By Michael E. Groher PhD, Michael A. Crary PhD F-ASHA
Get all of the info you want to hopefully deal with dysphagia in specialist perform with Dysphagia: scientific administration in Adults and kids, 2d Edition! This logically prepared, evidence-based source displays the newest developments in dysphagia in an approachable and elementary demeanour that can assist you grasp the scientific overview and diagnostic decision-making procedures. New assurance of the newest insights and study in addition to increased info on youngster and baby swallowing can help organize you for the stipulations you’ll face within the medical surroundings. Plus, the real looking case eventualities and particular assessment questions threaded through the e-book can assist you strengthen the medical reasoning talents wanted for pro good fortune.
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Extra info for Dysphagia: Clinical Management in Adults and Children, 2e
Liquid boluses, depending on viscosity, often precede this wave of contractions. 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.
The primary sensory receptors on the dorsum of the tongue responsible for the perception of salt, sweet, sour, and bitter are activated by saliva. In addition to facilitating taste and bolus formation, saliva is important in the maintenance of adequate oral hygiene by controlling microorganisms, in the regulation of the acidity levels in the stomach and esophagus because of its bicarbonate composition, and in the breakdown of carbohydrates. 6 Sensations of taste are carried by the chorda tympani branch of CN VII on the anterior two thirds of the tongue and through the greater petrosal branch on the hard and soft palate.
This resulted in reduced opening of the PES, thus making it difficult for pudding to enter the esophagus, which caused the feeling that food was sticking in his throat. Liquids were aspirated because the vocal folds could not close fast enough because of the involvement of the recurrent branch of CN X that may have been damaged during the heart surgery, combined with the failure of the larynx to forcefully elevate and tilt forward because the tongue was weak. The pharyngeal branch of CNs IX and X was unaffected as evidenced by an intact gag reflex.
Dysphagia: Clinical Management in Adults and Children, 2e by Michael E. Groher PhD, Michael A. Crary PhD F-ASHA