What are the four phisiologic phases of the normal swallow?
- 1. Oral preparatory phase
- 2. Oral Phase
- 3. Pharyhgeal Phase
- 4. Esophageal Phase
What are modified diets?
Diets in which composition, consistency/texture, and/or presentation of food has been changed to prevent or treat disease for diagnosis/examination/treatment procedure.
What main diets for dysphagia are uusually available in acute care hospitals?
- National Dysphagia Diets (NDD)
- NDD Level 1: Pureed
- NDD Level 2: Mechanically Altered
- NDD Level 3: Advanced
Which foods should not be included in the clear liquid diet?
Foods soild at body temp. and/or containing residues or fibers.
What is the purpose of the clear liquid diet?
Supply body with fluids, electrolytes, small quanity of energy, while requiring minimus digestion and stimulation of the digestive tract.
What is the osmolality of liquids?
When should the osmolarity of liquids given to clients be controlled?
- 1. Gastrointestional function is significantly perturbed
- 2. Not fed enterally for a long time.
Which fluids are hyperosmolar?
- 1. More than 400 mOsm/kg
- 2. Prune juice, cranberry juice, grape juice,
Which fluids have a low osmolarity? Give some examples.
Diet soft drinks, tea, diet fruit beverages, coffee
What can be done to increase the tolerance of hyperosmolar fluids?
- 1. Take them slowly.
- 2. Diluted with water to reduce the osmolarity
Which foods are included in the blenderized liquid diet?
Foods that blend/blenderize well, such as milk, and smooth custard, soft bread, cooked cereals, canned vegtables, noodles
What is not included in a blenderized luquid diet?
- Foods that do not blenderize well.
- Hard Cheeses, fried foods, tough meat, nuts and seeds, crunchy foods.
What foods are recommended for clents on the mechanically altered diet?
Foods requiring min chewing such as soft, moist foods. E.g. ripened fruits, cooked vegtables, and pureed, mashed, ground, or chopped soft foods.
Which foods are not recommended for a mechanically altered diet?
- Foods requiring intense mastication.
- Hard/crunchy foods, dry/tough meats, crips breads, dried fruits
What is achalasia?
Failure of sphincter muscles (such as cardiac sphincter) to relax and open.
What is dysarthria?
Difficulty speaking caused by a brain injury, emotional stress, noncoordination, paralysis, or spasticity of the muscles necessary to speak.
What is Ataxia?
The lack of capacity to coordinate muscles to accomplish volentary movements, resulting in lack of corrdination, inefficiency, and jerkiness.
What is a tremor?
The repetitive oscillatory muscle movements or shaking.
What is Dyskinesia?
The difficulty to accomplish voluntary movements.
What is Xerostomia?
Dry mouth due to the lack of salivary secretion.
What is trismus?
Refers to lockjar or persistent contraction of the jaw muscles.
What is Aspiration?
The passage of substance(s) beneath the vocal cords into the pharynx and trachea.
What health complications are associated with untreated dysphagia?
- 1. Increase wt. loss
- 2. dehydration
- 3. malnutrition
- 4. psychosocial problems
- 5. aspiration
- 6. reduced immunity, infection, poor wound healing, dimished quality of life.
Why is aspiration dangerous?
- 1. Leads to the development of pneumonia
- 2. Associated with recurrent pulmonary infection
- 3. rapid reduction od respiratory function
What are the types of aspiration?
- 1. Prandia: Aspiration during chewing or swalling
- 2. Reflux: Aspiration of stomach content into the lungs folowing a gastroesophageal reflux.
- 3. Salivary: Aspiration of saliva
What complications are associated with Oral preparatory phase?
- Difficulty chewing
- Food pocketing in the jaws
- poor bolus formation
- ecessive or thick saliva
- Drooling and food leaking out of the mouth
What are the complications are associated with Pharyngeal phase?
- wet "gurgly" vocal quality
What are the complications associated with esophageal phase?