Dysphagia

General

100

What are the 4 stages of swallowing

1. oral prep

2. oral transit

3. pharyngeal

4. esophageal

200

The 2 main goals of swallowing are

bolus efficiency & airway protection

300

Describe the first phase of swallowing

food is masticated in preparation for transfer

400

Describe the third stage of swallowing

material is transported away from oropharynx through a relaxed cricopharyngeal muscle into the upper esophagus

500

Describe the final stage of swallowing

material is transported through the esophagus into the gastric cardia (upper opening of the stomach)

Muscles

100

The muscles of mastication are innervated by this cranial nerve

cranial nerve V (trigeminal)

200

Describe the function of the masseter superficial muscle

 elevates and protracts the mandible

300

Describe the function of the masseter deep muscle

elevates and retracts the mandible

400

This muscle elevates and protracts the mandible, assisting the lateral pterygoid in drawing the mandible forward.   

Medial pterygoid 

500

Describe the function of the temoralis muscle

Elevates and retracts the mandible against the maxilla with great force 

Swallowing in adults

100

Most affected swallowing phase from presbyphagia

what is pharyngeal phase (hyoid movement declines decreasing the opening of UES)

200

Structures affected in head and neck cancer

soft palate, tongue, larynx, tonsils

300

During this swallowing maneuver, you hold tongue between your teeth and swallow. It improves posterior pharyngeal wall movement

Masako

400

Name 2 Esophageal disorders

GERD, Zenker's diverticulum, narrowing of lumen, peristalsis, achalasia, nutcracker esophagus

500

Describe the Mendelsohn maneuver

1. Sit or stand comfortably. 
2. Swallow normally. 
3. When your larynx is at its highest point, squeeze throat muscles and hold it there for 3 seconds. 
4. Relax your throat to complete the swallow. 

Swallowing in children

100

2 adaptive oral reflexes

rooting and suckling

200

Differences in oral structures compared to an adult

smaller oral cavity and jaw, larger buccal fat pads and tongue, Newborn larynx is positioned higher, Uvula and epiglottis are in contact

300

Name at least 3 of the protective reflexes

tongue protrusion, tongue lateralization, phasic bite, gag reflex, coughing, laryngeal chemoreflex, swallow

400

When solids (purees) should be introduced

6 months

500

Signs of readiness for solids

1. Good head control  

2. Sit up for a few minutes unassisted 

3. Mouthing of objects 

4. Interest in food 

Other fun facts

100

Root of all evil

GERD

200

Risk factors for head and neck cancer

tobacco and heavy alcohol use, HPV, poor oral hygiene, processed foods, radiation, mechanical irritation (men are more likely to get HNC)

300

Name 3 swallowing strategies that can be used during therapy

masako, mendelsohn, shaker, effortful swallow, chin tuck, 3 second swallow prep, double swallow

400

What muscle closes the glottis

Lateral cricoarytenoid (this is innervated by CN X)

500

When does tongue protrusion diminish?

3-6 months