obturator, palatal augmentation/reshaping
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Therapy procedures are designed to__
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change physiology of swallow
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What's indirect therapy?
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Work with saliva
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Indirect therapy is used with patients who__
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Aspirate on all food consistencies and volumes
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Therapy techniques include
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oralal-motor, ROM exercises, sensory enhancement, and swallow maneuvers
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ROM exercises improve mvt of
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lips, jwa, tongue (oral and base), larynx, vocal folds
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Thermal-tactile stim. should be done when?
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Delay in trigger of pharyngeal swallow has been ID's on min. 2 consecutive swallows
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The role of thermal-tactile stim. is to __
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heighten sensitivity for the swallow in CNS
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How does the dump and swallow technique work? Who is it for?
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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.
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What to do for reduced labial closure?
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ROM lip exercises
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What to do for reduced tongue lateralization?
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Lateral ROM exercises for tongue
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Reduced buccal tension
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Facial exercises; also place external pressure on cheek
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What to do for reduced ROM of mandible
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mandible ROM exercises
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What to do for reduced oral sensitivity?
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Place food in best part of mouth.
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What to do for tongue thrust?
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1) verbal instructions
2) applying downward pressure on middle of tongue 3) put food posteriorly in mouth |
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What to do for tongue pumping?
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Alert patient, tell htem to hold bolus against palate and initiate swallow with one stroke
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What to do for reduced tongue strength?
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Resistance exercises
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What to do for swallowing apraxia?
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Heighten sensory awareness
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What to do for scarred tissue?
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Can't be improved with exercises; place food posterior to scarring
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What to do for delayed/absent pharyngeal swallow trigger?
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THermal-tactile stim, suck-swallow, or sensory enhancement
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What does Masako maneuver do?
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exercise glottopharyngeus muscle --- increased forward mvt of pharyngeal wall
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Compensatory techniques for reduced pharyngeal wall contraction include
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1) alternate bolus consistencies
2) limit diet to thin or liquid boluses 3) repetitive dry swallows to clear pharynx |
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Surface electromyography can provide biofeedback on __
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degree of muscle effort
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Ultrasound can probide biofeedback on__
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tongue movement
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Videoendoscopy can provide biofeedback on___
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closure of true vocal folds
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When should swallowing treatment begin for surgically treated head and neck patients?
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As soon as healing has progressed enough
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Tracheostomy and nonoral feeding tubes are generally left in place during swallowing therapy -- true or false?
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True
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Surgical intervention to improve oropharyngeal swallowing should not be attempted until at least ___
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6 months of therapy
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