CSD Final

What is dysphagia?

An impairment in the ability to swallow.

Why is dysphagia considered a feeding disorder?

Because the individual can no longer eat safely.

What professional evaluates and treats dysphagia?

SLPs (ASHA, 2002).

What is swallowing?

A complex neuromuscular act moving substances from the oral cavity to the esophagus.

What is a bolus?

The substance being moved from mouth to stomach.

Approximately how many times do we swallow per day?

About 580 times.

Purpose of oral preparatory phase?

To prepare the substance to be swallowed.

What occurs during the oral preparatory phase?

Lips close, bolus formation, mastication, increased saliva.

Purpose of oral phase?

To move the bolus to the back of the mouth.

What triggers the end of the oral phase?

Tongue propulsion of bolus toward the pharynx.

When does the pharyngeal phase begin?

When bolus reaches posterior oral cavity and reflex triggers.

What protects the airway during pharyngeal phase?

Epiglottis lowering and brief halt in respiration.

What starts the esophageal phase?

Bolus passing through the UES.

How is the bolus moved in the esophageal phase?

By an involuntary peristaltic wave.

What is penetration?

Food or drink enters the larynx.

What is aspiration?

Food or liquid passes into the lungs.

What is silent aspiration?

Aspiration with no coughing or choking.

Common causes of dysphagia?

Neurological injuries, cancer, radiation, low birth weight, developmental disorders.

What is a pediatric feeding disorder?

Failure to eat adequately ≥1 month with weight loss or failure to gain.

Symptoms of pediatric feeding disorders?

Unsafe swallowing, growth delay, poor appetite, texture intolerance.

Importance of coordinated suck-swallow-breathe?

Ensures safe feeding.

Down syndrome feeding issue?

Hypotonia → weak suck → swallowing impairment.

What two parts make an SLP swallowing assessment?

Case history and physical evaluation.

When is MBS used?

When signs of dysphagia appear.

What is a motor speech disorder?

Impairment of speech production from motor control issues.

Two categories of MSDs?

Apraxia (planning) and dysarthria (execution).

Four speech systems?

Respiratory, phonatory, resonatory, articulatory.

Speech inhalation/exhalation ratio?

1:6 to 1:9.

What causes voiced sounds?

Vocal fold vibration.

What causes unvoiced sounds?

Lack of vocal fold vibration.

What is the VP port?

Opening between velum and pharyngeal wall.

Major articulators?

Tongue, jaw, lips.

Consonants vs vowels?

Consonants = constriction; vowels = little/no constriction.

Causes of acquired MSDs?

Stroke, TBI, degenerative disease, tumors.

Causes of developmental MSDs?

CP, genetic syndromes, early brain injury.

What characterizes apraxia?

Impaired motor planning; sequencing difficulty.

Spastic dysarthria?

Hypertonicity, weakness, slow movement.

Flaccid dysarthria?

Hypotonicity, weakness.

Hypokinetic dysarthria?

Bradykinesia, rigidity (Parkinson’s).

Hyperkinetic dysarthria?

Involuntary movements, variable tone.

Perceptual measurement?

Judging intelligibility, accuracy, speed.

Acoustic measures?

Visual representations of speech (Praat).

Respiratory treatment example?

Vowel prolongation or controlled exhalation.

What is LSVT used for?

Increasing loudness in hypokinetic dysarthria.

What is pediatric hearing loss?

Inability to detect/distinguish sounds normally available to the ear.

What is APD?

Damage to auditory processing centers in the brain.

Types of hearing loss?

Conductive, sensorineural, mixed.

Prelingual hearing loss?

Occurs before language acquisition.

Postlingual hearing loss?

Occurs after language acquisition.

Normal hearing range?

-10 to +15 dB.

Profound hearing loss?

91 dB or higher.

Conductive hearing loss cause?

Outer/middle ear damage.

Most common cause of conductive HL?

Otitis media.

Sensorineural hearing loss cause?

Inner ear or auditory nerve damage.

Impact of SNHL on speech?

Poor speech perception; difficulty hearing with noise.

Hearing aids typically used for children?

Behind-the-ear (BTE).

What is a cochlear implant?

Surgically implanted device stimulating auditory nerve.

What is acoustic highlighting?

Slower rate, increased pitch, repetition.

Most important factor in hearing-loss outcomes?

Early intervention.

What is VP?

Velopharyngeal port: opening between velum (soft palate) and the back of the pharynx wall

When the VP is open…

Air goes through nasal cavity producing nasal sounds (/m/, /n/, and /ing/)

When the VP is closed…

Air goes through the oral cavity producing any other sound besides nasal (/b/)

Consonants

Constriction in vocal tract

Vowels

Little/no constriction in the vocal tract

Hypotonia

Low muscle tone

Fiberoptic endoscopic evaluation of swallowing (FEES)

Provides direct visualization before and after a swallow

Modified Barium Swallow (MBS) / Video fluoroscopy

“Gold standard”, most common swallowing evaluation—> shows all phases of swallowing