Dysphagia 5

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What is pureed food used for? decreased motor control, chewing difficulties, apraxia  
What is soft food used for? Poor oral motor control, easily formed bolus, cohesive  
What is ground food used for? Assess ability to chew, to form cohesive bolus, move food in mouth  
What is thick liquid used for? Move slowly from front to back, delay swallow to control liquid until swallow responses are triggered  
What are some issues associated with thin liquid? Most difficult to control, requires normal swallow  
How does the therapist palpate swallow? Index finger at hyoid notch, middle at top of larynx, ring along mid larynx, evaluate strength and smoothness of swallow and oral transit time (1 sec)  
What should the therapist do after the patient swallows? Sweep to check for remaining food, patient says "Ah" to listen for voice quality (strong, clear, gurgly), if gurgly - delayed swallow response, collection in larynx, patient should take a second dry swallow, then check again  
What are the indicators of swallowing dysfunction? Coughing or throat clearing before, during, or after a swallow, gurgly voice quality, changes in breathing pattern, delayed or absent swallow response, poor cough, reflux of food after meals, aspiration pneumonia  
What are the types of aspiration? Before, during, or after swallow  
What might cause aspiration before swallow. Reduced oral control, absent swallow response  

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