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Care of the Hospitalized Child
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Anushree Algotar, Anna Tuttle, Mark R. Corkins
Oral feeding is always preferred and recommended if the swallowing mechanism and the gastrointestinal tract are intact. Certain circumstances may limit oral nutrition intake. Oropharyngeal dysphagia with concerns for aspiration, neurological abnormalities affecting deglutition, and gastrointestinal dysmotility may make oral feedings unsafe.
Oropharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The chief action in which the muscles of the pharynx combine is deglutition (swallowing); this is also discussed in detail in Chapter 10. Briefly, deglutition is a complicated, neuromuscular act whereby food is transferred from the oral cavity through the pharynx and into the oesophagus. The pharyngeal stage is the most rapid but also the most complex phase of deglutition. In the oropharyngeal phase of swallowing, the food bolus enters the base of the tongue triggering the phase.
Brainstem Organization of Swallowing and Its Interaction With Respiration
Published in Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop, Neural Control of the Respiratory Muscles, 2019
André Jean, Alexandre Car, Jean-Pierre Kessler
The oropharynx subserves a common pathway for deglutition and respiration, and obviously these two functions must interact to prevent pulmonary aspiration. These interactions, which have been described in experimental reports before the beginning of the century,47 are considered, with accuracy, to consist of an inhibition of respiration by swallowing.
Voice evaluation – contribution of the speech-language pathologist voice specialist – SLP-V: part B. Acoustic analysis, physical examination and correlation of all steps with the medical diagnoses
Published in Hearing, Balance and Communication, 2021
Mara Behlau, Glaucya Madazio, Thays Vaiano, Claudia Pacheco, Flávia Badaró
VLP is relevant to voice function [25]. The resting level of the larynx is evaluated after a deglutition, and it is most often directly related to the activity of the thyrohyoid and sternothyroid muscles. The clinician visually and manually checks laryngeal displacement during tasks of high frequencies (upper movement) and low frequencies (lower positioning) [25]. Vertical freedom is important, and the tendency of high or low positioning is directly related to the patient’s voice quality. Individuals with classical training learn to maintain a lower larynx during singing, which is not observed in popular singing or untrained singers [25]; however, the larynx is not fixed when singing, and there might be a healthy displacement throughout the music. A higher hyoid bone and larynx is typical in muscle tension dysphonia patients [26] and can be triggered by asking individuals to count numbers in a low and loud voice. Moreover, high lung volume is associated with a lower larynx position and is stronger in males than in females, which indicates that the lung volume is a factor that is highly relevant to larynx height, at least in untrained subjects [25].
Predictive value of laryngeal adductor reflex testing in patients with dysphagia due to a cerebral vascular accident
Published in International Journal of Speech-Language Pathology, 2019
Megan E. Cuellar, Jennine Harvey
The academic and clinical study of deglutition, or swallowing, is an important focus of medical speech pathology. Dysphagia can occur at any age, and typically results from oropharyngeal structure anomalies or neuromuscular diseases. Cerebrovascular accident (CVA), traumatic brain injury (TBI), Parkinson’s disease (PD), dementia, amyotrophic lateral sclerosis (ALS), progressive supranuclear palsy (PSP), Huntington disease (HD) and myasthenia gravis (MG) are just a few examples of the many neurological pathologies and disease processes that lead to dysphagia (National Institute of Neurological Disorders and Stroke, 2015). Dysphagia is most frequent among older adults with a neurological disorder. According to a recent report by the National Institute on Aging, nearly 17% of the world’s population will be aged 65 and older by 2050 (National Institute of Aging, 2016). As the incidence and prevalence of dysphagia increases, so does the need for research regarding efficacious dysphagia evaluation and treatment methodologies.
High elevation training mask as a respiratory muscle strength training tool for dysphagia
Published in Acta Oto-Laryngologica, 2019
Shih Chieh Shen, Yuval Nachalon, Derrick R Randall, Nogah Nativ-Zeltzer, Peter C. Belafsky
Deglutition is divided into four phases: oral preparatory, oral transfer, pharyngeal and esophageal. Each of these stages depends on the coordinated involvement of multiple cranial and somatic nerves, exerting their effects on numerous end target muscles to successfully navigate food from the oral cavity to the stomach without inadvertent aspiration. Impairments of any phase may result in dysphagia, which can cause dehydration, malnutrition, prolonged meal times, social isolation, aspiration, pneumonia and death. Pharyngeal phase impairment is one of the most common causes of dysphagia among patients with stroke, head and neck cancer and neurologic disorders. Swallowing rehabilitation techniques to address pharyngeal phase impairments include alteration of food viscosity or bolus size, swallowing exercise, swallowing manoeuvres and nerve stimulation. Respiratory muscle strength training (RMST) is a relatively new form of swallowing rehabilitation that has been proposed to have cross-system benefits on swallowing function and airway protection [1–7].