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Dysphagia

Components of bedside swallow exam

QuestionAnswer
Components of bedside swallow exam 1. Alertness of patient 2. Intact sensory and motor components of swallowing 3. Assess pt's ability to manage own secretions 4. Assess swallowing with trial bolus
Head Tilit To better, or unaffected side in order to push the food to that side for chewing/swallowing.
Head Turn To weaker or affected side in order to close off that side of the throat.
Direct Modification to boluses, Postural interventions (chin tuck, head tilt, head turn), and swallowing adaptations: Supraglottic Swallow (to close airway) and Mendlesohn's Maneuver (prolonging rise of larynx -increased time to form swallow)
Indirect Do not include use of Bolus: Cold stimulation to faucial arches (chilled dental exam mirror), reflex facilitation, strengthening/coordination movements (exercises) and positioning.
Decrease Tonic bite reflex Firm pressure in the middle of the tongue with back of spoon.
Gag reflex Press back of spoon down firmly in middle of tongue - movements should be DISTAL (tip) to PROXIMAL (back of tongue)
Created by: hesselrach