Dysphagia Tutoring Guided Notes

Vocabulary flashcards covering the definitions, anatomy, cranial nerves, and clinical assessment/treatment of dysphagia based on lecture notes.

Dysphagia

Difficulty swallowing.

Bolus

A mass of food, liquid, or saliva that is prepared in the mouth to be swallowed.

Mastication

The process of chewing food to break it down and mix it with saliva.

Deglutition

Swallowing.

Aspiration

Material passes below the vocal folds.

Penetration

Material enters the airway but stays above the vocal folds.

Silent Aspiration

Aspiration without a cough response, happening because of reduced airway closure or sensation.

Residue

Food or liquid that remains in the mouth, pharynx, or esophagus after a swallow.

Pocketing

Food remaining in the cheeks or gums after swallowing, often due to reduced oral sensation or weakness.

Anterior Spillage

Food or liquid leaking out of the front of the mouth due to poor lip closure or oral control.

Reflux

The backward flow of stomach contents into the esophagus or throat.

NTS (Nucleus Tractus Solitarius)

The sensory control center that detects food/liquid and helps trigger protective responses; it is the "Notices" part of the swallow.

Nucleus Ambiguus (NA)

The motor control center that contains cranial nerve nuclei and helps coordinate the automatic swallow response; it is the "Acts" part of the swallow.

CN V (Trigeminal)

Cranial nerve responsible for mastication (chewing) and general sensation of the anterior $\frac{2}{3}$ of the tongue.

CN VII (Facial)

Cranial nerve responsible for lip closure, facial expression, salivation, and taste for the anterior $\frac{2}{3}$ of the tongue.

CN IX (Glossopharyngeal)

Cranial nerve responsible for taste and sensation of the posterior $\frac{1}{3}$ of the tongue, the swallow trigger, and pharyngeal sensation.

CN X (Vagus)

Cranial nerve responsible for vocal fold movement, velum elevation, airway protection, and UES/esophageal function.

CN XII (Hypoglossal)

Cranial nerve responsible for tongue movement, bolus manipulation, and propulsion.

Upper Esophageal Sphincter (UES)

A muscular ring, also called the cricopharyngeal sphincter, that opens to allow the bolus into the esophagus and closes to prevent backflow.

Valleculae

The space between the base of the tongue and the epiglottis where residue may collect before swallow initiation.

Pyriform sinuses

Spaces in the pharynx where residue may collect; weak pharyngeal constrictors can lead to residue here.

Yale Swallow Protocol

A standardized screening tool involving a $3\,\text{oz}$ water swallow test to identify patients at risk for aspiration.

Modified Barium Swallow Study (MBS)

A video fluoroscopic X-ray procedure using barium to visualize oral, pharyngeal, and esophageal phases of swallowing in real time.

FEES (Fiberoptic Endoscopic Evaluation of Swallowing)

A procedure using a flexible endoscope through the nose to view the pharynx and larynx; it allows for longer observations and assessment of secretions.

Suprahyoid Muscles

A group of muscles (Mylohyoid, Geniohyoid, Digastric, Stylohyoid) that lift the hyoid and larynx up and forward for airway protection and UES opening.

Infrahyoid Muscles

A group of muscles (Sternohyoid, Omohyoid, Sternothyroid, Thyrohyoid) that lower and stabilize the hyoid and larynx.

Effortful Swallow

A restorative strategy where the patient swallows hard and squeezes muscles to improve tongue base contraction and pharyngeal constriction.

Mendelsohn Maneuver

A restorative strategy where the patient holds the larynx up at the peak of the swallow to improve laryngeal elevation and UES opening.

Masako Maneuver

A restorative exercise where the patient swallows while holding the tongue between the teeth to improve posterior pharyngeal wall movement.

Shaker Exercise

A restorative exercise consisting of head lifts while laying down to improve hyolaryngeal elevation and UES opening.

Chin Tuck

A compensatory strategy used to improve airway protection by narrowing the laryngeal inlet.

Pharyngeal Constrictors

Muscles (Superior, Middle, Inferior) that create a pharyngeal stripping wave to push the bolus down toward the esophagus.