Week One Dysphagia Tutoring

Dysphagia

Difficulty swallowing foods, liquids, saliva, or medication safely and efficiently.

Why does swallowing matter?

Nutrition, hydration, medication intake, airway protection, social participation, and quality of life.

A normal swallow requires:

Strength, sensation, coordination, timing, and airway protection.

Neurological causes of dysphagia

Stroke, Parkinson's disease, traumatic brain injury, dementia.

Structural causes of dysphagia

Head and neck cancer, surgery, swelling.

Muscular/general medical causes of dysphagia

Weakness, aging, respiratory disease.

What is aspiration?

Material goes below the vocal folds and enters the airway.

What is penetration?

Material enters the airway but remains above the vocal folds.

Complications of dysphagia

Aspiration pneumonia, dehydration, malnutrition, choking, reduced quality of life.

Signs of dysphagia

Coughing during meals, choking, wet/gurgly voice, prolonged chewing, drooling, food sticking, recurrent pneumonia, weight loss, avoiding certain foods, multiple swallows.

True or False: Coughing and choking every meal is normal aging.

False.

How can swallowing change with age?

Swallowing may slow with age.

Goal #1 of swallowing

Move food and liquid to the stomach.

Goal #2 of swallowing

Protect the airway.

Oral Preparatory Phase

Getting food ready for swallowing.

What occurs during the oral preparatory phase?

Chewing (mastication) and bolus formation.

Oral Propulsion Phase

Moving the bolus to the back of the mouth.

What occurs during the oral propulsion phase?

Moving the bolus posteriorly.

Pharyngeal Phase

The automatic swallow.

What occurs during the pharyngeal phase?

Airway protection and swallow trigger.

Esophageal Phase

Food travels to the stomach.

What occurs during the esophageal phase?

Transport of food to the stomach.

Which swallowing phase is considered the big automatic swallow?

Pharyngeal phase.

Bolus

A mass of food, liquid, or saliva prepared to be swallowed.

Mastication

Chewing food to break it down and mix it with saliva.

Propulsion

Movement of the bolus from one area of the swallowing system to another.

Residue

Food or liquid remaining after a swallow.

Reflux

Backward flow of stomach contents into the esophagus or throat.

Secretion

Saliva or mucus naturally produced in the mouth and throat.

Airway Protection

The body's ability to keep food and liquid out of the airway during swallowing.

Swallow Trigger

The point when the pharyngeal swallow begins automatically.

Anterior Spillage

Food or liquid leaking from the front of the mouth.

Pocketing

Food remaining in the cheeks or gums after swallowing.

When can aspiration occur?

Before, during, or after the swallow.

Why might aspiration occur before the swallow?

Delayed swallow trigger.

Why might aspiration occur during the swallow?

Reduced airway closure.

Why might aspiration occur after the swallow?

Residue falls into the airway after the swallow.

A patient has food remaining in their cheeks after swallowing. What term describes this?

Pocketing.

A patient has liquid leaking out of the front of their mouth. What term describes this?

Anterior spillage.

A patient has food remaining in the throat after swallowing. What term describes this?

Residue.

A patient coughs because liquid entered below the vocal folds. What occurred?

Aspiration.

A patient has difficulty chewing food into a manageable consistency. Which swallowing skill is impaired?

Mastication.

Which swallowing phase involves airway protection?

Pharyngeal phase.

Which swallowing phase involves chewing and bolus formation?

Oral preparatory phase.

Which swallowing phase moves the bolus to the stomach?

Esophageal phase.

Which swallowing phase moves the bolus to the back of the mouth?

Oral propulsion phase.

What are the two primary goals of swallowing?

Move food/liquid to the stomach and protect the airway.

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