Swallowing Flashcards Preview

ESA 4 - Head and Neck > Swallowing > Flashcards

Flashcards in Swallowing Deck (25)
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1
Q

What are the phases of swallowing?

A

Oral
Pharyngeal
Oesophageal

2
Q

Is the oral phase of swallowing voluntary or involuntary?

A

Voluntary

3
Q

What does the oral phase of swallowing consist of?

A

Preparatory phase

Transit phase

4
Q

What happens in the preparatory phase of swallowing?

A

Making bolus

5
Q

What happens in the transit phase of swallowing?

A

Bolus compressed against palate and pushed into oropharynx by tongue and soft palate

6
Q

Is the pharyngeal phase of swallowing voluntary or involuntary?

A

Involuntary

7
Q

What are the features of the pharyngeal phase of swallowing?

A

Tongue positioned against hard palate
Soft palate elevated
Suprahyoid and longitudinal muscles shorten
Epiglottis closes over larynx
Bolus moves through pharynx by sequential contraction of constrictors
Relaxation of UOS

8
Q

Why is the tongue positioned against the hard palate in the pharyngeal phase of swallowing?

A

So food cannot reenter the motuh

9
Q

What is the position of the tongue against the hard palate in the pharyngeal phase of swallowing co-ordinated by?

A

CN XII

10
Q

Why is the soft palate elevated in the pharyngeal phase of swallowing?

A

Opens ET

Seals of nasopharynx

11
Q

What is the raising of the soft palate in the pharyngeal phase of swallowing coordinated by?

A

Tensor palatine (CN V3) and levator palatine (CN X)

12
Q

What is the shortening of the infrahyoid muscle in the pharyngeal phase of swallowing coordinated by?

A

CN V3, CN VII, CN XII

13
Q

What is the shortening of the longitudinal muscle in the pharyngeal phase of swallowing coordinated by?

A

CN IX and X

14
Q

What does the shortening of the suprahyoid and longitudinal muscles in the pharyngeal phase of swallowing cause?

A

Pharynx to widen and shorten to receive bolus

Larynx to elevate and be sealed off by vocal folds

15
Q

What is the closure of the epiglottis over the larynx in the pharyngeal phase of swallowing due to?

A

The elevated hyoid

16
Q

Is the oesophageal phase of swallowing voluntary or involuntary?

A

Involuntary

17
Q

What muscle is involved in the oesophageal stage of swallowing?

A

Upper striated muscle of oesophagus

18
Q

What is the upper striated muscle of oesophagus innervated by?

A

CN X

19
Q

What can cause dysphagia?

A

Stroke
Progressive neurological disease
COPD
Dementia

20
Q

Give 2 progressive neurological diseases that can cause dysphagia?

A

Parkinsons

MS

21
Q

What % of post stroke deaths are due to pneumonia?

A

30%

22
Q

What are the signs and symptoms of dysphagia?

A
Coughing
Choking
Sialorrhea (drooling)
Recurrent pneumonia
Change in voice/speech - wet voice
Nasal regurgitation
23
Q

What happens in a swallow assessment?

A
First assess level of consciousness and postural control
Give small spoonfuls of water
Full history
Videofluroscopy
Fibre-optic endoscopic evaluation
24
Q

Why is a swallow assessment needed in dysphagia?

A

Because gag reflex is unreliable in determining risk

25
Q

What are the frequently used interventions in dysphagia?

A
Modify consistency of food and fluid
Modify feeding strategies
Indirectly modify swallow techniques
Modify physiology of swallow mechanism during swallowing
Modify posture
Improve oral hygiene
Introduce strategies to increase confidence and reduce fear of choking
Educating carers