SHH 350 Swallowing/Dysphagia

Swallowing

process of moving food from mouth to stomach

Oral pocketing places and spaces

Buccal cavities, Labial cavities, Under the tongue

Swallowing Phases

Oral phase, Pharyngeal phase, Esophageal phase

Oral Phase

Chewing phase, bolus moved from oral cavity to pharynx

Pharyngeal Phase

Pyroclastic movement

Esophageal Phase

Gastroenterologist = when food in throat, their job

Extrinsic muscles of the tongue

Hyoglossus, Genioglossus, Styloglossus, Palatoglossus, Mylohyoid

Laryngeal elevators - Suprahyoids

Digastricus, Mylohyoid, Stylohyoid, Geniohyoid Mylohyoid

Laryngeal depressers - Infrahyoid muscles

Sternohyoid, Sternothyroid, Thyrohyoid, Omohyoid

What has to close to keep food and/or liquid from going up into the nose

soft palate/epigottis

What is the primary biological function of the larynx

airway protection, when larynx closes it traps the air in lungs

What are the 4 structures that close over the larynx to protect it?

true vocal folds, false vocal folds, aryepiglottic folds, epiglottis

What are the 3 risks for dysphagia

aspiration pneumonia, loss of muscle function cough reflex and sensation, malnutrition

Aspiration

food/liquid goes below the level of true vocal folds, food/liquid entered airway

Penetration

food/liquid has gone down to level of larynx, in the vestibule

Backflow

food/liquid has entered the esophagus, but the esophagus peristalsis motion reverses and squeezes the food back up

What is a symptom of dysphagia you could identify in a bedside swallowing eval

coughing/choking while eating or drinking

What is FEES

Fiberoptic endoscopic evaluation of swallowing

What is barium

radioactive substance on X-ray, coats the food/liquid so can see what happens when people swallow food/liquid

What is the hardest bolus consistency to manage

solid food thats hard, sticky or dry

Suprahyoids

Laryngeal elevators

Digastricus

Means 2 bellies, anterior and posterior

Mylohyoid

This muscle forms the floor of the mouth

Stylohyoid

Long and slender muscle that is lateral and superficial to digastricus posterior belly

Geniohyoid

Located superiorly to the mylohyoid

Infrahyoid muscles

Laryngeal depressors