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Lecture 13

11:709:364 Lecture Notes - Lecture 13: Hyoid Bone, Epiglottis, Malnutrition

Nutritional Sciences
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4 Phases of A Normal Swallow
1) Oral preparatory phase*
a. Labial seal
b. Liquid or solid material is pulled together into a cohesive
bolus by the tongue before oral transport is initiated
c. Solid foods are lateralized and masticated
2) Oral transit phase*
a. Starts when the tongue moves the bolus posteriorly
b. In a normal swallow the following are intact:
i. Labial musculature
ii. Lingual movement
iii. Buccal musculature
iv. Palatal muscles
3) Pharyngeal phase
a. Starts when the bolus passes the base of the tongue and
the swallow is triggered
b. Velum elevates
c. Hyoid and larynx elevate and move anteriorly (forward)
i. Helps the epiglottis cover the larynx to protect the
airway, vocal cords also close to protect the larynx
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d. Larynx closes
e. Epiglottis retroflects
f. Upper esophageal sphincter (UES) opens
4) Esophageal phase
a. The bolus enters the esophagus
i. Upper esophageal sphincter
ii. Peristaltic wave (helps food move downt the
iii. Lower esophageal sphincter
Who is at High Risk for Dysphagia?
- Head and neck cancer
- Stroke/neurologic impairments/TBI/neurodegenerative diseases
- Dementia
- Tracheostomy/respiratory problems
- Intubation
- Lung transplant
- Heart surgery
- Vocal fold paralysis/paresis
- Anterior cervical spinal surgery
What tests do SLPs perform?
- Beside swallow evaluation/clinical dysphagia evaluation
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