Quiz 1: dysphagia

Define dysphagia and identify common symptoms associated with the disorder

• A symptom that is characterized by deficits in the ingested food or liquid 

  • Most commonly referred to as a swallowing disorder 

• Symptom 

  • Coughing, choking, food falling from mouth, liquid in mouth, pain, throat clearing, difficulty chewing, prolonged meals, weight loss, respiratory infections, chronic congestion 

• Identify disorders that often result in dysphagia

  • Neurological:

• Stroke

• TBI 

• Tumor 

• ALS 

• Dementia

• Identify disorders that often result in dysphagia

  • non-neurological

• Head and neck cancer 

• Cardiothoracic surgery trauma 

• Pulmonary disease

Identify and describe the common effects of dysphagia

• Bolus Airway Entry 

  • penetration/aspiration 

  • Entrance of material into the airway 

• Dehydration and Malnutrition

  • Insufficient ingestion of sufficient water or nutrients 

• Respiratory morbidities 

  • Pneumonia, respiratory infections, bronchiolitis, chronic ingestion 

    • Most common in children 

    • Biggest concern with dysphagia 

• Diminished quality of life and financial burden 

  • Social isolation, eating disinterest, prolonged hospital stays 

Define penetration

Penetration = ingested materials entering the larynx but not progressing below true vocal folds

Define Aspiration

Aspiration = ingested materials entering the larynx and professing below true vocal folds

• Identify which swallowing organ is one of the most important for swallowing

• Tongue 

  • Pressure pump for swallowing 

  • Serves as a muscular hydrostat, which means that it is not bound by a skeletal system therefore, it is capable of a wide range of refined movements that would not be possible without a muscular hydrostat

Describe what makes the tongue a muscular hydrostat and how that provides it unique abilities

• Only bound by skeletal system on one side, therefore it is capable of a wider range of movement 

Identify how intrinsic lingual muscles differ in function from extrinsic

• Intrinsic lingual muscles are responsible for changing the shape of the tongue allowing for precise movements necessary for speech and swallowing. (fine motor)

• while extrinsic muscles control the tongue's position within the oral cavity (gross motor)

Describe the role of the pharyngeal constrictors during swallowing

• Squeeze the pharynx to push the  bolus down into the esophagus for swallowing 

• Compress in to make it so there is not much space in the tube/pharynx to push it down 

• Squeezes in and down 

• To contract and squeeze things out of the pharynx 

• Identify the two muscle groups that make up the pharyngoesophageal segment

• The two muscle groups that make up the pharyngoesophageal segment are the pharyngeal constrictors and the upper esophageal sphincter (UES). The constrictors help in the contraction process during swallowing, while the UES controls the passage of food into the esophagus.

Describe how the PES is positioned at rest and how that changes during the swallow

• Closed at rest - when person is not swallowing, protects from air ingestion during respiration 

  • Insufficient opening causes residue in the throat that can then go into the lungs 

• When you swallow the PES has to open so that the bolus can pass through, allows for food to go through the esophagus and into the stomach 

Describe how the larynx is suspended and what happens with the larynx during the swallow

• Larynx is suspended by the hyoid bone by means of the thyrohyoid membrane 

• suprahyoid group that pulls the larynx up and forward during the swallow 

• Can tell where a swallow initiates based on movement of the hyoid bone 

Describe the role of the long pharyngeal muscles during the swallow

• Shorten the pharynx and elevate the larynx during swallowing 

• Squeeze the larynx in a superior/inferior direction 

Identify the how the pharyngeal constrictors and long pharyngeal muscles move/contract and change the shape of the pharynx during the swallow

When you swallow pharyngeal constrictors contract laterally and posteriorly so that you can swallow and move the bolus down and back 

While the long pharyngeal muscles shorten the pharynx and elevate the larynx during the swallow

Describe how the bolus travels down the esophagus

Peristalisis: series of involuntary wave-like muscles contractions that move food and liquid through the esophagus 

Describe what primary peristalsis is and where it takes place

• esophageal peristalsis occurring to squeeze food/liquid/saliva down after pharyngeal swallow 

• Takes place in esophagus  

Describe how the muscular contraction of the esophagus occurs to facilitate esophageal peristalsis 

• Persitalsis: Squeezes in and down 

• Wave like motion of esophageal muscles to push the bolus down