Pathophysiology Of Swallowing In Infants And Adults

Front 1

Cannot hold food in the mouth anteriorly due to reduced lip closure
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
Adherence of food to hard palate due to reduced tongue elevation or reduced lingual strength
Reduced anterior-posterior lingual action due to reduced lingual coordination
Repetitive lingual rolling in Parkinson disease
Uncontrolled bolus or premature loss of liquid or pudding consistency in to the pharynx due to reduced tongue control or linguavelar seal
Piecemeal deglutition
Delayed oral transit time

Back 1

Oral phase

Front 2

Delayed pharyngeal swallow
Nasal penetration during swallow due to reduced velopharyngeal closure
Pseudoepiglottis (after total laryngectomy) - Fold of mucosa at the base of the tongue
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
Stasis of residue in pyriform sinuses due to reduced anterior laryngeal pressure
Delayed pharyngeal transit time

Back 2

Pharyngeal phase

Front 3

Esophageal phase

Back 3

retention of food and liquid in the esophagus after swallowing. This retention may result from mechanical obstruction, motility disorder, or impaired opening of the lower esophageal sphincter

Front 4

what is aspiraion?

Back 4

Aspiration is the passage of food or liquid through the vocal folds. People who aspirate are at increased risk for pneumonia. People without swallowing abnormalities routinely aspirate microscopic amounts of food and liquid. Gross aspiration, however, is abnormal and may lead to respiratory complications.

Front 5

Risk factors for infants with swallowing disorders

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malnutrition, dehydration, and respiratory problems

Front 6

Etiology of feeding and swallowing problems

Back 6

Prematurity
Cerebral palsy
Autism
Head and neck abnormalities
Muscle weakness in the face and neck
Gastroesophageal reflux
Multiple medical problems
Respiratory difficulties
Medications that may cause lethargy or decreased appetite
Problems with parent-child interactions at mealtime

Front 7

Treatments for infants with swallowing disorders

Back 7

Medical intervention, as needed
Direct feeding therapy designed to meet your child's individual needs
Nutritional changes
Postural or positioning changes (different seating, etc.)
Behavior management techniques
Desensitization to new foods or textures
Food temperature and texture changes
Referral to other disciplines, such as psychology or a dentist

Front 8

SLP intervention for feeding therapy with infants

Back 8

therapy with infants 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

Front 9

What is Videofluoroscopic Swallowing Study (VFSS)?

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VFSS is used to document occurrence of aspiration, reasons for aspiration, and possible therapies for aspiration. In this study the infant is given breastmilk or formula mixed with liquid barium. The infant is placed in a feeding seat and the fluoroscope table is tilted so that the response of the pharyngeal area during feeding can be captured as a permanent video image

Front 10

What is pediatric dysphagia?

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Swallowing problems in infants and children is often diagnosed as this.

Front 11

Deglutition is another term for

Back 11

swallowing

Front 12

________ typically appears in older children with dysphagia as the predominant symptom; when it occurs in younger children, vomiting (regurgitation) is often the primary symptom

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Achalasia

Front 13

silent aspiration is a particularly insidious manifestation of the ______ in infants or neurologically abnormal older children.

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motor disorders

Front 14

Typical symptoms Children with feeding and swallowing problems of

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Poor feeding
Difficulty chewing
Difficulty breast feeding Refusing food or liquid
Gagging
Vomiting during meals

Front 15

What are the causes of Dysphagia?

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Brain tumors, spinal cord injuries, progressive diseases, and individuals who have suffered from a stroke or from traumatic brain injury

Front 16

What is an Ischemic stroke?

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This type of stroke refers to lack of blood borne oxygen. It is more common that hemmorhagic strokes.

Front 17

What is the cause of an Ischemic stroke?

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Narrowing of the arteries, blockage of the artery, or from pieces of plaque breaking off and making it's way toward the brain where it lodges in the narrower artery.

Front 18

What is peristalsis?

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The wave-like motion that moves the bolus down the esophagus.

Front 19

Children with feeding and swallowing dificuties are at risk for ______________, ___________, and ____________.

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Malnutrition, Dehydration, and Respiratory problems

Front 20

What are some causes of Feeding and Swallowing problems in children and infants?

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Prematurity, Cerebral Palsy, Autism, Head and Neck abnormalties, Gastroesophageal Reflux, and Respiratoy difficulties

Front 21

What is the size of a newborn's larynx?

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<4mm (premature <3mm)

Front 22

____________is the most common primary esophageal motility disorder in children.

Back 22

Achalasia

Front 23

What is the most common cause of oral dysphagia?

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Dementia

Front 24

Dementia affects the following area___________,____________,___________, and __________.

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Memory, Attention, Language, Problem solving

Front 25

________ is the act of swallowing in which a food or liquid bolus is transported from the mouth through the pharynx and esophagus into the stomach.

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Deglutition