dysphagia signs/physical impairments

anterior spillage of food (dysphagia sign)

decreased labial seal (physical impairment)

premature spillage of bolus (dysphagia sign)

decreased lingual control (physical impairment)

poor bolus prep (dysphagia sign)

decreased oral bolus manipulation (physical impairment)

prolonged mastication (dysphagia sign)

impaired mastication (physical impairment)

oral residue and inability to move bolus into pharynx (dysphagia sign)

decreased A>P transport (physical impairment)

diffuse oral residue/stasis (dysphagia sign)

reduced lingual strength (physical impairment)

nasopharyngeal regurgitation (dysphagia sign)

poor soft palate/velar elevation

residue in pyriform sinuses (dysphagia sign)

reduced laryngeal elevation (physical impairment)

reduced epiglottic inversion (dysphagia sign)

decreased anterior movement of the hyoid (physical impairment)

laryngeal penetration/aspiration

reduced laryngeal closure (physical impairment)

residue along pharyngeal wall (dysphagia sign)

reduced pharyngeal constriction (physical impairment)

pooling in pyriform sinuses (dysphagia sign)

decreased UES opening (physical impairment)

vallecular residue (dysphagia sign)

impaired tongue base retraction (physical impairment)

predictors of dysphagia in trach patients

• intubation

• age

• comorbidities

• tachypnea

• tracheostomy

• pre - existing dysphagia

• length of stay

• dysphagia will most likely be secondary to the events that preceded the tracheostomy vs. the tracheostomy itself