Term
|
Definition
-Compensatory Strategies
-Diet Changes
-Exercises |
|
|
Term
|
Definition
Chin Down example 2
-Decreased tongue control
-Delayed swallow reflex
-Tucks airway beneath tongue base
Chin down posture helps with those with decreased tongue control- helps to keep bolus in mouth untill ready to swallow
Delayed swallow- keeps bolus in mouth longer and increases the vellecular space so that the food pools better, and protects airway. So also good for those with reduced laryngeal momement.
Chin down is a bit over-used. - for some, it does not increase the vellecular space ,this needs to be assessed during a MBS. |
|
|
Term
|
Definition
Head rotation to the weak side
-Directs food toward strong side
-Increases v.f. closure
-Reduces resting tone in the CP muscle
-good for hemiparesis |
|
|
Term
|
Definition
Propels bolus back so only for someone with bad a-p movement
must have reasonably intact pharyngeal phase |
|
|
Term
|
Definition
Tongue hemiparesis
Tilt toward strong side |
|
|
Term
|
Definition
Sour- increase in sensory imput may help initiate the swallow and increase tongue base swallow.
-Only for those who can manage thick liquids.
(Deep Pharyngeal neural stim- frozen, sour swabs. Pressure, temp and sour stimulation to what ever CN you are trying to stim) also to help improve the timing of initiation of swallow. |
|
|
Term
|
Definition
| usually food is mid-tongue, but if there is tongue hemi- pt could put food on side that is strongest |
|
|
Term
|
Definition
Decreases food in lateral sulcus
Pushes food toward tongue
Tactile cue |
|
|
Term
|
Definition
| for those with poor closure |
|
|
Term
|
Definition
Smaller bites
Spoon only
Alternate consistencies
Clear residue in oral cavity
Avoid foods of mixed consistencies
Multiple swallows
Gravy/butter to increase cohesiveness |
|
|
Term
|
Definition
1. Take a breath
2. Hold breath
3. Take a bite
4. Swallow while holding breath
5. Cough after swallow is completed
6. Reswallow
Better for cancer patients because this is a lot of directions. |
|
|
Term
|
Definition
Swallow and hold larynx up at it’s highest point before letting go
This is really hard! But effective |
|
|
Term
| Thin Liquids indicated for |
|
Definition
Indicated for:
Reduced pharyngeal wall contraction and reduced cp opening |
|
|
Term
| Thin Liquid contraindicated for: |
|
Definition
| Poor back of tongue control, delayed swallow trigger |
|
|
Term
| Honey, Nectar/pudding consistencies are indicated for: |
|
Definition
| Indicated for: difficulty with bolus control, delayed swallow trigger |
|
|
Term
| Oral Pharyngeal Excercises |
|
Definition
To improve function : so a combination of compensatory and facitative.
There is some literature that excercises help the swallow. (swallowing is good work for swallowing) |
|
|
Term
|
Definition
Back of tongue
Tongue towards back of throat
Forceful /k/ or /g/
) Bolus Propulsion A.-P. mvnt.
Tongue along alveolar ridge
Tongue protrude-retract
Tongue lateralization
Encircle lips (for coordiation)
d) Bolus Maintenance (holding bolus)
Press tongue to alveolar ridge and maintain
Try to touch chin and nose with tongue
Practice /s/ sound
b) Bolus Manipulation
Tongue depressor exercises
Tongue click
Chew gauze
Dental floss tied to life saver |
|
|
Term
Laryngeal adduction/elevation
excercises |
|
Definition
Pushing, pulling, glottal attack
Hand on forehead (isometric)
Straw sucking exercises
Breath Hold (Valsalva)
Falsetto/pitch exercises
Supraglottic
Effortful swallow
Mendelsohn
Head lift/Shaker Maneuver |
|
|
Term
|
Definition
facilitation technique -
Intervention without the presence of food or liquid, used with patients who are NPO |
|
|
Term
|
Definition
facilitation technique -
heightens oral awareness and provides an alerting stimulus to the brain
Delay of >2 sec.
Dip laryngeal mirror in ice water
Rub each faucial arch X 5
Instruct patient to swallow |
|
|
Term
| Facilitative techniques for NPO patients |
|
Definition
Exercise/Sensory Stimulation Programs:
Oral sensitivity training |
|
|
Term
Facilitative
Maintenance programs |
|
Definition
| Assess swallow; make recs |
|
|
Term
|
Definition
Refer to G.I. Doctor
Recommendations:
Elevate head of bed
Upright after meal
Smaller meals
Avoid certain foods
Avoid late night snacks
Sleep with head elevated |
|
|
Term
|
Definition
Postural
sensory input
Food presentation |
|
|
