By Michael E. Groher PhD, Michael A. Crary PhD F-ASHA
Get the entire info you must with a bit of luck deal with dysphagia in specialist perform with Dysphagia: medical administration in Adults and youngsters, 2d Edition! This logically geared up, evidence-based source displays the newest developments in dysphagia in an approachable and undemanding demeanour that can assist you grasp the medical overview and diagnostic decision-making tactics. New assurance of the most recent insights and study in addition to elevated info on baby and baby swallowing may help arrange you for the stipulations you’ll face within the medical atmosphere. Plus, the lifelike case eventualities and particular evaluate questions threaded during the booklet may help you advance the scientific reasoning abilities wanted for pro luck.
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Extra resources for Dysphagia: Clinical Management in Adults and Children, 2e
Do the same thing with the nose open and then pinch the nostrils closed and swallow. Oral Preparation Food or liquid in the mouth stimulates taste, temperature, and pressure (touch) receptors. The primary receptors of taste are located on the tongue, on the hard and soft palate, in the pharynx, and in the supralaryngeal region. The receptors are activated by saliva. Saliva is produced by the activation of the submandibular, submaxillary (autonomic aspects of CN VII), and parotid glands (autonomic aspects of CN IX).
Critical Thinking 1. Did the patient’s physician believe the swallowing problem represented new disease or normal aging? 2. Speculate on why the patient did not have a swallowing problem 1 year ago. as well as delay in esophageal emptying and an increase in nonperistaltic contractions resulting in increased esophageal dilation and stasis79 (review Clinical Corner 2-3). TABLE 2-5 Afferent Controls Involved in Swallowing Sensory Function Innervation (Cranial Nerve) General sensation, anterior two thirds of the tongue Taste, anterior two thirds of the tongue Taste and general sensation, posterior third of the tongue Mucosa of valleculae Lingual nerve, trigeminal (V) Primary afferent Secondary afferent Tonsils, pharynx, soft palate Pharynx, larynx, viscera Chorda tympani, facial (VII) Glossopharyngeal (IX) Internal branch of superior laryngeal nerve (vagus; X) — Glossopharyngeal (IX) Pharyngeal branch of vagus (X) Glossopharyngeal (IX) Vagus (X) TABLE 2-6 Efferent Controls Involved in Swallowing NEUROLOGIC CONTROLS OF SWALLOWING Neuroregulation of swallowing involves the activation of multiple levels of afferent and efferent pathways at different levels of the nervous system, including the cranial nerves, brainstem, cerebellum, subcortex, limbic cortex, and neocortex.
The cervical portion of the esophagus works in conjunction with the hypopharynx, allowing the PES to fully relax and distend to accommodate bolus size. As the bolus enters the esophagus, a primary contraction wave (primary peristalsis) is triggered in the proximal, striated portion by vagal (CN X) efferent activity. 29 Typically, the contraction force in the cervical esophagus is the strongest and is accompanied in time by a drop in pressure (relaxation) in the LES to allow the bolus to enter the stomach.