Foundational Knowledge/Overview of Dysphagia

Pathophysiology?

Processes that cause, result from, or are otherwise associated with disease or injury

The study of the mechanisms underlying disease processes

Explains the functional and biochemical changes that are associated with or a result of disease or injury

Ex. We don't treat the stroke, we treat the aphasia

Dysphagia spans the __________ and the __________.

Lifespan and work settings

When we make decisions regarding dysphagia and any disorder in general, we emphasize?

Patient-centric, evidence-based approaches

When we look at the extent of a disorder we focus on ___________ VS. ___________.

And what does that entail?

Functionality versus normality

Can they be functional with their disorder or for example their diet

GOAL is to not get back to normal but to get them back functional

What are two key considerations with treatment?

Advocacy and Ethical Implications

Dysphagia occurs in ______ in 25 adults and ______ in 1,000 children per year.

1 in 25 adults
9 in 1,000 children

What are some devastating consequences on health and QOL?

Malnutrition, dehydration, possible death
Limit socialization (which is extremely important for working memory and health) - less socialization accelerates those cognitive issues

According to the AHCPR, approximately ________ if individuals with dysphagia develop PNA.

________ individuals die each year from complications related to PNA.

1/3

60,000

Who does the patient/care team involve with dysphagia?

Patient
SLP
Nursing
Nutrition
Medicine
Psychology
OT or PT
Respiratory therapy
Social Work

Team members very based on settings for e.x. case managers, case navigators

What are some roles of an SLP when working with dysphagia?

Perform: Clinical swallowing, feeding evaluation, instrumental assessment of swallowing functions
Identify: normal and abnormal swallowing anatomy and physiology/sings of possible disorders
Make referrals and decisions of the management of swallowing and feeding disorder
Provide treatment, teaching, counseling
Education and Advocating

What is the swallowing tract that we work on?

Upper aerodigestive tract

What is a sign verus a symptom?

Sign: Something you can see, Ex. A low bolus is a sing of aspiration

Symptom: Something patient is presenting with, Ex. Fever is a symptom of the flu

The nervous system is?

The body’s communication network

What are the two parts of the Nervous System?

Peripheral Nervous System

Central Nervous System

What are the main functions of the nervous system?

Sends signals between different parts of the body

Controls bodily functions and responses

Maintains homeostasis

What is the CNS and what does it include?

Central Nervous System: Sensory Perception: Receiving information from sight, hearing, touch, taste, and smell

Includes the Brain and Spinal cord

What is Motor Control?

Sending signals to muscles to initiate movement

What is thought processing?

Involves cognition, reasoning, decision making, and complex thinkingWhat is

What is emotional regulation?

Processing and Expressing Emotions

What is Learning and Memory in CNS?

Storing and Retrieving Information

What is Homeostasis Maintenance?

Regulating Body Temperature, Breathing, and other vital functions

What is the PNS and what does it include?

Peripheral Nervous System

Nerves that branch out of the brain and spinal cord
Transmits signals between the CNS and the rest of the body

Sensory, Motor, Mixed - Cranial Nervous VS. Spinal Nerves?

CN - Sensory, Motor, and Mixed

Spinal Nerves - Mixed

Somatic Nervous System Vs. Autonomic Nervous System?

Somatic - Controls Voluntary Muscle Movements

Autonomic Nervous System - Regulates involuntary functions and is divided into Sympathetic and Parasympathetic

Sympathetic Vs. Parasympathetic?

S - Fight or Flight
ParaS - Rest or Digest

What are the cranial nerves? Emerge from? How many? Control?

Emerge directly from the brain and the brain stem 12 pairs

Control motor and sensory functions in the head, neck, and beyond

CN I?

Olfactory: Sense of Smell

Sensory

CN II?

Optic: Vision

Sensory

CN III?

Oculomotor: Eye movement (pupil dilation)

Motor

CN IV?

Trochlear: Eye Movement (Superior oblique muscle - vertical eye movement)

Motor

CN V?

Trigeminal: Facial Sensation, Chewing Muscles

Mixed

CN VI?

Abducens: Eye movement (lateral rectus movement - lateral movement of eyeballs)

Motor

CN VII?

Facial: Facial Expressions and Taste (anterior tongue)

Mixed

CN VIII?

Vestibulocochlear: Hearing and Balance

Also known as auditory nerve

Sensory

CN IX?

Glossopharyngeal: Taste (posterior tongue) and swallowing

Mixed

CN X?

Vagus: Heart, Lungs, Digestion

Mixed

CN XI?

Accessory: Shoulder and neck muscles

Motor

CN XII?

Hypoglossal:Tongue Movement

Motor

What are the three types of muscles?

Cardiac, Smooth, and Skeletal

What is the Skeletal Muscle?

Voluntary, attached to bones, responsible for movement

What are the two types of Skeletal Muscles?

Slow Twitch Muscles = Endurance Not speed, Contract Slowly
Ex.
Fast Twitch = Sprint, Twitch Faster, Fatigue Easier

What are type 1 fibers?

slow twitch

Low Speed, High Endurance

What are type 2a fibers?

Fast Twitch - Oxydative

Faster Speed, Less Endurance

What are type 2b fibers?

Fast Twitch - Glycolytic

High Speed, Low Endurance

Is the oropharynx consisted of Fast or Slow Twitch Muscles?

Both, it is both fast and slow twitch, don't fatigue easily

What is the Smooth Muscle?

Involuntary, controls internal movement (organs)

What is the cardiac muscle?

Involuntary, pumps blood in the heart

How does the nervous system control muscles?

Transmits signals from the CNS to muscles

What type of muscle?

Skeletal

What type of muscle

Smooth

What type of muscle?

Cardiac

What type of muscle?

Smooth

What type of muscle?

Cardiac

What type of muscle?

Skeletal