Dysphagia Evaluation & Management – Key Vocabulary

Vocabulary flashcards covering key terms, assessments, impairments, and interventions related to dysphagia evaluation and management.

Dysphagia

Difficulty swallowing; may involve the oral, pharyngeal, or esophageal phases.

Oral Phase Dysphagia

Swallowing difficulty caused by deficits during chewing, bolus prep, or oral transit.

Pharyngeal Phase Dysphagia

Swallowing difficulty due to problems in the pharyngeal stage (e.g., delayed swallow trigger, weak epiglottic inversion).

Esophageal Phase Dysphagia

Swallowing difficulty related to impaired esophageal function (handled primarily by GI, not SLP).

Clinical (Bedside) Swallow Evaluation

Non-instrumental assessment of swallowing that includes an oral-motor exam and trial swallows at bedside.

Oral-Motor Exam

Assessment of lip, tongue, and other articulator strength, range of motion, and coordination.

Modified Barium Swallow Study (MBSS)

Radiologic swallow study using barium-infused food/liquid to visualize all phases, especially pharyngeal.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Instrumental exam in which a naso-endoscope views pharyngeal/laryngeal structures during swallowing.

Penetration

Swallowed material enters the larynx but stays above the vocal folds.

Aspiration

Swallowed material passes below the vocal folds into the airway/trachea.

Silent Aspiration

Aspiration with no cough or other outward response from the patient.

Cough Reflex

Protective reflex that expels material from the airway; its absence ↑ risk of silent aspiration.

Anterior Labial Spillage

Food or liquid leaking from the front of the mouth due to weak lip seal.

Pocketing

Food retained in the cheeks after a swallow, often unnoticed by the patient.

Premature Spillage

Bolus enters the pharynx/airway before the swallow is initiated.

Lingual Pumping

Excessive tongue pumping movements while trying to propel the bolus posteriorly.

Delayed Swallow Response

Late initiation of the pharyngeal swallow after bolus reaches the pharynx.

Epiglottic Inversion

Downward movement of the epiglottis to cover the airway during swallowing.

Hyolaryngeal Elevation

Upward movement of the hyoid and larynx that helps protect the airway and open the UES.

Upper Esophageal Sphincter (UES)

Muscular valve that opens to allow bolus entry into the esophagus; failure to relax causes residue.

Esophageal Peristalsis

Wave-like muscular contractions that move the bolus through the esophagus.

Aspiration Pneumonia

Acute lung infection/inflammation resulting from aspirated material entering the lungs.

Risk Predictors of Aspiration Pneumonia

Combination of aspiration, poor oral hygiene (bacteria), and weakened immunity.

Oral Prep Phase

Stage of swallowing involving bolus formation through chewing and mixing with saliva.

Oral Transport Phase

Stage in which the tongue propels the bolus posteriorly toward the pharynx.

Signs (Overt) of Dysphagia

Coughing, choking, wet/gurgly voice, visible effort during eat/drink.

Clinical (Covert) Signs of Dysphagia

Fever, ↑ white blood cells, chest X-ray changes suggesting aspiration pneumonia.

Postural Techniques

Body or head positions (e.g., chin tuck, head turn) used to improve swallow safety.

Swallow Maneuvers

Behavioral strategies that actively change swallow physiology (e.g., effortful swallow).

Effortful Swallow

Deliberate hard swallow to increase tongue base retraction, airway closure, and clearance.

Mendelsohn Maneuver

Voluntarily holding the larynx up during swallow to prolong UES opening.

Super-Supraglottic Swallow

Breath-hold with bearing down before and during swallow, followed by a cough, to close the airway.

Double/Dry Swallow

Performing a second swallow with no additional bolus to clear residue.

Shaker Exercise

Head-lift exercise to strengthen suprahyoid muscles and improve UES opening.

IDDSI Framework

International Dysphagia Diet Standardisation Initiative that unifies texture/thickness levels worldwide.

Thin Liquid (IDDSI Level 0)

Normal, non-thickened liquid consistency such as water or coffee.

Extremely Thick Liquid (IDDSI Level 4)

“Pudding-like” liquid that cannot be poured; eaten with a spoon (also Level 4 purée).

Minced & Moist (IDDSI Level 5)

Soft, small (≤4 mm) moist food pieces easily mashed with tongue; minimal chewing.

Soft & Bite-Sized (IDDSI Level 6)

Tender foods cut to ≤1.5 cm that require some chewing but no knife.

NPO

Medical order meaning “nothing by mouth”; all nutrition via non-oral routes.

Nasogastric (NG) Tube

Short-term feeding tube passed through the nose into the stomach.

Gastrostomy (G-tube)

Long-term feeding tube surgically placed through the abdominal wall into the stomach.

PEG Tube

Percutaneous endoscopic gastrostomy tube; a type of surgically placed G-tube for long-term feeding.