Term
| Structures involved in swallowing |
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Definition
oral facial musculature
pharyngeal and laryngeal structures
piriform sinuses
vocal folds
bronchioles/bronchi
lungs
esophagus |
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Term
| Symptoms of facial paralysis |
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Definition
incomplete closure of mouth
loss of bolus out of front of oral cavity |
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Term
| Symptoms of praxis/motor planning deficits |
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Definition
inability to effectively chew and coordinate tongue movements to propel bolus toward base of tongue
residual food centrally located in oral cavity
difficulty forming a bolus with smoother consistencies |
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Term
| symptoms of sensory impairment in oral cavity |
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Definition
lack of awareness of residual food on side of mouth that has decreased sensation:
1. pocketing of food
2. spillage of residual food into airway at time when vocal cords are open; timing sequence of swallow is off |
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Term
| symptoms of weakness of tongue/base of tongue structures |
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Definition
inefficient propulsion of bolus at an efficient rate of speed past the base of tongue to pharyngeal cavity
lack of closure @ cricopharyngeal junction:
1. sub-optimal propulsion of bolus
2. interference with normal timing of swallow sequence
3. failure to trigger closure of vocal folds during swallow (aspiration) |
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Term
| symptoms of weakness of elevation of pharynx during swallow |
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Definition
| incomplete triggering (diminished neural stimulation) of pharyngeal phase of swallowing |
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Term
| symptoms of vocal cord paralysis |
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Definition
inefficient closure of vocal folds during pharyngeal phase of swallow:
1. vocal cords in paramedian position; swallow may be safe
2. vocal cords fail to meet/close to protect airway; aspiration may occur |
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Term
| symptoms of penetration of the bronchioles/bronchi by bolus when aspiration occurs |
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Definition
food enters lung (true aspiration occurs):
1. bacteria can cause pneumonia (aspiration pneumonia)
2. if person's immune system is functioning well, he/she may not experience pneumonia |
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Term
| symptoms of clinical aspiration |
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Definition
food enters airway:
1. person can clear airway by coughing (reflex intact)
2. person silently aspirates
- bolus enters lung and person does not react
- bolus enters lung and person experiences respiratory distress
- person coughs too weakly to raise bolus in order to expel it |
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Term
| symptoms of diminished esophageal motility |
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Definition
bolus sits in esophagus and can slowly either move toward stomach or upward toward pharynx:
1. person may feel that food is stuck in esophagus
2. person aspirates when food propels upward and he/she cannot swallow it |
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Term
| Symptoms of esophageal reflux |
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Definition
aka Gastric esophageal reflux disease (GERD)
food enters stomach and mixes with stomach acid/digestive juices
lower esophageal sphincter inefficiently closes, stomach contract propels acid/acidic bolus back into esophagus:
1. person reports heartburn sensation, indigestion, or dull chest pain
positional elevation of head above stomach, when person is reclined, may discourage upward retropulsion of bolus from stomach |
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Term
| Swallow disorder interventions |
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Definition
provide family-centered intervention to determine an acceptable dinner table alternative to interaction
work with person toward developing new roles and occupations to transition from old role (ie: head of table)
provide ongoing education and information regarding person's feeding/nutrition |
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Term
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Definition
Gastric esophageal reflux disease
1. sleep with more than one pillow at night (elevating head to discourage regurgitation associated with body posture)
2. drug therapy
3. diet modification
- less spice
- small meals on a more frequent basis |
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