7/30/2019 Lecture Slides Week6 6-8 Dysphagia

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Dysphagia

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Dysphagia

oDisrup'onofswallowoMaybeindicatorofoneormoredisorders

UnitedStatesDHHS,CDC,Na0onalCenterforHealthSta0s0cs,28)

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Image:JosePaoloS.Borromeo

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Dysphagia Causeso Strokeo Nervoussystemdisorder

Parkinsons Cerebralpalsy

o Mostcommoninolderadultso Headinjuryo Cle@palateo Cancerofthehead,neck,chesto Demen'a,memoryloss,cogni'vedecline

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Screening for Dysphagiao Drooling,excessivesecre'onso Pocke'ngoffoodo Poorcontroloftonguemovementso Facialweakness/difficultychewingo Slurredspeecho Coughingbefore,during,ora@er

swallowingfoodorfluidschoking

o Frequentthroatclearingo Delayedswallowreflexo Poorcontrolofhead/bodyposi'on

o Nasalregurgita'ono Presenceoforallesionso Wet,"gurgly"voicea@erswallowingfoodsorliquids

o Hoarseorbreathyvoiceo Absentswallowreflexo Complaintsoffoodgeng"stucko Poorcontrolofhead/bodyposi'ono Mucosi'so XerostomiaAmericanDiete0cAssocia0on,Nutri0onCareManual,211.

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Oropharengeal Dysphagia

oProblemtransferringfoodfrommouth&pharynxesophagus

oCanberesultofproblemwithtongue,swallowingreflex,mouth'ssues

oCantswalloworcoughswhenswallowingorregurgita'onofcontents

oResultsinbadbreath,hoarsevoice,speechdisorder-o@encausedbystroke

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Esophageal Dysphagiao Problemtransferringfoodfromesophagusstomacho Feelslikefoodisstuckinesophaguso Canberesultofesophagealstricture,tumororpressurefromsurroundingarea

o Achalasia:peristalsis&promotesrelaxa'onofLES,degenera'venervedisorderofunknowne'ologydysphagia,heartburn,regurgita'on,weightloss;nutrientdenseliquids&semisolidfoodsatmoderate

temperaturesgiveninsmall,frequentquan''escanusuallybetolerated

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Dysphagia Management

oSpeechtherapistassessesswallowcapability&choosesmodifieddietasappropriate: Texturedeterminedwithchoiceofna'onaldysphagiadiet:pureed,mechanicallyaltered,dysphagiaadvanced

Liquidconsistencydeterminedtobe:thins,nectarlike,honeylike,spoon-thick

oSpeechtherapyhelpspa'entsrelearnorstrengthenswallowingmechanism

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For More InformationoAmericanSpeechLanguageHearingAssocia'on:h\p://www.asha.org/slp/clinical/dysphagia/

oMedlinePlus:SwallowingDisordersh\p://www.nlm.nih.gov/medlineplus/swallowingdisorders.html

oNa'onalIns'tuteonDeafnessandOtherCommunica'onDisorders:

h\p://www.nidcd.nih.gov/health/voice/pages/dysph.aspx