Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Assessment head/neck
Assessment strategies in head/neck cancer
| Term | Definition |
|---|---|
| What is the role of SLP on cancer team? | Education and counseling |
| When does SLP intervention occur? | Pre-operatively and post operatively |
| Dysphagia assessment must be__________ | multifactorial |
| Impact Factors of treatment | Pain Dryness Taste/smell Fibrosis nutritional status psychological issues |
| Understand the _______ of treatment | Burden |
| Impact factors are ________ | things that directly/indirectly negatively impact swallow function |
| Why could there be aspiration issues? | Larynx helps with aspiration. When there is a glottal gap, aspiration is more likely. |
| How can you diagnose aspiration? | By seeing it |
| Supports the need for imaging studies | Larynx doesn't elevate on swallow Secretions after swallow Poor voice quality after swallow Spontaneous coughing Swallow efficiency is off |
| Swallowing breath pattern | Inhale- exhale- swallow- exhale- inhale |
| MNA | Standard nutritional assessment |
| More likely to aspiration | Sedentary, Snuffing (disfigurement), |
| Assess patient reported outcomes for third party | PROM |
| How to get mandible to open when there is stenosis? | Stretcher |
| When is trismiss? | Less than 35mm, should open by 55mm |
| When should assessment begin? | At tumor diagnosis |
| What to do when late onset of treatment? | Work with what is left, function is key |
| Where are the deficits? | CNx and XII (vagus and hypoglossal) from radiation leaking to body |
| Prevention includes | Smoking and tobacco ending |
| Surgical treatment approaches | Airway protection PES Opening (myotomy- cut the muscle) Scar management- via surgery only |
| Pharyngeocise | exersize during and post treatment Holding breath Inhibited by patient fear |
| Obturator | Plugs hole in hard palate, fake upper denture |
| Maxillary reshaping prosthodontist | Fake hard palate, benefits sound, not documented for swallowing |
| Compensatory strategies | What we do while we wait for improvement (not rehab) Adaptive feeding |
| Goals of post acute treatment | Increase/reinitiate safe oral feeding Removal of feeding tubes |
| Why use feeding tube? | Increase nutritional support Short term Certain body weight tigers= |
| Osteonecrosis treatment | Hyperbaric oxygen therapy Adequate nutrition Surgery |
| Fibrosis treatment | Mandibular stretching PT ROM stretching Muscle relaxants Pain management |
| Taste = | Tounge |
| Flavor = | Nose |
| Treatment of infections | Topical antifungals Systemic antifungals Antibiotics |
| Treatment for loss of taste | Zinc sulfate supplements if levels low Alter feeding regimes to stimulate different taste groups Enhance flavors, not practical |
| What should you do prior to treatment? | Irrigation to remove buildup of thick mucous |
| Treatment for xerostomia | Exersize Ice chips Artificial saliva chewing gum (baking soda) |
| Treatment for mucosal changes | Saliva supplements/water Analgsics (block pain) Cold ice chips (analgesics- blocks pain) Mouth wash (biotin, baking soda) Gels medications |
| Treatment for muscle changes | Cold (ice chips) Stretching Exercises |
| Three things to assess in head/neck cancer | Cognition Mouth status Ability |
| When should swallow function be assessed for cancer patient going through radiation? | Prior During Following Later |
| Why should head and neck patients continued to be monitored for dysphagia well after end of radiation? | Still cooking, further impacts from radiation can occur |
| When should swallow function be assessed for head and neck cancer patients going through surgery? | Pre-surgery Post-surgery (earlier the better to make a plan for safe swallow) |
| How does xerostomia affect swallow? | Ability for mastication of more solid foods impairs normal sensory function in oral cavity |
| What differentiates between muscle weakness and fibrosis? | Fibrosis limits BOTH active and PASSIVE movements |
| Areas to assess in head and neck cancer | Follow directions mouth/dentition Oral motor Condition of neck muscles Voice Taste/smell Diet Weight Swallow quality of life |
| Efficiency in swallow | Swallows per bolus |
| Nutritional measurements | BMI MNA 3 day diet record |
| 3 complications of radiation | Stricture Edema Pain |
| 3 Primary rendition issues following cancer treatment | 1) loss taste/smell 2) dysphagia 3) nutritional |
| During acute treatment | Address cancer side effects Keep eating for as long as can Pharyngocise Temporary alternative food source if needed |
| During post cancer treatment | Reinitiate oral feeding Expanding oral feeding |
| When latent effects emerge______ | A new problem begins or existing symptoms are increasing |
| How do you treat latent effects of cancer treatment? | Treat underlying problem and mitigate symptoms if possible |
| When is surgery utilized to mitigate impact factors? | For airway protection For PES opening For scar management |
| What causes airway protection deficits? | Compromise laryngeal valve Uncoordinated swallow Obstruction leading to residue in pharynx |
Created by:
morganmc3
Popular Speech Therapy sets