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Quiz

LING 1P92 Quiz: LING 1P93 Seminar Presentation – Feeding and Swallowing Disorders

9 Pages
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Department
Linguistics
Course Code
LING 1P92
Professor
Carolyn Windsor

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Description
find more resources at oneclass.com Feeding and Swallowing Disorders Introduction 1. Introduce ourselves and give the name of our disorder. 2. The goal of our presentation is to inform you all about what dysphagia and feeding disorders are. 3. We will be covering what a normal vs. a dysphasic swallow looks like and the causes and treatment options for those with feeding and swallowing disorders and dysphagia accompanied with an activity to give you all a better understanding of the swallowing process 4. We will also be discussing the effects of the disorder not only on the person with the disorder but also the effects on the family and caregivers. 5. We have 2 case studies that we will discuss throughout the presentation to help better your understanding. ▯First I would like everyone to place thei▯ ha▯d o▯ thei▯ th▯oat, a▯d s▯allo▯▯. ______They swallow. • Here, everyone was conscious of his or her act of swallowing. However, normally ▯e are▯’t at all ▯o▯s▯ious of s▯allo▯i▯g. For i▯sta▯▯e, ▯a▯▯ of ▯ou ▯a▯ fi▯d it surprisi▯g ho▯ ▯a▯▯ ti▯es a da▯ ▯e s▯allo▯ appro▯i▯atel▯. ▯Ho▯ ▯a▯▯ ti▯es a da▯ do ▯ou gu▯s thi▯k ▯e s▯allo▯ o▯ a▯erage?▯ - 2000 time/day approx. • ▯We all take eati▯g for gra▯ted. We ▯he▯ a▯d s▯allo▯ ▯ut do▯’t gi▯e it ▯u▯h thought. But it is so essential to humans for developing and maintaining themselves physically and mentally. • However, some children and adults have the ability to eat and drink safely, compromised by disease or injury. • Mismanagement of this disorder could have life-threatening consequences such as choking and blocking of the airway, aspiration of foods into their lungs, or pneumonia. Dysphagia and Feeding Disorder: • Impairment in the ability to swallow is known as dysphagia. Since the individual who has dysphagia is now unable to eat safely, dysphagia is a type of feeding disorder. • Dysphagia occurs across the age spectrum, meaning in people of all ages. • We will be focusing on dysphagia, however there are also different types of pediatric feeding disorders that include dysphagia as well as other individualized disorders that can occur, to get more information on Pediatric Feeding Disorders you can consult the textbook or the ASHA website, as well as there being many scholarly articles on the topic as it has become increasingly popular. o O’Bria▯ et al. ▯▯99▯▯ resear▯hed infants who are born premature or with low birth weights and how they are at greater risks for feeding and swallowing disorders o Babies born with cleft palates until treated will also have a feeding find more resources at oneclass.com find more resources at oneclass.com disorder since they have inadequate physical features to produce a normal swallow. • However, it is most common in infants and the elderly we will be focusing on adult or older adult dysphagia. • It occurs as a variety of developmental (meaning they were born with it), neurological, or structural problems that alter the ability to swallow normally • Those with dysphagia will find that eating becomes a burden. • Also, eating will become an unpleasant experience because they are now limited in what foods or liquids they can safely consume • This can also affect social activities that we typically enjoy. For example, going to the movies – we like to order a large soft drink and popcorn. However for individuals with dysphagia, they would not be able to do so Introduce Case Study: What type of disorder would you classify them as? Normal versus Dysphasic Swallow The Four phases of a swallow: 1. The oral preparatory phase, 2. The oral propulsive phase, (sometimes just oral phase) 3. The pharyngeal phase, 4. The esophageal phase Play Video: Speak over top. (Guide to Dysphagia - 3D animation of swallowing) https://youtu.be/adJHdrQ4CRM Oral stages might be combined Oral Preparatory Dysphagia – In the oral preparatory phase, the teeth and muscles of the mouth work together to form the food into a bolus through what the textbook calls mastication (also known as chewing). Adequate production of saliva adds moisture to the bolus, which helps bind it together. This is where most people extract the most pleasure because we get to taste the flavors of our food or drink. In oral preparatory dysphagia, the lips, tongue, cheeks and mandible do not function, as they should. Characterized by: • Decreased lip closure resulting in difficulty eating and drinking from utensils, straws or cups which causes food to leak from the mouth • Problems controlling ingested materials causing food or liquid to fall in the space between the teeth and gums • Difficulty biting or chewing • Reduced saliva – enabling them to form a bolus out of dry food • Refusal to eat – complaints of taste or a loss of taste sensation Oral Propulsive Dysphagia – (Oral Transiet) In the oral phase, typically the bolus will move to the back of the mouth toward the pharynx to trigger a swallow. This begins find more resources at oneclass.com find more resources at oneclass.com with the tongue moving back in order to push the bolus into the throat. This stage is considered delayed if it takes more than 2 seconds to complete • However, in oral phase dysphagia, there is difficulty in moving that bolus to the pharynx, which results in residual food or liquid remaining in the mouth. • The food gets ▯po▯keted▯ i▯ the spa▯es ▯et▯ee▯ the gu▯s a▯d ▯heek • Abnormal tongue movements – to▯gue is sort of ▯pu▯pi▯g▯ to initiate swallowing – may also occur • This can also cause excessive saliva resulting in drooling and food or liquid dripping from the nose Pharyngeal Dysphagia In this phase, the main purpose is to propel the bolus downward through the throat to the entrance of the esophagus. • In this phase, the main purpose is to propel the bolus downward through the throat to the entrance of the esophagus • It begins when the pharyngeal swallow reflex is triggered • The pharyngeal wall and back of the tongue move toward each other to create pressure which, in combination with the squeezing of pharyngeal muscles, helps move the bolus downward • It is important to note that at this point the bolus can potentially enter the wrong pathway to the lungs or nasal cavity which would cut off breathing in the individual • However this phase consists of protective mechanisms to prevent this from happening • The soft palate elevates to form a barrier between the pharynx and nasal cavity to prevent this • Also, the larynx moves forward and higher in the neck to decrease the risk of the bolus entering the airway • Thirdly, the epiglottis forms a cover over the larynx by folding downward • Lastly, the vocal folds come together which keeps food from entering the trachea • However if these mechanisms fail to protect, a reflexive cough will propel the material back out – Ask, ▯ho has e▯e▯ felt like they ▯e▯e choki▯g a▯d had to say, ▯it ▯e▯t do▯▯ the ▯▯o▯g ▯ay▯?- cough it out – reflexive cough • If they do work, then the esophageal sphincter relaxes and allows passage of the bolus into the esophagus • All in all, this phase lasts about 1 second • Breakdowns in the pharyngeal stage occur when the pharyngeal structures do not function, as they should in order to move the bolus through the pharynx to the entrance of the esophagus. This is critical because it poses the greatest threat of allowing materials to enter the airway. It is also important to note that unlike the oral phases, pharyngeal difficulties are not always obvious. • Characterized by: find more resources at oneclass.com find more resources at oneclass.com o Delayed trigger of swallow reflex o The epiglottis may not drop down to protect airway o Weak pharyngeal constrictors – the ▯olus ▯o▯’t al▯a▯s ▯o▯e do▯▯▯ard o Vocal folds have poor closure so the food enters the larynx o Upper esophageal sphincter may not open long enough or at all, to allow the bolus to move downward o Slow or absent esophageal peristalsis o Pain in the chest o Leaves residue and may result in infection o Lower esophageal sphincter may not open o Bolus does▯’t e▯ter stomach o Coughing or choking o Shortness of breath Esophageal Phase Dysphagia • This phase moves the bolus through the esophagus to the stomach • When the bolus passes through the upper esophageal sphincter, it closes • The bolus is propelled through the esophagus by an involuntary contraction and then into the stomach • Lasts 8-▯▯ se▯o▯ds depe▯di▯g o▯ a perso▯’s age • Esophageal phase dysphagia is characterized by: o Heartburn o Food may feel like its getting stuck in the throat or chest o Mouth tastes sour (especially in mornings) Case Study: What phase is mostly affected by their disorder? Or where do they have the most difficulties? Dysphagia in More Detail • Because swallowing in individuals with dysphagia is inefficient, it does not provide adequate nutrition • Spend so much time in oral preparatory phase that they: o Become fatigued o Unable to consume enough food to meet nutritional needs Unsafe swallowing could have life-threatening consequences • For instance, 1. I▯▯reases a ▯hild’s or adult’s risk of penetration (food or liquid enters the larynx where it can cause choking) 2. Increase the risk of aspiration (food or liquid passes through the larynx and into the lungs- be cautious of silent aspiration – when an individual shows no sign of choking such as coughing or speaking in that gurgly voice • Silent aspiration occurs in people that have dysphasia and occurs when food, liquids, or stomach contents are swallowed poorly, and go into
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