Dysphagia 3
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| What does the evaluation for dysphagia include? | Hx, chart review, hx of pneumonia, fevers/respiratory infections, psychosocial factors, nutritional status (oral, NG tube, G tube, TPN/IV drip, know %), respiratory status (independent, ventilator, tracheostomy), suctioning needs, mental status, general physical status | |
| What should the therapist evaluate for mental status? | Level of alertness, ability to follow instructions, cognitive level, impulsivity, judgment and safety | |
| What should the therapist evaluate for general physical status? | Gross asymmetries in positioning, drooling, motor control, head/neck control (ROM, muscle tone), trunk control, endurance, supported vs. unsupported sitting, effects of positioning on swallowing | |
| What should the outer oral evaluation include? | facial muscles, lips, jaw, sensation (hot/cold, light touch), ROM of facial musculature, lips, jaw control, tone, motor coordination | |
| *What should the inner oral status evaluation include? | Oral structures and dentition, tongue musculature (ROM , strength), sensation, reflexes | |
| *What should the evaluation on reflexes include? | Cough (voluntary or reflexive), gag, palatal (closes nasal passage, trigger swallow response), swallow (1-3 sec), primitive reflexes (rooting, biting, suck, prevent isolated motor control), tongue thrust (interferes with mouth closure) | |
| What should a swallowing trial include? | Sample of pureed, soft, & ground food, thick, semi-thick, and thin liquid | |
| Give examples of pureed food. | Pudding, applesauce | |
| Give examples of soft food. | Bananas, macaroni and cheese | |
| Give examples of ground food. | Ground meat, tuna with mayo |
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