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25 Cards in this Set

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How are disorders of swallowing categorized?
Disorders of swallowing may be categorized according to the swallowing phase affected.
What does impaired control of the tounge usually cause?
Oral-phase disorders affecting the oral preparatory and oral propulsive phases.
Name symptoms and or disorders associated with oral phase swallowing.
Cannot form a bolus or residue on the floor of the mouth due to reduced range of tongue motion or coordination
Cannot hold a bolus due to reduced tongue shaping and coordination
Unable to align teeth due to reduced mandibular movement
Food material falls into anterior sulcus or residue in the anterior sulcus due to reduced labial tension or tone.
Food material falls into lateral sulcus or residue in the lateral sulcus due to reduced buccal tension or tone.
Abnormal hold position or material falls to the floor of the mouth due to tongue thrust or reduced tongue control
Delayed oral onset of swallow due to apraxia of swallow or reduced oral sensation
Searching motion or inability to organize tongue movements due to apraxia of swallow
Tongue moves forward to start the swallow due to tongue thrust.
Residue of food on the tongue due to reduced tongue range of movement or strength
Disturbed lingual contraction (peristalsis) due to lingual dyscoordination
Incomplete tongue-to-palate contact due to reduced tongue elevation
Unable to mash material due to reduced tongue elevation
In the event that pharyngeal clearance is severely impaired, what happens?
a patient may be unable to ingest sufficient amounts of food and drink to sustain life.
Name 6 pharyngeal-phase swallowing symptoms and disorders.
Cervical osteophytes
Coating of pharyngeal walls after the swallow due to reduced pharyngeal contraction bilaterally
Vallecular residue due to reduced posterior movement of the tongue base
Coating in a depression on the pharyngeal wall due to scar tissue or pharyngeal pouch
Residue at top of airway due to reduced laryngeal elevation
Laryngeal penetration and aspiration due to reduced closure of the airway entrance (arytenoid to base of epiglottis)
Aspiration during swallow due to reduced laryngeal closure
retention of food and liquid in the esophagus after swallowing is the result of _______________.
Impaired esophageal function
What is the definiton of aspiration?
Aspiration is the passage of food or liquid through the vocal folds.
People who aspirate are usually at risk for ________________.
pneumonia
What factors usually influence the effects of aspiration?
quantity, depth, physical properties of the aspirate, and pulmonary clearance mechanisms.
How can the severity of aspiration be described?
(1) Estimate the percentage of the total bolus aspirated or (2) estimate the depth of bolus invasion into the airway. The Eight-Point Penetration-Aspiration Scale is an example of an estimation tool.
What are children with dysphagia at risk for?
malnutrition, dehydration, and respiratory problems
What are the causes of feeding and swallowing problems?
Prematurity, Cerebal palsey, autism, head and neck abnormalities,gastroesphogeal reflux,multiple medical problems,respiratory difficulties
What typical symptoms do children with feeding and swallowing problems usually exhibt?
Poor feeding, difficulty chewing, difficulty drinking from a bottle or cup,difficulty breast feeding,refusing food and liquid,coughing or choking while eating/drinking,vomiting during meals, gaging, leaking liquid from the nose,excessive drooling or food spilling from the mouth,poor weight gain
If a problem is noticed with feeding and swallowing, who should be contacted?
The child's pediatritian
If further assessment is believed to be warranted by the pediatritian, who will the child be referred to?
An SLP and or feeding team.
Who is the feeding team comprised of?
SLP, physical therapist, occupational therapist, a physican or nurse and a dietician
What may a feeding team and or a SLP reccomend after a feeding evaluation?
Medical intervention,direct feeding therapy,nutritional changes,postural or position changes,behavior management techniques,food temperature and texture changes, referal to other disciplines,Desensitization to new foods or textures
What will the focus of intervention include if feeding therapy with an SLP is reccommended?
Strengthening the muscles of the mouth,Increasing tongue movement,Improving chewing patterns,Increasing tolerance of different foods or liquids,Improving sucking /drinking ability,Coordinating the suck-swallow-breathe pattern (for infants),Altering food textures and liquid viscosity to ensure safe swallowing, and other interventions depending on the child's needs.
Infant dysphagia rates increased as a result of what?
improved survival rates for infants born prematurely or with life-threatening medical disorders.
What has nasopharyngeal reflux been associated with?
Apnea, choking, and pnuemonia in infants.
What key symptoms are present in infants/young children?
subtle prolongation of feeds, delay in milestones of feeding abilities, impairment of normal weight gain, excessive drooling of saliva, increases of regurgitation beyond that expected physiologically, unexplained fussiness, or chronic/recurrent respiratory symptoms.
What diagnostic methods are used with children?
radiography (particularly esophagram or videofluoroscopic swallowing study), manometry, endoscopy of the esophagus or airway (including fiberoptic endoscopic evaluation of swallowing with sensory testing), scintigraphy, esophageal pH-metry or impedance, or central nervous system imaging.
What does a complete feeding history include?
A complete feeding history includes information on the duration and progression of the symptoms and many other aspects of the feeding experience for the young child .
What is sialorrhea?
the unintentional loss of saliva and other oral contents from the mouth
How can dysphagia be displayed in the less verbal child?
it may be represented by refusal by a hungry child of offered nutrients, by regurgitation of undigested ingested food, or even by drooling in a child unable to handle oral secretions appropriately. In young or developmentally delayed nonverbal children, slow eating or repeated swallowing may be the only visible signs of dysphagia.