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HLTEN504A - INCP Swallowing Difficulties. Dysphagia Is a problem or difficulty with swallowing.

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Presentation on theme: "HLTEN504A - INCP Swallowing Difficulties. Dysphagia Is a problem or difficulty with swallowing."— Presentation transcript:

1 HLTEN504A - INCP Swallowing Difficulties

2 Dysphagia Is a problem or difficulty with swallowing

3 Swallowing During the oral phase, the lips, teeth, tongue, and jaw muscles mix the food with saliva to create the proper consistency for ingestion. Once the bolus is formed in the oral cavity it is propelled into the oropharynx by the tongue; this completes the oral phase of swallowing.

4 Swallowing During the oral phase, the lips, teeth, tongue, and jaw muscles mix the food with saliva to create the proper consistency for ingestion. Once the bolus is formed in the oral cavity it is propelled into the oropharynx by the tongue; this completes the oral phase of swallowing.

5 Swallowing Once the bolus reaches the tonsils, it triggers the pharyngeal phase of the swallowing reflex. This phase of the swallow mechanism is completely automatic. –The palate closes against the back wall of the throat separating the oral cavity from the nasal cavity. –The epiglottis tilts posteriorly, covering and protecting the vocal cords. –The upper esophageal sphincter relaxes.

6 Swallowing The final phase of the swallow is the oesophageal phase. Once the food bolus enters the esophagus, it is actively transported down to the stomach. Swallowing is complete when the bolus passes the lower esophageal sphincter and into the stomach

7 Causes of dysphagia These may develop suddenly or develop slowly over an extended period of time Severe pain Trauma/accident Surgery Radiation Obstruction Structural defects Radiation

8 Causes of dysphagia (cont) Abnormal peristalsis Neuromuscular Degenerative diseases Metabolic/toxic Impaired gag reflex Neurological Degenerative diseases Unconscious states Metabolic/toxic Excessive, scant, or thick oral secretions

9 Some conditions that cause dysphagia Stroke Closed head injury Parkinson’s disease Motor neuron disease Huntington’s disease

10 Clinical manifestations of impaired swallowing Patient reports difficulty Coughing with food or liquid intake Longer time taken with meals than other people Drooling, constantly open mouth, constantly mopping mouth "Gurgly" voice Food remaining in mouth after meals Choking or asphyxiation with oral intake

11 Clinical manifestations of impaired swallowing Diminished or absent cough Diminished or absent gag reflex Weight loss Pneumonia X-Ray evidence of aspiration Fluctuating levels of consciousness Tracheostomy Naso-gastric feeding tube

12 To prevent aspiration/choking Sit person upright to assist gravity. Sometimes the person needs to sit out of bed for all meals. Maintain slight neck flexion Ensure that patient is awake and alert Modifications to the consistency of the food and fluid may be required: Soft/pureed diet, thickened fluids (nectar or honey consistency) Initiation of the swallowing reflex may be required – press on the tongue

13 To prevent aspiration /choking Offer food and fluid at a rate that the person can cope with – prevents aspiration One mouthful at a time Effective swallow before next mouthful Examine mouth at end of meal Unhurried mealtime If facial paralysis is present offer the food to the non-affected side. Check that they have swallowed each mouthful offered. Ensure that there is no food left in the mouth before you leave the person unattended. Maintain upright position 1/2 hour post meal


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